When a Cough Isn't "Just a Cough"
Five Questions to Help You Decide Whether to Worry
From a discreet tickle in the throat to a relentless "smoker's cough," coughing is a reflex we can't resist. Though these odd noises that come up the respiratory tract and out the mouth are wordless, they have plenty to tell.
In fact, coughing is the top complaint people bring to doctors' offices. "Coughing is a very general symptom that can reflect minor irritation or serious problems in the airways or the lungs themselves," says internist and pulmonologist Norman Edelman, medical director of the American Lung Association.
So what's your cough saying? Here are six questions that lead to important clues.
Cough Clue #1: How Long Has the Cough Been Going On?
Not long; minutes or hours.
We cough because something irritates the nerves of the respiratory tract. The pest can be fleeting -- a cloud of perfume or bug spray, an inhaled hot chili pepper, water swallowed the wrong way so that it clogs the windpipe. Or it can be something that hangs around longer, like dust, mucus, or stomach acid.
With any cough, first we take a short breath and then the voice box (larynx) closes. The abdominal and chest muscles contract, and pressure builds to release air from the lungs when the larynx reopens -- whereupon whoosh, the fast burst of air whisks through the airways, clearing them. That's important, because invasive bodies in the lower respiratory system can harbor bacteria that cause an infection in the airways or even pneumonia (infection of the lung itself).
For many sudden coughs, the drama ends when the airway is cleared and/or the offending substance goes away.
It's been less than a month.
The common cold is the number-one reason for "acute" coughs (those lasting less than three weeks). Colds tend to run their course in seven to ten days. But the rule of thumb on the cough that usually accompanies a cold is that it can take as long as two to four weeks to end, says Edelman. That's because airways may continue to be inflamed and sensitive even after the infection has cleared.
Most coughs that come with colds clear on their own without any treatment, research shows.
Argh, it's been more than two months now.
Between one and two months, coughs are considered "subacute" -- they might clear up or they might flag an underlying disease. After eight weeks, a cough is considered "chronic." Among the most common causes of a chronic cough:
- Upper-airway cough syndrome (UACS), the newish term for postnasal drip syndrome. It's the most common cause of acute and common coughs.
- Asthma, a constriction of the airways. A top cough-causer for kids, adults get it, too.
- Chronic obstructive pulmonary disease (COPD). This can take the form of chronic bronchitis (damage to the bronchi or large air tubes) or emphysema (damage to the tiny air sacs deep in the lungs), or both. People who smoke are at highest risk.
- Gastroesophageal reflux disease (GERD). (The old term "acid reflux" is fading because there's also nonacid reflux.) GERD happens when the stomach content backs up into the esophagus.
In many cases, when the problem is treated, a long-term cough disappears.