DefinitionA cough is a sudden expulsion of air from the lungs. Its purpose is usually to clear secretions and inhaled foreign substances from the lungs and respiratory tract. There are different types of cough:
- Acute cough—lasts for less than three weeks
- Subacute cough—lasts 3-8 weeks
- Chronic cough—lasts longer than eight weeks
CausesAn acute cough is usually caused by an infection, such as a cold or flu. In some cases, an acute cough can be the sign of other conditions, such as:
- Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis or emphysema
- Acid reflux from the stomach into the esophagus, a condition called gastroesophageal reflux disease (GERD)
- Postnasal drip, which may be due to:
- Repeated inhalation of environmental irritants
- Sinus inflammation
- Certain medications, such as ACE inhibitors
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Risk FactorsFactors that may increase your risk of developing a cough include:
- Tobacco smoke
- Harmful fumes
- Allergens, such as pollen and dust
- Smog and other environmental pollutants
SymptomsA cough can be a symptom of an underlying condition.Coughs can be productive or dry. You may find that your cough is worse when waking up and during the night while lying down.
When Should I Call My Doctor?Call your doctor if you have:
- Acute cough that worsens or does not go away on its own
- Cough lasting more than eight weeks
- Signs of an infection, including fever and chills
- Cough with wheezing
- Blood in the sputum
When Should I Call for Medical Help Immediately?Call for medical help or go to the emergency room right away if you have cough with:
- Pink or frothy sputum
- Trouble breathing
- Chest pain
- Rapid heartbeat
- Swelling in the legs
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done.Acute cough is usually diagnosed by its accompanying symptoms.Your bodily fluids may be tested. This can be done with:
- Blood tests
- Skin tests
- Analysis of a sputum sample
TreatmentThe best treatment for a cough is to treat the underlying condition.
MedicationThere are many over-the-counter (OTC) cough and cold products available. These include decongestants, expectorants, antihistamines, and antitussives.Note: Cough and cold medications should not be used in children under 2 years old, and they are not recommended in children under 4 years old. The US Food and Drug Administration has not completed its review regarding the safety of over-the-counter cough and cold medications in children ages 2-11 years. Rare, but serious side effects have been reported.
Lifestyle ChangesConsider putting a steam vaporizer or cool-mist humidifier in your room. This type of moisture therapy may help to make secretions looser and easier to cough up.
PreventionTo reduce your chances of developing a cough:
- If you smoke, talk to your doctor about strategies to quit. Smoking affects your lung function and increases your risk of many diseases.
- Get proper treatment for the underlying condition.
- When working in areas where harmful fumes or airborne substances are present:
- Be sure the area is properly ventilated.
- Wear a protective mask or respirator.
Family Doctor—American Academy of Family Physicians
American Lung Association
The Canadian Lung Association
Chronic cough in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 18, 2014. Accessed September 17, 2014.
Cough. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/cough.html. Accessed September 17, 2014.
Coughlin L. Cough: Diagnosis and management. Am Fam Physician. 2007;75(4):567-575.
1/30/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Public health advisory:Nonprescription cough and cold medicine use in children—FDA recommends that over-the-counter (OTC) cough and cold products not be used for infants and children under 2 years of age. US Food and Drug Administration website. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm051137.htm. Updated August 20, 2013. Accessed September 17, 2014.
1/30/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med. 2007;161:1149-1153.
11/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Smith S, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev. 2010;(9):CD001831.
- Reviewer: David Horn, MD
- Review Date: 08/2014
- Update Date: 09/17/2014