Coughs, Age 12 and Older

Overview

Coughing is the body's way of removing foreign material or mucus from the lungs and upper airway passages or of reacting to an irritated airway.

Coughs have certain traits you can learn to recognize. A cough is only a symptom, not a disease. Often, you can't tell how serious the problem is until you also look at the other symptoms.

Productive coughs

A productive cough produces phlegm or mucus (sputum). The mucus may have drained down the back of the throat from the nose or sinuses. Or it may have come up from the lungs. In most cases, you shouldn't suppress a productive cough. The cough clears mucus from the lungs. There are many causes of a productive cough, such as:

• Viral illnesses. It's normal to have a productive cough when you have a common cold. Coughing is often triggered by mucus that drains down the back of the throat.
• Infections. An infection of the lungs or upper airway passages can cause a cough. A productive cough may be a symptom of pneumonia, bronchitis, sinusitis, or tuberculosis.
• Chronic lung disease. A productive cough could be a sign that a disease such as chronic obstructive pulmonary disease (COPD) is getting worse or that you have an infection.
• Stomach acid backing up into the esophagus. This type of coughing may be a symptom of gastroesophageal reflux disease (GERD). It may awaken you from sleep.
• Nasal discharge (postnasal drip) draining down the back of the throat. This can cause a productive cough or the feeling that you constantly need to clear your throat. Experts disagree about whether a postnasal drip or the viral illness that caused it is causing the cough.
• Smoking or other tobacco use. Productive coughs in a person who smokes or uses other forms of tobacco are often a sign of lung damage or irritation of the throat or esophagus.

Nonproductive coughs

A nonproductive cough is dry. It doesn't produce sputum. A dry, hacking cough may occur toward the end of a cold or after exposure to an irritant, such as dust or smoke. There are many causes of a nonproductive cough. They include:

• Viral illnesses. After a common cold, a dry cough may last several weeks longer than other symptoms. It often gets worse at night.
• Bronchospasm. A nonproductive cough, particularly at night, may mean spasms in the bronchial tubes caused by irritation.
• Allergies. Frequent sneezing is also a common symptom of allergic rhinitis.
• Medicines called ACE inhibitors.
• Exposure to dust, fumes, and chemicals in the workplace.
• Asthma. A chronic dry cough may be a sign of mild asthma. Other symptoms may include wheezing, shortness of breath, or a feeling of tightness in the chest.
• Blockage of the airway by an inhaled object, such as food or a pill.

Antibiotic use

Many coughs are caused by a viral illness. Antibiotics aren't used to treat viral illnesses. They don't change the course of viral infections. Using an antibiotic when you don't need it exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill helpful bacteria and encourage the growth of dangerous antibiotic-resistant bacteria.

Self-Care

Coughing is your body's way of removing foreign substances and mucus from your lungs and upper airway passages. Productive coughs are often useful. Don't try to stop a productive cough. Sometimes, though, coughs are severe enough to impair breathing or prevent rest. Here are some things you can do at home to help you feel more comfortable when you have a cough.

• Prevent dehydration.

  Fluids may help thin mucus and soothe an irritated throat. Honey or lemon juice in hot water or tea may help a dry, hacking cough.

• Gargle.

  Try gargling with warm salt water to help ease a sore throat caused by coughing.

• Prop up your head with extra pillows at night.

  This can help ease a dry cough.

• Try a cough drop to soothe an irritated throat.

  Medicine-flavored cough drops are no better than candy-flavored drops or hard candy. Most cough drops have no effect on the cough-producing process.

• Try moist air.

  Try a vaporizer or humidifier to add moisture to the room. Warm or cool mist may help relieve symptoms. Follow all cleaning instructions and precautions for the machine.

• Stay away from tobacco.
  • Don't smoke or use other forms of tobacco, especially while you have a cough.
• Avoid exposure to inhaled irritants.
  • Stay away from smoke, dust, and other pollutants.
  • Wear a face mask that is the right kind for the exposure. Many kinds of face masks are available. Check with your doctor or pharmacist to find out which type of face mask will help most.
• Think about using cough medicine, which may help your cough.

  Avoid cold remedies that combine medicines to treat many symptoms. In most cases, it's better to treat each symptom separately. There are two kinds of cough medicines: expectorants and suppressants.

• Try an expectorant for a productive cough.
  • Expectorants thin mucus. They make it easier to cough up mucus when you have a productive cough.
  • Use an expectorant if you have a cough that produces thick mucus and you are having trouble coughing up the mucus.
  • Don't use just an expectorant to thin the mucus. Drink plenty of water too.
• Try a cough suppressant for a dry, hacking cough that keeps you awake.
  • Use cough suppressants such as Delsym, Mucinex DM, or Robitussin wisely. Don't suppress a productive cough too much, unless it's keeping you from getting enough rest. Coughing is useful. It brings up mucus from the lungs and helps prevent bacterial infections. People with asthma and other lung diseases need to cough.
  • If an over-the-counter medicine doesn't help, ask your doctor if there is another cough suppressant you can try.
• Be aware of cough medicine precautions.
  • Read the package carefully or ask your pharmacist or doctor to help you choose a cough medicine. These medicines can cause problems for people with other health problems, such as asthma, heart failure, high blood pressure, glaucoma, or an enlarged prostate. They may also interact with other medicines, such as sedatives and certain antidepressants.
  • Read the label so you know what ingredients you are taking. Some cough medicines contain a large percentage of alcohol. Others contain codeine. Don't give codeine to children younger than age 18. There are many choices. Ask your pharmacist to advise you.
  • Use cough medicines with caution if you are older than 60 or if you have chronic breathing problems.
  • Keep them out of the reach of children to prevent accidental use.
  • Don't take someone else's prescription cough medicine.
  • Watch how much you use. Some of these medicines can cause problems if you use too much.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse trouble breathing.
• A fever.
• Coughing up blood.
• Coughing up yellow or green mucus.
• Symptoms occur more often or are more severe.

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