Most of us cough several times a day without even noticing it. A cough is simply your body’s way of keeping lungs clear of mucus and irritants such as dust, smoke and foreign bodies. Infections, such as colds, can make you cough more, but once the cold clears, the coughing stops. However, a chronic cough is one that goes on for weeks, months or even years, in which case you might need some further help to stop coughing.
Professor Peter Barnes is professor of thoracic medicine and head of airway disease at the National Heart & Lung Institute at Imperial College London.
Here are some of the most common cough causes he encounters:
The symptom: You’ve had a streaming cold that has left you with an irritating dry cough
What’s the cause? It’s thought to be the result of nerve endings in the airways becoming irritable, causing the cough reflex to be more easily triggered.
Who gets it? Anyone can get this after a cold, flu or other respiratory virus.
Will it go away? Yes, in a week or two.
What’s the treatment? There are no effective drug treatments but warm, humidified air can ease the tickle. Buy a humidifier, or try the old wives’ trick of inhaling boiling water from a bowl with a towel over your head.
The symptom: A constant phlegmy cough, recurring chest infections, a tight chest and wheezy breathing
It could be? Chronic Obstructive Pulmonary Disease (COPD)
What’s the cause? Damage to the airways or bronchial tubes (bronchitis), and the smaller airways and air sacs in the lungs (emphysema). The most common culprit is smoking or passive smoking.
Who gets it? You are most at risk if you are over 45 and have been a smoker (or lived with a smoker). Women are more susceptible, but it’s not known why.
Will it go away? Damage to the airways is permanent, however stopping smoking, if you need to, can stop things getting worse.
What’s the treatment? Short- and long-acting inhaled drugs to relax and open up the airways, medicines to make sputum thinner and antibiotics for chest infections. In severe cases, oxygen might be needed. Help yourself by getting an annual flu jab, taking regular exercise and losing weight if you need to.
The symptom: Your cough sounds like a whistle, your chest is tight and you struggle for breath
It could be? Asthma.
What’s the cause? Passages that carry air to and from your lungs become inflamed. This is thought to be a combination of genes and exposure to tobacco smoke, infections, and some allergens early in life.
Who gets it? One in 12 adults in the UK have asthma. Women are more at risk.
Will it go away? There’s no cure, but you might get more attacks at specific times – for example after a cold or in the winter.
the treatment? Quick-relief inhalers to relax airways and preventative inhalers to keep attacks at bay. Help yourself by knowing your triggers (smoke, cold air, exercise) and avoid them.
The symptom: A cough that started after being prescribed drugs for your blood pressure.
It could be? A side effect of medication.
What’s the cause? Chronic cough is a side effect of drugs called angiotensin-converting enzyme (ACE) inhibitors used to treat high blood pressure. it’s thought that this is because they stop the breakdown of a chemical called bradykinin, which makes the nerve endings in the lungs more sensitive to stimuli.
Who gets it? Fifteen per cent of women who are prescribed ACE inhibitors.
Will it go away? Yes, if you stop taking ACE inhibitors, although itcan take weeks.
the treatment? Your doctor can prescribe alternative medicines that don’t cause coughing.
The symptom: As well as a cough, you have heartburn, a sour taste in your mouth, acid reflux and wake up hoarse
It could be? Gastroesophageal reflux disease (GERD).
the cause? GERD happens when the valve at the bottom of your gullet or oesophagus doesn’t close properly. As a result, food and acid leak back, or reflux, into your oesphagus. It’s not known why this triggers chronic cough but it’s thought the inflammation cause by GERD may stimulate nerve endings in the gullet, causing the cough reflux to kick in.
Who gets it? Anyone but you’re more at risk if you are over 40, overweight, pregnant or a smoker, as chemicals in the smoke relax the oesophageal valve.
Will it go away? Controlling GERD can diminish coughing.
the treatment? Over-the-counter antacids or acid suppressants, or stronger prescribed medications. Very occasionally, surgery. Lose weight if you need to, avoid eating within two or three hours of bedtime, steer clear of alcohol, cut down on caffeine, fizzy drinks, chocolate, fatty and fried food, and avoid tight clothing.
Should you take a cough medicine?
Cough medicine canbe antitussive (capable of relieving or suppressing coughing) for dry, itchy coughs (works by blocking the cough reflex), and for ‘productive’ coughs (thin mucus, making it easier to cough up). However, most are pretty ineffective.
Simple cough mixtures containing soothing ingredients, such as glycerin, honey and syrup are probably best. More complex cough mixtures may contain antihistamines, decongestants and ingredients, such as paracetamol, to reduce a fever. Check with your GP or pharmacist before taking, and never take cough medicine for more than two weeks.
3 natural ways to ease a cough
Sip ginger tea. Grate some ginger in to boiling water, steep for ten minutes and sweeten with honey. Ginger is said to boost circulation and help clear sinuses and lungs of mucus.
Pick up a pineapple. Pineapple contains an enzyme called bromelain, which is a natural cough suppressant and can help to soften and loosen hard, sticky mucus.