Cough

A cough is a spontaneous reflex that helps clear dust, germs, and mucus out of the throat and airways. Coughing keeps the body safe from invaders, and most coughs are not serious.

Colds, sinus congestion or infection, and allergies can cause a cough, as can the flu. In some cases, a cough can be a symptom of a more serious condition like pneumonia or gastroesophageal reflux disease (GERD). Some medicines—including those that treat kidney or heart disease or high blood pressure—lung disease, smoking, and allergies can also cause a cough.

This article covers the symptoms, types, causes, diagnosis, and treatment of a cough, and when to get help for a cough.

Symptoms of a Cough

Coughing is frequently associated with various types of respiratory infections or conditions. Some common symptoms that may accompany cough include:

• Congestion: You may have mucus clogging your nasal passages and sinuses or in your lung airways.
• Fever: Coughing due to an infection may be accompanied by a fever.
• Wheezing: A whistling sound when breathing may be noted with asthma, respiratory infections, or allergic reactions.
• Runny nose
• Headache
• Fatigue
  

Causes of a Cough

A cough can be categorized as acute (short-term) or chronic (long-term).

The most common causes of acute cough are:

• Upper respiratory infection (URI) such as a cold or the flu, or acute bronchitis (also known as a chest cold)
• Allergy or hay fever
• A flareup of asthma or chronic obstructive pulmonary disease (COPD), a lung disease that makes breathing difficult
• Dust or smoke

Some causes of chronic cough include:

• Chronic bronchitis
• Asthma
• Allergies
• Smoking
• Chronic obstructive pulmonary disease (COPD)
• Postnasal drip (when mucus from the nose reaches the back of the throat)
• Medications, including some that treat heart disease and high blood pressure
• Tuberculosis

What Medications Can Cause a Cough?

Medications known for causing a cough include:

• ACE inhibitors: ACE (angiotensin-converting enzyme) inhibitors are medicines that lower blood pressure. They are also prescribed for heart disease, kidney disease, and diabetes. People on ACE inhibitors could experience dry cough as a side effect.
• Opioids: Opioids are pain relievers prescribed for surgery, major injury, or chronic pain. About 30% to 66% of people who take prescription opioids could experience chronic cough.
• Statins: Statins lower cholesterol, and coughing is a well-known side effect.

There are rare reports of coughing as a side effect of:

• Omeprazole, a medication for acid reflux disease
• Arava (leflunomide), an arthritis treatment
• Interferon (IFN) and ribavirin (under brand names Rebetol and Virazole), which are medications for Hepatitis C
• Januvia (sitagliptin), a type 2 diabetes treatment

How to Treat a Cough

Short-term coughs usually go away on their own, but there are ways to manage them. To treat a cough, it might help to do the following:

• Drink plenty of fluids
• Rest
• Add lemon and honey to a warm beverage
• Avoid carbonated drinks
• Ingest a mixture of lemon and honey
• Sit in a steamy bathroom or run a humidifier (for dry cough)
• Take over-the-counter painkillers like Advil and Motrin (ibuprofen)
• Take over-the-counter cough medicines or cough drops
• Avoid allergens and smoke
• Stop smoking

Chronic, long-term coughs require medical attention, and treatments might include:

• A bronchodilator or steroid inhaler for asthma
• Antihistamines for allergies
• Antibiotics if the cough is a result of a bacterial infection like pneumonia
• Antacids or proton pump inhibitors (PPI) for GERD
• Bronchodilators for COPD

Complications and Risk Factors Associated With a Cough

In some cases, a cough could mean a life-threatening condition, such as:

• Pulmonary embolism: When a blood clot travels to the lungs. Symptoms include a dry cough with shortness of breath.
• Collapsed lung: When the lung is deflated. Symptoms include chest pain, shortness of breath, and dry cough.
• Heart failure: Symptoms of heart failure can include swelling in the legs (edema), shortness of breath, and cough.
  

Are There Tests to Diagnose the Cause of a Cough?

To determine the cause of a cough, a healthcare provider might ask about other symptoms like:

• Fever
• Chest pain
• Shortness of breath
• Coughing up blood
• Headaches
• Drowsiness
• Confusion

A medical professional might also ask questions about the cough's history and the patient's medical history. This might include inquiring about:

• Mucus color
• Allergies
• Medical conditions
• Medications
• Smoking

One or more of the following medical tests could pinpoint the reason behind a cough:

• Blood tests to diagnose infections like pneumonia
• Mucus (sputum) tests for a bacterial infection or lung cancer
• Chest X-ray
• CT scan, which can capture images of the heart, lungs, and other organs
• Spirometry, which measures lung function
• Methacholine challenge tests, which measure lung reactions and help with diagnosing asthma

When to See a Healthcare Provider

When a cough lasts longer than three weeks or is accompanied by the following symptoms, it is advised to see a healthcare provider as soon as possible:

• Shortness of breath
• Coughing up blood
• Spasms
• Turning blue
• For children, a fever for longer than two days
• Lumps in the throat

Summary

A cough is a spontaneous reflex that keeps the body safe from dust, bacteria, and other pathogens. The most common reasons behind an acute cough include the common cold, flu, allergies, dust or smoke, or a flare-up of a chronic condition like asthma. Medications that can cause a cough include ACE inhibitors, which reduce blood pressure and are prescribed for heart and kidney disease.

See a healthcare provider immediately if you're experiencing shortness of breath, a bloody cough, spasms, lumps in the throat, or turning blue with a cough.