Having a cough is a clear sign that something just isn’t right in your lungs. It can be easy to chalk it up to something like a lingering cold, your partner’s smoking habit, or another obvious culprit, but sometimes a cough can actually point to a sneaky health condition like asthma.
For the record, you don’t just have to live with a constant cough, even if it feels like yours has been with you since birth. “I have patients who come in and say, ‘I don’t have any problems, but I have a cough,’” Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. “But a cough is never normal.”
If you’re coughing, it means your lungs are trying to eject irritants or goopy fluids like mucus, the Mayo Clinic explains. With that in mind, it makes perfect sense that coughing happens to be a hallmark of asthma, which messes with the tubes that carry air in and out of your body. Under normal circumstances, these airways do their job with no trouble. But if you have asthma, your airways overreact to triggering substances by tightening, swelling, and pumping out too much mucus. All that adds up to having more trouble breathing than usual. You may also experience symptoms like wheezing (a whistling noise when you breathe), chest pain or tightness, and yup, a cough, according to the National Heart, Lung, and Blood Institute (NHLBI).
So, how do you know if your hacking might indicate that you have asthma? Here are signs to keep in mind.
1. Your cough never really goes away.
In most cases, a “regular” cough from something like a cold will annoy the crap out of you for a week or so and then recede. But an asthma cough “tends to be more severe and last longer than a normal cough with illness,” pulmonologist Ryan Thomas, M.D., director of the Multidisciplinary Severe Asthma Team at Michigan State University, tells SELF. A chronic cough like the one that often signals asthma lasts for eight weeks or more, the Mayo Clinic explains. “If the cough is always there, there’s a reason for that,” Dr. Casciari says. “It’s probably not going to go away on its own.”
2. It’s usually a dry cough, too.
Asthma typically causes a dry, non-productive cough (meaning you don’t expel substances like mucus), according to the American College of Allergy, Asthma & Immunology (ACAAI). It’s a little confusing that asthma can cause you to have a dry cough even though you may produce more mucus than usual, but it’s usually because that extra mucus is in the smaller parts of your airways deep in your lungs, so it’s harder to get it all the way up to your mouth, Dr. Casciari explains.
Since few things in life are black and white, it’s still possible to have a wet asthma cough, especially if you have an infection like bronchitis, Dr. Casciari says.
3. The cough gets worse when you’re exposed to certain triggers.
If you have asthma, your symptoms will typically flare up in the face of triggers, although the connection might be so subtle you don’t realize it at the time. While everyone’s triggers can be different, some of the most common ones are pollen, animal dander, dust mites, mold, smoke, air pollution, cold air, exercise, and stress, the ACAAI says.
4. You have other asthma symptoms, like wheezing.
“Wheezing … happens when air is moving through narrowed passages,” Dr. Casciari says. “That is exactly what asthma is—the airways are narrowed, and air is trying to get through there.” So, if your cough comes along with evidence of compressed airways such as trouble breathing, wheezing, and chest discomfort, it’s pretty likely you’re dealing with asthma, Dr. Casciari says.
- Why a Cold-Weather Workout Can Make You Cough—and What to Do About It
- Why Do I Wake Up Gasping for Air?
- Whooping Cough (Pertussis)
- Paroxysmal Nocturnal Dyspnea
- What to know about laryngospasm
- Breathing problems to look out for in children
- What signs and symptoms are linked with breathing problems?
- Runny nose, blocked nose and sneezing
- Breathing problems
- High temperature
- Problems with feeding and drinking
- Aches and pains
- Coloured mucus
- A change in skin colour
- Cough: dry cough
- How long does a cough normally last?
- Causes of dry cough
- Can I hurt myself coughing?
- Diagnosis and tests
- When should you seek medical advice about a dry cough?
- Treatments for dry cough
- What is a nagging cough?
- What are the most common causes?
- 1) Reactive airway disease after a cold or flu
- 2) Post-nasal drip (also known as upper airway cough syndrome)
- 3) Asthma with cough (also known as cough-variant asthma)
- 4) Acid reflux or GERD
- 5) Medication side effect
- What is not a likely cause of persistent dry cough?
- Cough Due to Cold or Flu
- What causes a cough?
- How long does a cough last?
- How Can I Treat A Cough?
Why a Cold-Weather Workout Can Make You Cough—and What to Do About It
Q: Sometimes after I finish a run outside on a cold day, I have a coughing fit. What’s up with that?
While winter workouts are great for some people, cold or dry air can trigger exercise-induced asthma (EIA) in others. EIA is a condition in which the small airways in the lungs swell, making it more difficult for air to pass through. Chilly weather can also spur cells to release histamine, a compound involved in allergic reactions that can lead to wheezing. Other signs of EIA include chest tightness and breathlessness; the symptoms usually go away 30 to 45 minutes after you’ve finished an intense workout.
RELATED: How to Keep Your Lungs Healthy, According to Pulmonologists
When you have any respiratory troubles, make an appointment with your doc to get to the bottom of the problem. If tests show you do have EIA, she may prescribe an inhaler to use before winter workouts, or medication you can take daily. You might also try running with a scarf over your mouth and nose; that will help warm and humidify the air you’re breathing in, so it doesn’t irritate your airways. And don’t skimp on your warm-up and cooldown—the longer they are, the better.
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Why Do I Wake Up Gasping for Air?
There are several different causes that can lead you to wake up gasping for air. Some are temporary and benign, while others are more serious.
Postnasal drip can cause nasal secretions to move down your throat at night and get trapped there, especially if you’re lying on your back. This can block your airway, which triggers the coughing and gasping reflex.
People who wake up gasping for air as a result of postnasal drip often say they feel like they’ve been suffocating. They may also have symptoms like a sore throat, a bad taste in their mouths, or sinus headaches.
Learn more about postnasal drip.
Hypnagogic jerks are the involuntary movements of the body that happen right when you’re falling asleep. They’re also sometimes called hypnic jerks. They can be small twitches of an arm or involve your entire body and make you feel like you’re falling upon waking.
Sometimes when this occurs, your muscles will be tense, causing you to gasp for air. You may have a heavy feeling in your chest. Other symptoms may include:
- rapid heart rate
- fast breathing
Hypnagogic jerks can be made worse by:
- stress or anxiety
- sleep deprivation
- an irregular sleep schedule
Obstructive sleep apnea
Obstructive sleep apnea can cause your breathing to start and stop while you sleep. It can lead to the throat muscles relaxing so much that they block your airway. You may wake up abruptly gasping for air or choking.
Other symptoms that accompany sleep apnea may include:
- excessive daytime fatigue
- loud snoring
- morning headaches
- high blood pressure
- mood changes
- difficulty concentrating during the day
Learn more about obstructive sleep apnea.
Pulmonary edema occurs when excess fluid collects in air spaces and tissue in the lungs. This makes it more difficult to breathe. While pulmonary edema can develop slowly over time, it can also develop suddenly. The difficulty in breathing can cause you to wake up gasping for air and feel like you’re suffocating or drowning. Acute pulmonary edema is a medical emergency.
Other symptoms you may experience include:
- difficulty breathing or shortness of breath that gets worse when lying down
- sudden anxiety or restlessness
- rapid and irregular heartbeat
- chest pain
- a cough that may produce frothy sputum, which may be tinged with blood
Learn more about pulmonary edema.
Anxiety and panic attacks
Both anxiety and panic attacks can cause you to wake up gasping for air. Attacks can occur while sleeping without any obvious trigger. Both conditions can bring about an increase in hypnagogic jerks.
Other symptoms include:
- feeling faint or dizzy
- having chills
- feeling a loss of control
- chest pain
- sense of terror or impending doom
- shortness of breath
Learn more about anxiety and panic attacks.
Acid reflux can cause a backflow of the stomach’s acid into the esophagus. This condition is also known as GERD. Sometimes this acid will move far enough up the larynx or throat. This can lead the person to wake up choking, coughing, and gasping for breath.
Other common symptoms of acid reflux include:
- erosion of the enamel of the teeth
- bad breath
- chronic sore throat
Learn more about acid reflux.
Congestive heart failure can cause extra fluid to accumulate in or around the lungs, resulting in congestion and difficulty breathing. While symptoms are most often seen with strenuous exercise, it can occur when laying down and sleeping as the heart failure progresses.
Other symptoms may include:
- swelling in the legs
- extreme fatigue
- chest pain
- abdominal distension
- gastrointestinal problems
Learn more about heart failure.
Whooping Cough (Pertussis)
What is pertussis?
Pertussis, commonly known as whooping cough, is a respiratory infection that is very contagious. It usually results in prolonged and repeated bouts (paroxysms) of coughing in children and adults. These coughing episodes can continue for weeks or even months after the onset of the illness. Prolonged coughing causes air to be expelled from the lungs. When the person gasps for air after a coughing fit, a loud, high-pitched “whooping” noise might accompany the inhalation of air. That is the reason pertussis is called whooping cough. However, someone may still have whooping cough without making a whooping noise.
Instead of coughing spells, babies who are infected with pertussis may experience breathing difficulties, such as a pause in breathing (apnea). About 50 percent of babies less than one year old who get whooping cough have to be hospitalized. In rare cases, death may occur.
How common is pertussis?
Pertussis is a common disease. Throughout the world, there are about 16 million cases of pertussis each year, resulting in about 195,000 deaths. In the United States, over 48,000 cases of pertussis were reported in 2012. However, many more cases occurred that were not reported. The number of reported cases of whooping cough has been increasing since the 1980s.
People of all ages can get pertussis, but it occurs most often in children and adolescents. Even adults and children who have been vaccinated against it can become infected, although their symptoms are usually milder.
Babies are especially susceptible to infection, because they cannot be vaccinated against pertussis until they are at least 2 months old. They may catch whooping cough from their parents, adult caregivers or other children.
What causes pertussis?
Pertussis is caused by Bordetella pertussis bacteria that can enter the respiratory system. If a person who is infected with the disease coughs or sneezes, tiny droplets of liquid containing the bacteria may be inhaled by a person who is nearby. Bacteria grow on the lining (mucosa) of the respiratory tract and increase the secretions of mucus.
A person with pertussis may be contagious even before symptoms appear and remain contagious for up to 2 weeks after coughing starts.
What are the symptoms of pertussis?
Early symptoms of pertussis may resemble those of the common cold. These symptoms may persist for 1 to 2 weeks.
They may include:
- Slight fever
- Mild or occasional coughing
- Runny nose
- Pause in breathing in babies
Symptoms of whooping cough after the first or second week has passed usually include:
- Prolonged, repeated or violent coughing episodes (paroxysms) that recur intermittently for up to 10 weeks or more
- Whooping sound when inhaling after the coughing stops
- Exhaustion due to prolonged coughing
Symptoms begin to lessen after 4 weeks, although bouts of coughing can recur for months after onset.
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Paroxysmal Nocturnal Dyspnea
Imagine awakening suddenly from sleep, gasping for air, coughing, wheezing and feeling like you’re suffocating. Anxious and scared, you might quickly sit up and put your feet on the floor. Sitting or standing up helps you breathe better again. This frightening occurrence is a sign of heart failure — and it sometimes happens to people who haven’t had any previous symptoms of heart trouble.
The scientific term for this occurrence is paroxysmal nocturnal dyspnea. “Paroxysmal” means “sudden attacks that recur,” “nocturnal” means “occurring at night” and “dyspnea” means “difficulty breathing” or “shortness of breath.”
Paroxysmal nocturnal dyspnea is also sometimes called cardiac asthma because its signs and symptoms mimic those of asthma. This term is actually misleading — the two conditions are very different. While asthma is a chronic condition caused by inflammation of the airways, which can lead to breathing difficulties, paroxysmal nocturnal dyspnea is a sign of heart failure.
Paroxysmal nocturnal dyspnea can be accompanied by swelling of the feet or ankles. It’s caused by congestion (excessive or abnormal accumulation of blood) in the lungs, perhaps along with accumulation of excess fluid in the lungs (pulmonary edema), which occurs as a result of left-sided heart failure.
Some patients who experience paroxysmal nocturnal dyspnea also experience orthopnea: breathlessness when lying down that is relieved when several pillows raise the head and upper body. People with this condition must keep their heads elevated to breathe comfortably. Paroxysmal nocturnal dyspnea is an intense form of orthopnea. It commonly occurs several hours into sleep (as opposed to immediately upon lying down), and it’s relieved by sitting upright, but not as quickly as is orthopnea.
Next, we’ll learn what causes paroxysmal nocturnal dyspnea and how you can treat it.
What to know about laryngospasm
Share on PinterestA laryngospasm may be a reflex to prevent accidental drowning.
Doctors think that a laryngospasm may be a reflex designed to prevent accidental drowning or suffocation.
People who accidentally inhale food while talking, for example, can benefit from a laryngospasm because it prevents the food from blocking the airway. This is the reason why it is common to experience a laryngospasm while eating or drinking. Some people experience symptoms after feeling as if food has gone down “the wrong pipe.”
Unlike choking, a person experiencing a laryngospasm will not feel something physically lodged in the throat. The Heimlich maneuver also does not stop a laryngospasm.
Eating is just one potential laryngospasm cause. Some alternative causes for this frightening sensation include:
Stress and anxiety
Some people may experience a laryngospasm in response to intense anxiety or stress. During a panic attack, hyperventilation or intense fear may trigger a laryngospasm. The tightness in the throat can then make the panic even worse.
Anesthesia can trigger the laryngospasm reflex, particularly in children. It is even more common in babies. Overall, about 1 percent of adults and children, receiving anesthesia, experience a laryngospasm. In children who have asthma or a respiratory infection, the incidence increases to about 10 percent.
People who experience a laryngospasm under general anesthesia for surgery might never know it happened since the anesthesiologist will immediately intervene.
Neurological issues can trigger a laryngospasm. For instance, people who have recently sustained a spinal cord or brain injury may experience muscle spasms, including laryngospasm.
Nerve injuries, particularly in or near the neck and spine, can also be a factor. Some people with paralyzed vocal cords experience laryngospasms.
Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD) is a syndrome that causes the stomach contents, including stomach acid, to flow back up the esophagus and into the throat.
Some people with GERD experience intense burning and pain. Some individuals also experience laryngospasm. A small study of eight people with GERD found that a recent respiratory infection increases the risk of laryngospasm. In this group, forceful coughing triggered both laryngospasms and fainting.
Asthma and allergies
People with asthma and respiratory allergies are more vulnerable to laryngospasm. Treating these allergies and carrying an asthma inhaler can reduce the risk of future spasms. People with respiratory issues, including asthma, are more vulnerable to laryngospasm while under anesthesia.
Breathing problems to look out for in children
Breathing problems in children can have a number of different causes. This page tells you what signs to look out for and what they might mean, from coughing or a runny nose to wheezing, fast breathing or coloured mucus.
- Severe breathing difficulties
- Grunting with the effort of trying to breathe
- The muscles under their ribs are sucking in with each breath
- Fast breathing
- Your child won’t wake up, or won’t stay awake
- Breathing stops for more than 20 seconds
- Regular shorter pauses in their breathing while they are awake
- Very pale or blue skin, or the inside of their lips and tongue are blue
- Fitting, if they have never had a fit before
The following signs and symptoms can all make it difficult for your child to breathe.
- a runny nose, blocked nose and sneezing
- a cough
- breathing problems
- a high temperature
- problems with feeding and drinking
- aches and pains, sore throat, earache
- coloured mucus
- a change in skin colour
Runny nose, blocked nose and sneezing
A runny nose is usually caused by a cold.
Sometimes it’s caused by an allergy – this is often called hay fever.
If your child’s runny nose is caused by allergies, they may be more likely to have asthma and problems sleeping too.
Everyone coughs from time to time. A cough helps clear the airway of mucus and things like dust and smoke. An occasional cough is not usually a sign of anything serious.
More persistent coughs are due to a cold or viral infection that usually clears up in a few days. Some coughs carry on for a few weeks after the infection has cleared. Common cough medicines do not stop coughing and are not recommended. If your child is older than 1 year, you could give them honey to help soothe their throat. Honey must not be given to infants under 12 months.
Visit your doctor if:
- your child is vomiting after they cough
- has bouts of coughing that last over a minute several times a day, or
- has a cough that lasts for longer than 3-4 weeks
It is very helpful to doctors and nurses if you can video the cough on your mobile phone. This is because different coughs are signs of different conditions:
- croup (barking cough)
- bronchiolitis (raspy and moist cough)
- whooping cough (bouts of coughing where your child may bring up mucus or vomit. They may gasp after coughing, or make a whooping noise)
- asthma (usually a dry cough). If your child has asthma they may cough more at night. Symptoms might also be brought on by hot or humid weather, or cold or damp air or smoke.
- long term conditions like cystic fibrosis and primary ciliary dyskinesia (PCD) (constant wet cough)
It’s important to seek help if your child is breathing in a different way than usual. Check out when to call 999 and when to go to the doctor.
Fast breathing can be a sign of an infection of the lower airways, such as bronchiolitis or pneumonia. All children are different, but as a rough guide, fast breathing can be defined as:
- more than 50 breaths per minute for infants (2 months to 1 year)
- more than 40 breaths per minute for children (1-12 years)
- more than 20 breaths per minute for children over 12 and adults.
The main thing to watch out for is if your child is breathing persistently faster than usual.
Wheezing is a high-pitched sound that comes from the chest when your child is breathing out. Wheezing is a common symptom of asthma. However wheezing can have many causes, so it does not necessarily mean your child has asthma.
We know that different doctors, nurses and parents all mean something different by wheeze. If your child is well enough, a video on your mobile phone is a very helpful way of showing the nurse or doctor what happens.
Breathlessness or difficulty breathing that becomes worse over a few hours could be a sign of an asthma attack.
Pneumonia and chest infections can also cause breathlessness. Children usually have a fever with these conditions.
Sudden and unexpected breathlessness or difficulty breathing could mean your child has something blocking their airway and is choking.
Difficulty breathing during exercise can be a sign of asthma.
What do breathing difficulties look like?
- Breathing may be faster than usual, or irregular
- Your child’s nostrils may flare (get wider) when they breathe
- They may wheeze when breathing out
- They may make a high-pitched sound when breathing in (stridor)
- They may make a grunting sound when breathing out. Call 999 if this happens
- The muscles under their ribs may suck in with each breath. Call 999 for urgent medical help.
Find out when to call 999 about your child’s breathing difficulties
A fever is a high temperature. In children, a temperature of over 38C (100.4F) is a fever.
What’s causing my child’s fever?
A high temperature can be a sign of infection – including infections in the upper respiratory tract and lungs. Fever helps children and adults to fight infection.
Your child’s fever could also be caused by other illnesses, or by vaccinations.
In itself, a fever is not dangerous. It is the cause of the fever that is the concern. Always seek medical advice if you are worried.
NHS advice on fever
The NHS website has more information on temperature and fever.
They recommend that you seek urgent help if your child:
- is under 3 months and has a temperature of 38C (101F) or over
- is 3-6 months and has a temperature of 39C (102F) or over
Contact your GP for an urgent appointment. Out of hours, call NHS 111 (in England and Scotland), 0845 46 47 (in Wales) or your local out-of-hours service in Northern Ireland.
The NHS also suggests you should always get medical help for your child of any age who has a high temperature if:
- you think your child may be dehydrated
- your child develops a red rash that doesn’t fade when a glass is rolled over it
- your child has a fit
- your child doesn’t stop crying
- the fever lasts for more than 5 days
- your child’s health is getting worse
- you’re concerned about looking after your child at home
Treating a fever in hospital
A high temperature will make your child feel poorly, have a faster breathing rate and a faster pulse. Children who are becoming severely ill will also have faster breathing and a faster pulse.
Health care professionals may treat a temperature to see if the pulse and breathing are slower without the fever.
If your child has a high temperature (fever) they may also be drowsy or confused.
Children with a temperature often lack interest or are more sleepy or irritable than usual. They usually improve after taking children’s paracetamol or ibuprofen to bring their temperature down.
Seek urgent help from your GP or health visitor if your child is drowsy and:
- has other symptoms of breathing difficulty
- doesn’t improve after taking paracetamol or ibuprofen
Out of hours, call NHS 111 (in England and Scotland), 0845 46 47 (in Wales) or your local out-of-hours service in Northern Ireland.
Call 999 if you’re unable to wake your child or, if woken up, they are very drowsy and don’t stay awake.
Problems with feeding and drinking
Problems with feeding and drinking can be a sign of a problem with the lungs and airways.
Your child may not be feeding or drinking if:
- they have an infection and a high temperature
- they are struggling to feed and breathe at the same time
Seek help if your child is having difficulty breastfeeding or they are drinking half, or less than half, the amount they usually would. They may need to go to hospital to make sure they get enough food and fluid.
Aches and pains
Chest pain, headaches and other aches and pains can be symptoms of a chest infection.
A tight, sore chest can be a sign of asthma.
Babies and small children do usually not complain about aches and pains. But they might be irritable if you pick them up.
If your child is older they might say, ‘My chest’s hurting’ or ‘I’ve got a tummy ache’.
Mucus protects your child’s airways. It traps unwanted particles and carries them away.
Mucus can be a problem if it doesn’t work properly or if there’s too much of it. A build-up of mucus in your child’s airways is called catarrh.
Young children usually swallow their mucus so you may not know what colour it is.
But if you are able to see it, yellow, green or brown mucus is a sign of infection or allergy. It might not be serious or need treatment. For example, green mucus running from their nose can be caused by mild infections that don’t need antibiotics.
A change in skin colour
A change in your child’s skin colour may mean they do not have enough oxygen in their blood or their circulation is poor.
Call 999 if:
- your child’s skin is very pale and they have other symptoms of an infection or difficulty breathing
- your child’s skin looks blue
- the inside of their lips and tongue are blue.
Next: information on respiratory tract infections >
Cough: dry cough
A dry cough is a cough where no phlegm or mucus is produced (known as non-productive). A dry cough is irritating and usually associated with a tickly throat. Dry coughs are often caused by viral illnesses such as colds and flu, but they can also be caused by allergies or throat irritants.
Specific treatment for a dry cough will depend on the cause of the cough.
How long does a cough normally last?
Coughs associated with a cold or the flu tend to last a week or 2, most clearing up within about 3 weeks. A post-viral cough may persist for several (up to about 8) weeks after a viral illness, while some coughs persist for longer and are usually a sign of an underlying problem.
In adults and children, a cough is described as acute (short term) if you have been coughing for up to 2 weeks.
In adults, a cough that lasts for more than 8 weeks is described as a chronic (ongoing) persistent cough.
In children, a cough that lasts 2 to 4 weeks is called a prolonged acute cough. A cough that lasts more than 4 weeks is considered to be a chronic cough.
Causes of dry cough
A dry cough is often the result of:
- a viral illness, such as a cold or influenza (the flu), or novel coronavirus 2019; or
- a post-viral, or post-infective, cough (cough that persists for weeks after a viral illness).
However, a dry cough may be a result of other problems, such as:
- gastro-oesophageal reflux;
- allergic rhinitis (hay fever) due to inhaling substances you are allergic to, such as pollen, dust or pet dander;
- post-nasal drip (the drainage of mucus secretions from the nose or sinuses down the back of the throat – also known as upper airway cough syndrome);
- laryngitis (inflammation of the larynx, also known as the voice box);
- whooping cough;
- obstructive sleep apnoea and snoring;
- habit cough (a cough that is only present in the daytime and not caused by illness – it most often affects school-aged children);
- an inhaled foreign body (e.g. food or other objects accidently being inhaled – usually in babies and small children);
- certain types of lung disease known as interstitial lung disease; or
- a side effect from a medicine (for example, cough is a possible side effect of most ACE inhibitors – often prescribed for high blood pressure).
Other, less common, causes of a dry cough include:
- heart failure;
- pulmonary embolism (a blood clot in the lungs); or
- lung cancer.
A dry cough can be aggravated by:
- breathing cold, dry air;
- air pollution;
- inhaled irritants such as dust or smoke;
- exposure to tobacco smoke;
- excessive use of your voice; or
- a change in temperature.
A persistent dry cough can cause problems, including the following complications.
- Repeated coughing can lead to urinary incontinence in women, especially older women, pregnant women and those who have been pregnant.
- Interrupted sleep resulting in tiredness is a common problem for people with a persistent cough.
- Severe or uncontrollable coughing fits can sometimes cause vomiting.
- Headaches may result from a persistent cough.
Can I hurt myself coughing?
When a cough is severe, pulled chest muscles and even fractured ribs are a possible complication.
Diagnosis and tests
Your doctor will ask about your cough and any other symptoms you may have, and perform a physical examination. Depending on your age, history and examination, your doctor may order tests such as:
- a chest X-ray;
- a throat swab (sample of secretions from the back of your throat which can be tested for infections);
- lung function tests; or
- allergy tests.
Dry coughs are often related to a viral illness and in most cases special tests are not needed.
When should you seek medical advice about a dry cough?
You should you seek medical advice if:
- you start to cough up blood or copious amounts of mucus (phlegm);
- you are short of breath or wheezy;
- the cough is mainly at night;
- you have associated chest pain;
- you have a fever;
- you are a cigarette smoker;
- you have a hoarse voice;
- the cough is associated with vomiting or a choking sensation;
- you have other symptoms such as an ongoing headache, sore ears or a rash;
- you have recently lost weight or have general muscle aches;
- the cough is in an infant aged 6 months or younger;
- the cough has lasted longer than 10 days, with little or no improvement; or
- you have high blood pressure, a heart complaint, respiratory illness (such as asthma), gastrointestinal problems or are taking other medicines.
Treatments for dry cough
Dry coughs that are caused by a viral infection such as a cold usually get better on their own within a week or two. Self-help measures can help make you feel better in the meantime, and cough medicines may provide some short-term relief to adults with a dry cough.
Other treatments for dry cough will depend on the cause.
Self-help for dry cough
There are some simple things you can do to provide relief from a dry cough.
Honey can help treat a dry cough by coating and soothing the back of the throat (pharynx), and relieving the irritation that triggers a dry cough. Try drinking warm water containing honey and lemon, or taking one to 2 teaspoons of honey 30 minutes before bedtime. Note that honey should not be given to children younger than 12 months of age due to the risk of infant botulism (a rare bacterial infection).
Drinking plenty of liquids can help, and warm broths or teas may help soothe your throat.
Gargling salt water (in older children and adults) may also help with a dry cough associated with a cold and sore throat.
Dry cough can be a side effect of some medicines such as ACE inhibitors and beta blockers (used to treat high blood pressure and heart problems). Your doctor may recommend stopping any medicines that could be causing your cough and replacing them with other suitable medicines for your particular condition. Talk to your doctor about alternative medicines if you are having this problem.
Repeated coughing from any cause can irritate and inflame the larynx (voice box) and upper airways. So the coughing itself makes your airways more sensitive, leading to more coughing. Strategies that can help you reduce the urge to cough and help stop this type of self-perpetuating cough include:
- taking a sip of water with a hard swallow when you feel like coughing or clearing your throat; and
- avoiding any triggers that you know tend to aggravate your cough, such as overuse of your voice, cigarette smoke, or excessively cold, dry air such as from air conditioning.
Cough suppressants, sometimes known as antitussives, can sometimes be used for the short-term treatment of dry coughs in adults. Cough suppressants work by suppressing the urge to cough, and include any of the active ingredients pholcodine, dextromethorphan, codeine, dihydrocodeine, and pentoxyverine. They are available as:
- lozenges (which may also contain an antibacterial to help soothe a sore throat); or
- liquid or linctus (cough mixture).
Some cough suppressants need a prescription, while others are available from pharmacies without a prescription. Possible side effects of cough suppressants include drowsiness, nausea, vomiting, and constipation.
Some combination cold and flu medicines – available as tablets or liquid – may contain cough suppressants. Cold and flu combination medicines may also include:
- an antihistamine (antihistamines that have sedative effects may help if your dry cough is disrupting your sleep – your doctor may recommend you take these medicines before bedtime);
- a decongestant (to relieve a blocked or stuffy nose); and
- paracetamol for relieving pain and fever.
Always take care to check the active ingredients in any combination product. If you take a combination product and then also take additional medicines, you risk doubling up on ingredients. For example, added paracetamol may lead to an overdose of paracetamol if other paracetamol products are also being taken. If you have a dry cough, you should avoid taking combination products that contain an expectorant or a mucolytic, as these ingredients are used to treat productive (‘wet’ or chesty) coughs.
Cough and cold medicines (including cough suppressants, antihistamines and combination medicines) should not be used in children younger than 6 years of age, and should only be used in children aged 6 to 12 years after checking with your doctor or pharmacist. These medicines have not been shown to be effective in children, and there is some evidence that they can cause harmful side effects.
Nasal sprays and inhalers
If your doctor suspects that hay fever (allergic rhinitis) or post-nasal drip (when mucus runs down the back of your throat) may be causing you to cough, a saline nasal spray and a corticosteroid nasal spray may be recommended.
A corticosteroid inhaler, where the medicine is breathed in through your mouth, may be recommended by your doctor if asthma is a possible cause of your dry cough.
People with gastro-oesophageal reflux disease (where acidic stomach contents flow back up your oesophagus) sometimes have a persistent cough or a choking-type cough at night. Treating the reflux with acid blocking medicines (such as proton pump inhibitors) can help relieve a cough caused by reflux. Self-help measures for treating reflux (such as not eating just before bedtime and tilting up the head of your bed) can also help.
Last Reviewed: 06/03/2018
A nagging cough is one of the most common reasons why people schedule a doctor’s visit, especially during cold and flu season. It’s just a cough with no other symptoms. No runny nose. No headaches. But it won’t go away. Could it be lung cancer? Tuberculosis? Here are some possible causes for your cough, what you can do about them, and when it’s time to see a doctor.
What is a nagging cough?
A nagging cough is often a persistent dry cough—one that’s mostly annoying (where you aren’t coughing up much junk) and has been around for more than 3 weeks. A dry cough is often the symptom that hangs around after the rest of your cold or flu symptoms have resolved.
What are the most common causes?
To narrow down what may be causing your cough, first ask yourself these 2 questions:
- Do I smoke cigarettes, or did I in the past?
- Have I had a chest X-ray done? If so, was there anything wrong with it? Coughs lasting more than 8 weeks should be evaluated by a doctor, and a chest X-ray should be performed.
If you answered “no” to both of these questions, 99% of the time, one of the following 5 reasons is behind your chronic cough. If you answered “yes,” you should make an appointment with your healthcare provider.
1) Reactive airway disease after a cold or flu
At the end of cold and flu season, this is the most common cause of a lingering dry cough. It occurs after an acute upper respiratory illness like a cold, and though it may stick around, it will go away without specific therapy. Airway inflammation after infection causes the airways to be hyper-responsive and twitchy, making you cough.
2) Post-nasal drip (also known as upper airway cough syndrome)
Post-nasal drip syndrome, which often occurs with chronic rhinitis (stuffy nose), is now known as “upper airway cough syndrome.” Signs that this may be the cause of your cough: the sensation of liquid dripping down the back of your throat, always having to clear your throat, and nasal discharge. Over-the-counter nasal sprays like Flonase or Nasacort may help solve it.
3) Asthma with cough (also known as cough-variant asthma)
Asthma normally includes other symptoms, such as wheezing, difficulty breathing, and chest pain. But sometimes, the only symptom is coughing. Asthma-related coughing may follow an upper respiratory infection and worsen with exposure to cold temperatures or certain allergens (like dust or certain fumes). If your healthcare provider suspects this, they may recommend an oral inhaler.
4) Acid reflux or GERD
Acid reflux or gastroesophageal reflux disease (GERD) is a common cause of persistent dry cough. It’s unclear why GERD can make you cough, but the cough may be caused by a reflex or protective measure in response to stomach contents in your voice box or esophagus (the tube that connects your stomach to your throat). For many people, cough due to reflux will NOT come with heartburn or a sour taste in your mouth. A 2-week course of a GERD medication such as lansoprazole, pantoprazole, omeprazole, or esomeprazole may solve your cough if this is the cause.
5) Medication side effect
ACE inhibitor medications are well-known culprits of a persistent dry cough. ACE inhibitors are a group of drugs that treat high blood pressure, heart disease, diabetes, and other diseases. Popular ACE inhibitors include lisinopril, benazepril, captopril, and enalapril. If these medications are causing your cough, talk to your provider. Your next course of action might be to switch medications. However, do NOT stop taking your ACE inhibitor until your doctor says you can safely do so.
What is not a likely cause of persistent dry cough?
Here are the dangerous things patients often worry about when they have a cough that doesn’t go away. And here’s why you probably don’t need to lose sleep over them.
- Lung cancer. Studies have found that in cases of persistent coughs, lung cancer is the cause in less than 2% of them. A history of smoking is the biggest risk factor for lung cancer. Weight loss, difficulty breathing, coughing up blood—these are the serious warning signs of lung cancer (not a cough).
- Pulmonary embolism. A pulmonary embolism (PE) is when a blood clot in the deep veins of your legs dislodges, travels up your body, and gets stuck in your lungs. It will cause difficulty breathing, shortness of breath, and chest pain. If you just have a dry cough, that’s very very unlikely to be a sign of PE.
- Tuberculosis. Cough can be one of the symptoms if your lungs get infected with tuberculosis (TB), but you won’t get that alone. If you have TB, you’ll also likely have night sweats, sudden weight loss, and low-grade fevers. You won’t feel good at all.
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Final note: If you have a chronic cough along with fever, shortness of breath (difficulty breathing), chest pain, weakness, and/or nausea and vomiting, it is NOT a persistent dry cough. That’s a different story. See your provider if this is the case.
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Cough Due to Cold or Flu
What causes a cough?
There are many things that could cause a cough. Typically, coughing occurs when the nerve endings in your airways become irritated. This could be due to a viral infection resulting in the cold or flu. When foreign invaders enter your airways, the body reflexively responds with a cough to clear your airways and protect your lungs.
How long does a cough last?
The length of your cough primarily depends on the causes of your cough. An acute cough (one that’s caused by the common cold or an upper respiratory infection) should last less than three weeks. If your cough lasts more than 7 days, comes back or occurs with fever, rash or headache that lasts, you should call your doctor.
How Can I Treat A Cough?
The best way to treat a cough is to first identify what type of cough you have. If your cough brings up phlegm, you likely have a wet or chesty cough. To treat a wet cough, you can use an over-the-counter medication like DayQuil Cough & Congestion that contains an expectorant to help thin mucus and make your cough more productive. If you have a dry cough (it doesn’t bring up phlegm), look for an over-the-counter medication. NyQuil Cough offers you powerful cough relief so you can get the sleep you need, while DayQuil Cough gives you up to eight hours of non-drowsy cough relief so you can have a productive day. Both contain dextromethorphan, which helps reduce the frequency/intensity of the coughing.