What Is a Productive Cough?

A cough can be wet or dry. A dry cough is nonproductive and does not bring up fluid like mucus or phlegm. A wet, productive cough does bring up fluid.

This article will go over the common causes of a wet or dry cough, what it means for a cough to be productive or nonproductive, and the best treatments for each type of cough.

What Is a Productive Cough?

A productive cough brings up mucus or another fluid from the respiratory tract. It is also called a “chesty” or “wet” cough because you can hear a gurgling sound when you’re coughing.

A wet productive cough usually happens because something is irritating your respiratory tract, like an infection. Most wet coughs that are caused by cold or flu will go away after a few days. 

Possible causes of a wet cough include:

• Pneumonia
• Acute bronchitis
• Bronchiectasis
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• GERD (if there is severe inflammatory damage to the esophagus)

Your provider can do tests to figure out why you have a wet cough, including:

• Chest X-ray
• Sputum analysis (coughed-up mucus or phlegm is checked for infection or blood in a lab)
• Blood tests (to look for signs of infection)
• Pulmonary function tests (including spirometry and blood gases)

What Is a Nonproductive Cough?

A nonproductive cough does not bring up fluid. It’s also called a dry cough and is usually caused by irritation in the throat. Many people describe the feeling of a dry cough as a "tickling" or "scratchy" sensation.

While a cold is a common cause of a dry cough, a nonproductive cough can also be caused by swelling of the airways from conditions like asthma or bronchitis. 

A dry cough can also be caused by:

• Allergies
• Influenza (the flu)
• COVID-19
• Upper respiratory infections

If you have a dry cough, your provider may do tests to see if you have any of the following health conditions:

• Asthma: You can find out if you have asthma by doing a test called spirometry. You breathe into a device that measures the force of your breath and the capacity of your lungs.
• Gastroesophageal reflux disease (GERD): While GERD is associated with heartburn, 40% of people with the condition have a dry cough. GERD can be diagnosed with a procedure where a flexible scope is put down your esophagus to look in your stomach (endoscopy) and a pH acid test.
• Sleep apnea: About 44% of people with sleep apnea have a cough. The sleep disorder can be diagnosed with an in-lab sleep study or a home test that measures blood gases, heart rate, and airflow/breathing patterns.
• Vocal cord dysfunction: Breathing in an irritant or extreme exercise can cause narrowing of your vocal cords in the voice box (larynx). You might need to see an allergist to rule out allergic causes for your cough or have stress tests and imaging studies done to check for breathing abnormalities while you exercise.

Serious Causes of a Dry Cough

It’s less common but a dry cough that does not go away can also be a sign of more serious conditions like heart failure, a collapsed lung, or lung cancer.

Your provider may want you to have imaging tests, such as chest X-ray, computed tomography (CT), or magnetic resonance imaging (MRI) to rule out these more serious causes of a dry cough.

How to Treat Dry and Wet Coughs

The best treatment for a cough will depend on whether it's productive or nonproductive, as well as what is causing it.

For example, if you have a cold that's giving you a dry cough, taking a cough suppressant with dextromethorphan in it might help your symptoms.

Other treatments for a dry cough include:

• Inhaled bronchodilators (for asthma)
• Antacids and proton-pump inhibitors (for GERD) 
• Antihistamines (for allergies)
• Continuous positive airway pressure (CPAP) (breathing machines for sleep apnea)
• Humidifiers or breathing in steam

If you have a wet productive cough from a cold, taking over-the-counter (OTC) medications like an expectorant can help. This type of medication can loosen and thin the mucus so that it's easier to cough up. 

Chronic productive coughs may need more aggressive treatment, depending on what’s causing the cough.

For example, infections may require antibiotic therapy, while chronic disorders like COPD and cystic fibrosis may require ongoing care with oxygen therapy, inhaled or oral medications, and pulmonary rehabilitation.

When to Call a Healthcare Provider

A cough from a cold typically lasts a week or two and can be treated at home. However, you should call your healthcare provider if:

• Your cough is severe
• Your cough lasts longer than three weeks
• You cough up yellowish-green, pink, or pink/red colored sputum
• You have a fever of over 103 degrees F
• You experience shortness of breath or a fast heartbeat
• You had close contact with someone with COVID or pneumonia before your cough started
  

Summary

A cough can be productive (wet) or nonproductive (dry). Wet and dry coughs can have different causes and need different treatments.

You can usually handle a cough from a cold at home, but you may need to see your provider and get treatment for coughs related to a chronic health condition or an infection.

However, if you are coughing so hard you're struggling to breathe or you're coughing up blood, don't wait. These symptoms can be signs of a serious lung problem that needs immediate medical care.