Clues About a Cough

When a Cough Isn’t “Just a Cough”
woman with a cough

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 five questions that lead to important clues.

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.

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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.

 


about 1 month ago, said...

Thank You Paula Spencer Scott for sharing such an informative article. After reading this article i came to the connection between Bronchitis and Simple Cough. Do you know Is Bronchitis Contagious And How Does It Spread? . Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored, white, yellow-grey or green. There are two types of bronchitis.Chronic Bronchitis which means your airways are irritated over and over. This type lasts for a few months or longer, and usually comes back year after year. Things that irritate your lungs, like dust, chemicals, or smoke from a fire or cigarettes, usually cause it. Chronic bronchitis isn’t contagious, but it’s a serious health problem that requires a doctor’s care. Acute Bronchitis which can last for 1 to 3 weeks. It’s usually caused by cold or flu viruses. Since these viruses are contagious, acute bronchitis usually is, too. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often the smoker’s cough. Acute bronchitis usually is self-correcting condition which improves within a few days without lasting effects, although you may continue to cough for weeks. However, if you have repeated episodes of bronchitis for most of the days in three months per year: you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).


2 months ago, said...

Im desperate my 7 year old son have this cough fir like 5 months already sometimes is there he just ge t it sometimes one day no but he getscthis like 3 c to 4 days a week it takes like an hour to go away sometimes i give him the alergy meficine zitricen and goes away but wont go away for ever does anyone in the same situation as me


over 1 year ago, said...

Cough so bad can't catch my breath when coughing mucus n throat scare I might cough ta hard trying ta catch my breath I thought I was dying voice going out what do that mean sometimes cough to hard I end up p/n on my self


over 1 year ago, said...

This is very useful information, I had double pneumonia 013 and 014 almost exactly a year apart July 1-5 013 And July 1-4 014. This year I'm having nodules showing up in my right lung. Left lung cleared out. Having needle biopsy Thursday June 18th Hopefully find out what this is, stop this aggravating cough. It's terrible, I quite coughing up anything, but the cough goes on, irritating and wheezy Thank you


over 1 year ago, said...

My sister's cough was esophageal cancer.


over 1 year ago, said...

Very informative with my love of fragrances and air fresheners. They may like me as much as I like them. My husband has a lung problem and the winter and fall are horrible for him, the coughing and the wheezing! Keeping moisture from a kettle or a vaporizer in the room that he is in helps also a touch of Vicks vapor rub under his nostrils when he is headed out. It helps him breathe a lot better, thanks for listening.....


over 1 year ago, said...

My brother, a non smoker, health fantatic, ignored an ongoing mild cough. His stupid doctor did not insist on a chest X-ray because he did not smoke. Three yrs later my brother was dead of lung cancer.


over 1 year ago, said...

my persistent tickle or cough was ovarian cancer


almost 2 years ago, said...

I always have a itchy tickle in ms throat, Dr always says it ia my sinus but this not comforting or helping me. When I get sick I usually get antibotics for Ainus infection now I have Pneumonia he gives me Codeine Meds for cough which helps, I have ashtma too and use 3 inhalers 4 nasal sprays and Neti bottle, suck on lemon candies and drink lemon tea gargle with salt water, it will subside for awhile but even after I am better it comes back itching and starting coughing again, I have been to a Allergist, tested, Dr next ENT any other suggestions?


about 2 years ago, said...

Well, the cough is getting better. The inhaler they gave me is doing some good. I was finally able to sleep through the night. The cough still occurs, but further spaced out. Think I'll be able to go back to work soon.


about 2 years ago, said...

How dangerous is a cough due to an allergic reaction to that high blood pressure med know as lisinopril? I'll tell you. I know someone who coughed so hard he passed out, fell an his face and ended up with mulitiple fractures. Also know (knew) someone who coughed so hard he passed out, fell on his face, bruised his forhead badly. A week later he didn't wake up. Left behind a wife and 4 kids. I also had the coughing. Accidently found out that it was from Lisinopril and stopped taking it immediately. Why is this still on the market?


about 2 years ago, said...

The comment on upper airway cough syndrome was valuable; that obviously is what my husband has. He will have spells of coughing that last a few days and then go away for weeks. His epidodes are accompanied by a runny nose.


about 2 years ago, said...

Fortunately there is no hypertension or heart disease involved in my cough, but you're correct that this must be checked in a chronic cough.


about 2 years ago, said...

If some kind of relief for caughing comes up,, please let me know.. Al


about 2 years ago, said...

Wish I could find that prevent cough so much.


about 2 years ago, said...

Please, please, please include PH and PAH (pulmonary arterial hypertension) as a possible cause of a persistent cough and shortness of breath. It is often misdiagnosed a COPD. The correct treatment is not given and the person may die from heart failure.


about 2 years ago, said...

I have had a chronic cough for three months now. The primary doctor says I'm perfectly healthy except for that cough. My allergist had my lungs x-rayed to rule out both pneumonia and something they didn't discuss in the article, CANCER. My aunt's lung cancer was diagnosed as acid reflux by the doctor who failed to x-ray her lungs. By the time we convinced her to see a different doctor and get her lungs x-rayed, the cancer had spread to cover 1 & 3/4 of her lungs. She died just 6 months later. Meanwhile, my allergist is covering all bases and trying to stomp out the cough which is producing gelatin consistancy clear mucus. If anyone has any other suggestions as to what it can be, let me know and I'll bring it up with the doctor. He's ruled out COPD, pneumonia, lung cancer, bronchitis, asthma, infection, acid reflux, and a pile of other things. Sigh... Suggestions anyone?


over 2 years ago, said...

My Mom has Alzheimer's and for the last 2-3myths has developed a cough.Nonproductive and just spits up saliva. She still eats well and doesn't seem to have any problem swallowing. She says she has no problem and this just doesn't happen when she eats also when she lying down and during nite.Any clue what's going on or is this just a stage of the disease?


over 2 years ago, said...

Thank you for this very thorough coverage on the subject.


over 2 years ago, said...

I have had a persistent cough, for approximately 2 1/2 years. I have had lung infections in the past, prior to the start of my frequent cough. I sometimes have "coughing fits." I had chest x-rays, and testing of my lungs with a spirometer, and about a year ago another chest x-ray. Since we have moved during this time, in the last year I have seen a new physician, who order that last x-ray. She also recommended a CAT scan. With our current provider, that would cost $300. copay, so I have been reluctant to have one, but am beginning to wonder, if I should do so.