How to Diagnose and Treat a Cough

1
What Cough Symptoms Tell You

Woman coughing on the street
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There are many different types of coughs. Each has distinct characteristics which we can use to help identify the cause. A cough may be described as being dry, wet, productive (meaning you cough up mucus and/or sputum), or non-productive. Even the way a cough sounds can give us a pretty good clue as to what is going on.

2
Accompanying Symptoms of a Cough

Woman with the flu
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To further establish the cause of a cough, doctors look at not only the cough but the accompanying symptoms, as well. Together, they paint a clearer portrait of the illness. It is the totality of symptoms that will suggest to doctors which tests are needed to confirm the cause and direct treatment. Examples include:

  • A cough accompanied by fever and chest pain may indicate pneumonia.
  • A cough accompanied by head congestion, fever, shivers, and body aches are the classic features of the flu.
  • A persistent cough with wheezing, shortness of breath, and chest tights are symptom we would see with COPD.
  • A dry cough at night accompanied by bad breath, hoarseness, and a sudden increase in saliva would suggest to a doctor you have GERD.
  • A bloody cough accompanied by fever, night sweats, and weight loss may be suggestive of tuberculosis.

When meeting with a doctor, be sure to list all the symptoms you are experiencing no matter how minor and vague they may seem.

3
Choosing the Right Cough Medication

woman holding cough syrup on a spoon, taking it to improve hostile cervical mucus
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When treating an uncomplicated cough, we will often head to the pharmacy for an over-the-counter remedy. There are two categories of cough medications that you might choose, called expectorants and suppressants.  Their mechanisms of action are different as are their indications of use:

  • Expectorants are designed to help bring up mucus when you cannot clear the congestion with a cough. These are the most useful when you have a wet, non-productive cough.
  • Suppressants relax the cough reflex and are helpful when a cough is starting to cause pain. Suppressants work better for some people than others and are typically recommended at night to help you sleep. 

If you have a productive cough, it is best not to take medications than suppress it. Coughing is the body's normal reaction to any foreign object in the lungs, including dust and mucus.

If you have chest congestion, coughing will help clear lungs, allowing you to heal more quickly. Suppressing it can lead a worsening of symptoms and the development of pneumonia.

4
Other Ways to Help Treat a Cough

humidifier
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A humidifier is a great way to help relieve coughing and break up congestion. This is especially helpful when children have croup. Alternately, you can shut yourself into a steamy bathroom for the same effect.  While humidifiers are handy to have around, be sure to clean them regularly to prevent the growth of bacteria and mildew.

Here are other simple ways to treat a cough:

  • If a cough is related to an allergy, an oral antihistamine ​will often help. Also be sure to avoid any allergy trigger that may instigate or worsen an attack. 
  • Do not add further inflammation to the lungs by smoking. If your cough is related to COPD or any other chronic respiratory condition, it’s not enough just to cut back. You will need to stop.
  • Menthol lozenges can help numb the back of the throat, while hot tea with honey often has a soothing effect on a cough. If your cough is related to GERD, avoid peppermint or spearmint tea or lozenges which can increase acid reflux.
  • Keep yourself hydrated. Dehydration only exacerbates a cough.

5
When to See a Doctor About a Cough

A doctor checks a patient with breathing problems.
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Most uncomplicated coughs due to cold or flu can be treated at home. There are times, however, when a persistent or severe cough warrants a visit to your doctor. Generally speaking, you should see a doctor if:

  • You have a cough that has lasts longer than a week.
  • Your cough is extremely painful.
  • You are coughing up blood.
  • You have a persistent fever of 100 F (38 C) or higher.
  • You are coughing up yellow, tan, or green mucus.
  • You have shortness of breath, wheezing, or chest tightness.
  • You have a history of heart problems.
  • Your cough is accompanied by night sweats.

If, however, you are coughing up pink, frothy mucus or your child is choking and having trouble breathing or swallowing, go to the emergency room immediately.  

Source:

De Blasio, F.; Virchow, J.; Polverino, M.; et al. “Cough management: a practical approach.” BioMed Central. 2011; 7:7.

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