Coughs
DEFINITION
Coughs are sudden and explosive movements which remove
particles and excess mucus from the airways. Coughing is a
protective response which prevents foreign material from entering
and damaging the lungs. Coughs are a common symptom of respiratory
illnesses.
particles and excess mucus from the airways. Coughing is a
protective response which prevents foreign material from entering
and damaging the lungs. Coughs are a common symptom of respiratory
illnesses.
DESCRIPTION
Coughs may be acute (lasting less than 3 weeks) or chronic
(lasting longer than 3 weeks). Coughs fall broadly into two
categories: productive (mucus producing) and non-productive
(dry).
(lasting longer than 3 weeks). Coughs fall broadly into two
categories: productive (mucus producing) and non-productive
(dry).
Dry Coughs are usually caused by a viral illness. The cough is
triggered by a tickling sensation in the throat. The upper airways
may be inflamed and a post nasal drip may be present. A viral Cough
usually resolves within 2-3 weeks.
triggered by a tickling sensation in the throat. The upper airways
may be inflamed and a post nasal drip may be present. A viral Cough
usually resolves within 2-3 weeks.
Productive Coughs usually indicate a bacterial infection, or
allergic reaction. When the airways are irritated, excess mucus is
produced to trap foreign particles. Coughing then helps the body to
remove this extra mucus from the airways. Non-infected mucus,
produced during allergic reactions, appears white or clear. Mucus
with a green or yellow colour is a sign of infection. Streaks of
blood in the mucus may be a sign of mild trauma due to violent
coughing. Heart failure may cause a cough with frothy pink mucus,
while bright red mucus is a sign of fresh bleeding in the upper
airways. If any blood appears in the mucus, your Doctor should be
consulted. Productive Coughs are also referred to as ‘chesty’
coughs, with the related symptoms of ‘chestiness’ and
‘congestion’.
allergic reaction. When the airways are irritated, excess mucus is
produced to trap foreign particles. Coughing then helps the body to
remove this extra mucus from the airways. Non-infected mucus,
produced during allergic reactions, appears white or clear. Mucus
with a green or yellow colour is a sign of infection. Streaks of
blood in the mucus may be a sign of mild trauma due to violent
coughing. Heart failure may cause a cough with frothy pink mucus,
while bright red mucus is a sign of fresh bleeding in the upper
airways. If any blood appears in the mucus, your Doctor should be
consulted. Productive Coughs are also referred to as ‘chesty’
coughs, with the related symptoms of ‘chestiness’ and
‘congestion’.
CAUSE
INFECTION
An acute cough is usually caused by a viral infection such as
the common cold and is commonly associated with a sore throat. A
dry cough can be early symptom of pneumonia along with fever,
coloured mucus and breathlessness. Tuberculosis may present as a
chesty cough and is more likely to occur in high-risk people such
as the elderly, alcoholics, those with a suppressed immune system
and immigrants from Africa, south-east Asia and Eastern Europe.
Initial symptoms of whooping cough are similar to the common cold.
The cough then develops a characteristic ‘whooping’ sound.
the common cold and is commonly associated with a sore throat. A
dry cough can be early symptom of pneumonia along with fever,
coloured mucus and breathlessness. Tuberculosis may present as a
chesty cough and is more likely to occur in high-risk people such
as the elderly, alcoholics, those with a suppressed immune system
and immigrants from Africa, south-east Asia and Eastern Europe.
Initial symptoms of whooping cough are similar to the common cold.
The cough then develops a characteristic ‘whooping’ sound.
Post-nasal Drip (PND) often develops in people as a result of
allergies or the common cold. Nasal secretions entering and
irritating the lining of the throat cause the PND cough.
allergies or the common cold. Nasal secretions entering and
irritating the lining of the throat cause the PND cough.
Asthma may present as a chronic cough with wheezing,
breathlessness or tightness of the chest.
breathlessness or tightness of the chest.
Gastric reflux occurs when acidic stomach contents move upwards
into the oesophagus. This can cause a burning sensation in the
chest and a chronic cough may develop. A cough caused by reflux is
usually worse at night or on bending and straining.
into the oesophagus. This can cause a burning sensation in the
chest and a chronic cough may develop. A cough caused by reflux is
usually worse at night or on bending and straining.
Bronchitis refers to inflammation of the bronchial tree (the
breathing tubes within the lungs). Chronic bronchitis is
characterised by a long-term, productive cough.
breathing tubes within the lungs). Chronic bronchitis is
characterised by a long-term, productive cough.
Bronchiectasis is an abnormal enlargement of the main airways
(bronchi) that carry air into the lungs. This condition can cause a
chronic, chesty cough with large amounts of coloured, foul-smelling
mucus.
(bronchi) that carry air into the lungs. This condition can cause a
chronic, chesty cough with large amounts of coloured, foul-smelling
mucus.
Medication such as ACE inhibitors cause a dry cough in 15% of
people. The cough usually resolves within weeks of withdrawal of
the drug.
people. The cough usually resolves within weeks of withdrawal of
the drug.
Psychogenic cough, habit or nervous cough usually present as a
barking or honking sound or as a repeated dry cough. This type of
cough usually begins as part of a viral infection and continues
voluntarily due to the attention the person receives or as a result
of anxiety. Symptoms are absent during sleep with this type of
cough.
barking or honking sound or as a repeated dry cough. This type of
cough usually begins as part of a viral infection and continues
voluntarily due to the attention the person receives or as a result
of anxiety. Symptoms are absent during sleep with this type of
cough.
Heart Failure may cause a type of cough. Left-ventricular heart
failure may produce the symptom of a night-time cough, therefore it
is important to seek medical advice for any type of unexplained or
persistent coughing.
failure may produce the symptom of a night-time cough, therefore it
is important to seek medical advice for any type of unexplained or
persistent coughing.
TREATMENT OPTIONS
As with all conditions your Doctor should be consulted. Your
Doctor will diagnose and treat this condition. A specific diagnosis
by your Doctor can usually be made with a thorough history,
physical examination and simple laboratory investigations. Your
Doctor might suggest a chest X-ray and other tests to diagnose the
cause of the cough.
Doctor will diagnose and treat this condition. A specific diagnosis
by your Doctor can usually be made with a thorough history,
physical examination and simple laboratory investigations. Your
Doctor might suggest a chest X-ray and other tests to diagnose the
cause of the cough.
DIET HINTS
- – Try to avoid all foods that aggravate the cough reflex. Food
allergies or intolerances may promote coughing. - Dry foods e.g., biscuits or crispbread and spicy or very sweet
foods may promote coughing, while liquids tend to have a soothing
action. - Foods high in vitamins A, C, E and zinc may help the body to
combat any infections which may be present. Citrus fruits as well
as red, orange and yellow fruits and vegetables are high in these
vitamins. - Garlic and onions should be eaten regularly to help shift mucus
out of the lungs and help combat infections. Garlic has natural
antibiotic properties which is thought to be useful in combating
infections. - Try to drink plenty of fruit and vegetable juices at room
temperature. These may help expel mucus and sooth the throat.
Ginger, added to juices and cooking, is an effective herb for
coughing.
VITAMINS/MINERALS/HERBS
- Vitamin A may enhance immune function.
- Vitamin C may enhance immune function and may assist chronic
bronchitis via its anti allergy actions - Zinc may assist in boosting the immune system.
- Garlic may be useful due to its antibacterial properties.
- Liquorice herb can be effective to reduce coughing, enhance
immune function and sooth the respiratory tract. Note: Caution
should be used with people suffering from high blood pressure. - Echinacea herb can assist as has antiviral and antibacterial
actions. - Cherry bark has an expectorant action which may reduce
coughing.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Suppressants are effective in relieving a dry cough. Common
ingredients in cough suppressants include pholcodine, codeine and
dextromethorphan. It is important that a cough suppressant is not
used for a productive cough as this can worsen the condition. - Demulcents such as lemon, glycerin, honey and eucalyptus are
soothing and have few side effects. They are particularly suitable
for children due to their pleasant flavour. - Expectorants are used to treat productive coughs. They help
loosen the mucus to make it more easily coughed up. The active
ingredient is called guiphenesin. - Sympathomimetics are used when a combination of suppressants
and expectorants is desired. They may cause sleeplessness and are
not suitable for children, or patients taking certain medications.
Active ingredients include pseudoephedrine and
phenylpropanolamine. - Smoking is a common cause of coughing. It causes extreme
irritation to the airways and increases the risk of infections. Ask
your Pharmacist about the range of products available to help you
stop smoking. - A steam vaporiser can help by humidifying the air and reducing
irritation to the upper airways.
