Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015

Every single minute of every single day, you breathe in through your nose or mouth, bringing air into your trachea, bronchial tubes, and lungs. This passageway has to be clear for optimal inhalation and exhalation. When it is not, the result can be an irritating cough.


Definition & Facts

A cough is the body’s response to irritants in the airway, such as dust, smoke, or mucus. Coughing keeps the airway clear to help prevent infection. When the airways are irritated, the body works together to send air to the lungs to try to expel it. In fact, a vigorous cough through the nearly closed vocal cords can reach close to 500 miles per hour.

While the occasional cough is normal, keeping the airways clear, a cough that lasts more than a few days is not. There are three main types of coughs, and the diagnosis depends on the duration. The acute cough lasts less than 3 weeks, the sub acute cough lasts 3-8 weeks, and the chronic cough lasts longer than 8 weeks.


There are many causes of a cough. Since a cough is only a symptom of a larger problem, there are many potential culprits. Causes of airway irritation vary as well, depending on whether the cough is chronic or acute.

Chronic coughs can be caused by a number of issues. Asthma and chronic bronchitis cause a cough as the airways become inflamed and narrowed. Allergens can also be a source as post nasal drip from allergies can irritate the throat. And, the acid from gastroesophageal reflux (GERD) can cause airway irritation and thus, cough.

Common causes of acute coughs are the common cold, the flu, or pneumonia. Inhaling any sort of irritant can also cause an acute cough. And finally, whooping cough can be an issue if one does not get vaccinated.

There are other, less common causes of a cough. Some specific infections such as sinusitis and bronchiolitis are often accompanied by a cough. Other times, it can be caused by a disease such as cystic fibrosis, tuberculosis, emphysema, Parkinson's disease, heart failure, or lung cancer. Certain medications and choking are also potential cough stimulators. And, in very young children, croup and RSV sometimes cause coughs.

When to see a doctor

When a cough does not go away, it is often advisable to see your doctor. There are many causes of cough and, after several weeks of suffering with a cough, a doctor can help pinpoint the cause, and possibly offer a treatment.

There are several warning signs that you should get in to see a doctor. If the cough does not go away after three weeks, for example, it is probably a good idea to visit the doctor. Additionally, if the mucus you are coughing up is green, or very thick, or if you are wheezing, short of breath, or have a fever over 100F (37,8 °C), a doctor can help you to treat your symptoms, and alert you of any possible complications.

Some emergency situations can include choking, shortness of breath, or coughing up blood. In the case of these severe symptoms, you will want to see a doctor immediately, even if you must visit the emergency room. These are signs of serious complications.

Treatment & Therapy

Coughing is not its own disease and thus cannot be treated on its own. The best way to treat a cough, is to treat the underlying problem, if it is known. For example, when a person has a cough associated with an asthma attack, this can be treated with bronchodilators, which open and relax the bronchial tubes, that get constricted with asthma.

Similarly, if a cough is caused by an infection, such as bronchitis or sinusitis, these can be treated with antibiotics, which in turn will help the cough go away. Treating an ailment such as GERD is also important in reducing coughing. GERD is generally treated with medications that reduce the acid in the stomach, which in turn reduces the acids that can back up into the throat. Without the acid in the throat, coughing should significantly decrease.

Sometimes, if a cough is particularly bothersome, but not attributed to anything else treatable, prescription cough medicines will be prescribed by a doctor. Medicines called antitussives can help suppress a cough when nothing else will work. Other mediations called expectorants can help to loosen mucus, making it easier and more productive when you cough.

Otherwise, common sense treatments are the key. Keeping your throat moist with a cough drop or hard candy may be helpful, especially with coughs caused by postnasal drip. Similarly, keeping the air moist with a humidifier is advisable. Moist air is less irritating to the airways and thus, easier to breathe. Most importantly, is to keep your body well hydrated. Drink lots of fluids including water, soup, or juices, to help thin the mucus to make for easier coughing.

Prevention & Prophylaxis

The single most important factor in preventing coughs, especially those that stem from the common cold, is to wash your hands. You should wash your hands for at least thirty seconds with warm water and soap, being sure to wash both sides of the hands and in between fingers. Complete drying is also essential. Similarly, it is important to keep all surfaces you touch clean. Things like door knobs and light switches are likely hosts for germs.

Another way to avoid getting a cough is to keep airway irritants to a minimum. Avoiding such irritants as cigarette smoke, air pollution, paint fumes, and other strong scents is key. If you have allergies, avoiding allergens such as dust, mold, pet dander, and pollens from plants and grass can be helpful.

A healthy lifestyle does not assure that you will never get a cough but it is helpful. Take care to eat nutritious food, maintain a modest weight, and get plenty of exercise. Additionally, if you smoke, quitting will reduce the amount of coughing spells you encounter significantly. An overall healthy lifestyle will keep your immune system healthy as well, allowing your body to more easily fight off germs before they cause illness.

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