Cough



Coughing is a normal way to keep your throat and airways clear.  Too much coughing for too long may mean you have a disease.  Some coughs are dry; while others bring up mucus.  Mucus is also called phlegm or sputum. 

 

Coughs can be either acute or chronic.

• Acute coughs are often due to a cold, flu, or sinus infection.  They go away after 2 to 3 weeks.
• Chronic coughs last longer than 2 to 3 weeks.

 

Common Causes 

 

Besides recent colds and flu, other common causes of coughs include:

• Allergies and asthma.
• Lung infections such as pneumonia or bronchitis.
• COPD (emphysema or chronic bronchitis).
• Sinus infection leading to cough.
• Lung disease.
• Stomach reflux disease (GERD).
• Cigarette smoking.
• Breathing in secondhand smoke.
• Breathing in dirty air. 
• ACE inhibitors (medicines used to control blood pressure).

 

Home Care

 

Here are some tips to help ease your cough:

• Cough drops or hard candy can help dry, tickling coughs. 
• A vaporizer or steamy shower may help a dry cough by having more moisture in the air.
• Drink extra fluids to help thin the mucus in your throat 

 

Medicines you can buy without a prescription include:

• Guaifenesin (like Robitussin®) can help you bring up mucus.  Drink lots of fluids if you take this.
• Decongestants such as Sudafed® can be used to clear a stuffy nose and postnasal drip.  These should not be used if you have high blood pressure or for a child under 6 years old, unless prescribed by your doctor.

Although coughing can be a troubling symptom, it is your body's way of healing. Experts advise against using cough medicine in many cases.  You may want to talk to your doctor before using over-the-counter cough medicine such as dextromethorphan (Vicks 44®, Robitussin® DM).

 

Do not expect a doctor to prescribe antibiotics for viral infections like colds or flu.  Antibiotics do not work on viruses.  Antibiotics also will not help coughs from allergies.

 

Call 911 if you have

 

• Shortness of breath or difficulty breathing.
• Hives or swollen face or throat with trouble swallowing.

 

Call your doctor right away if you have

 

• Violent cough that begins suddenly.
• High-pitched sound (called stridor) when you breathe in.
• Cough with blood in mucus.
• Fever.  
• Thick, foul-smelling, yellow-green mucus.
• A history of heart disease, swelling in your legs, or a cough that worsens when you lie down.
• Been near someone with tuberculosis.
• Weight loss or night sweats.
• Cough that lasts longer than 10-14 days.

 

What to expect at your clinic visit

 

The doctor will ask questions about your cough, such as

• Are you coughing up blood?  How much?  How often?
• Do you bring up any mucus or sputum when you cough?  What does it look like?  Is it thick and hard to cough up?  How much sputum is produced per day?
• Is the cough severe?  Is the cough dry?
• Does the cough sound like a seal barking?
• What is the pattern of the cough?  Has it been getting worse?  Is the cough worse at night?  When you first awaken?
• How long has the cough lasted?
• Is the cough worse when you are lying on one side?
• Are there sudden attacks of coughing where you gag and vomit?
• What other symptoms do you have?

 

An exam will be done with a focus on the ears, nose, throat and chest.  Other tests that may be done include

• Breathing tests.
• Sputum analysis (if the cough produces sputum).
• X-ray of the chest.
• Bronchoscopy.
• Lung scan.

 

Prevention

 

• Do not smoke and stay away from secondhand smoke.
• If you have allergies like hay fever, stay indoors during days when airborne allergens are high.  Keep windows closed during this time and use an air conditioner if you have one.  Avoid fans that draw in air from outdoors.  Shower and change your clothes after being outside.
• If you have allergies year round, cover your pillows and mattress with dust mite covers, use an air cleaner, and avoid pets and other triggers.

 

Phone Numbers

 

UWHC Pulmonary Clinic, Monday-Friday 8:00am-4:30pm at (608)263-7203.

 

Toll free: 1-800-323-8942, please ask for Pulmonary Clinic.

 

After hours, the clinic phone will be answered by the paging operator.  Ask for the pulmonary doctor on call.  Leave your name and phone number with the area code.  The doctor will call you back.

 

 

References

 

Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):1S-23S.

 

Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):260S-283S. Review.

 

Holmes RL. Evaluation of the patient with chronic cough. Am Fam Physician. 2004; 69(9): 2159-2166.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/01/2010

Copyright © 02/01/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6500

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