Cough

Cough

Is this your symptom?

  • A cough is dry if there is little to no clear-white phlegm
  • A cough is wet if there is yellow, green, or brown phlegm

Some Basics...

  • A cough is a very common symptom. It is one of the top reasons for people to visit their doctor.
  • Coughing helps to protect lungs from infection. It helps to keep the throat and airways clear.
  • Short-term coughs are often caused by a cold. These coughs last less than 3 weeks. They can be treated at home.
  • A cough that lasts for more than 3 weeks may have a more serious cause. Smokers may have a long-term cough, mainly in the morning.

Causes

  • Most common causes: Postnasal drip from a cold, allergies, and sinusitis.
  • Other common causes: Asthma, bronchitis, pneumonia, gastroesophageal reflux, and smoking.
  • Less common causes: Lung cancer, congestive heart failure, pulmonary embolism, TB, Whooping Cough, and ACE inhibitor drugs. ACE inhibitors can cause a dry long-term cough.

How is a Cough Helpful for the Body?

  • Cough clears the airways of infection, foreign bodies, and other irritants.
  • It helps protect people from choking on oral and stomach contents.

Does Honey Help Treat a Cough?

  • Recent Research Study: A recent study compared honey to the drug dextromethorphan (DM). It showed that honey worked better. Honey scored better in decreasing cough frequency and severity. It also helped people to sleep better. DM scored little better than no treatment at all.
  • How Might Honey Work? Honey causes reflex salivation and airway secretions. These fluids may coat the airway. They also remove the tickle that causes a dry cough.
  • Adult Dose: Take 2 teaspoons (10 ml) at bedtime.

When to Call for Cough

Call 911 Now

  • Passed out (fainted)
  • Severe trouble breathing (struggling for each breath or cannot speak)
  • Lips or face are blue
  • Wheezing starts right after a bee sting, taking medicine, or eating an allergic food
  • Trouble breathing after being near flames, smoke, or fumes
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Wheezing
  • Coughing up more than a few streaks of blood
  • Fever over 103° F (39.4° C)
  • Fever over 100.4° F (38.0° C) and over 60 years old
  • Fever and have diabetes
  • Fever and have a weak immune system from:
    • HIV
    • Cancer chemo
    • Long-term steroid use
    • Splenectomy
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
  • Ankle swelling that is getting worse
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Severe coughing spells (whooping sound or vomit after coughing)
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Sinus pain (not just pressure) and fever
  • Known COPD or other severe lung disease (bronchiectasis, cystic fibrosis, and lung surgery) and symptoms are getting worse
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Coughing up blood
  • Coughing keeps you from working or going to school
  • Runny nose lasts more than 10 days
  • Symptoms of nasal allergy are also present (itchy eyes, clear nasal discharge, postnasal drip)
  • Taking an ACE inhibitor drug (benazepril/LOTENSIN, captopril/CAPOTEN, enalapril/VASOTEC, lisinopril/ZESTRIL)
  • Exposed to TB
  • Cough lasts more than 3 weeks
  • You have other questions or concerns

Self Care at Home

  • Cough with no other problems
  • Cough with cold symptoms (runny nose, postnasal drip, or throat clearing)

Care Advice

Mild to Moderate Cough

  1. What You Should Know:
    • Coughing helps to protect lungs from infection. It also helps to keep the throat and airways clear.
    • Short-term coughs are often caused by a cold. These coughs last less than 3 weeks.
    • You can treat most short-term coughs at home.
    • Here is some care advice that should help.
  2. Cough Medicines:
    • Over-the-Counter (OTC) Cough Syrups: Some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters "DM" appear in the name.
    • OTC Cough Drops: Cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.
    • Home Remedy - Hard Candy: Hard candy works just as well as OTC cough drops. Diabetics should use sugar-free candy.
    • Home Remedy - Honey: Honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 ml) at bedtime.
  3. OTC Cough Syrup - Dextromethorphan (DM):
    • Cough syrups with DM in them may help your cough. Cough syrups work best for coughs that keep you awake at night. They can help with a dry, hacky cough at the end of a cold or flu. They can be used along with cough drops.
    • Examples: Benylin, Robitussin DM, Vicks 44 Cough Relief
    • Read the instructions on the package insert for all medicines that you take.
  4. Caution - Dextromethorphan (DM):
    • Do not try to stop coughs if you are coughing up phlegm. Coughing is helpful in bringing up mucus from the lungs. This helps keep you from getting pneumonia.
    • Research Notes: Some research shows DM helps a cough get better. Other research shows it has little to no effect.
    • Drug Abuse: DM has become a drug of abuse.
    • Do not take DM if you have taken a MAO inhibitor in the past 2 weeks. These include: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
    • Do not take this drug if you are taking venlafaxine (Effexor).
  5. Coughing Spasms:
    • Drink warm fluids. Breathe in warm mist. This will relax your airway and loosen up the phlegm.
    • Suck on cough drops or hard candy to coat your throat.
  6. Stay Well Hydrated:
    • Drink plenty of liquids.
    • This will help soothe your throat and loosen up the phlegm.
  7. Avoid Smoking: Smoking or being exposed to smoke makes coughs much worse.
  8. Fever Medicine:
    • For fevers above 101° F (38.3° C) take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
    • They are over-the-counter (OTC) fever drugs. You can buy them at the drugstore.
    • The goal for treating fever is to bring it down to a comfortable level.
    • Fever medicine usually lowers fevers by 2° F (1 - 1.5° C).
    • Use the lowest amount of a drug that makes your fever get better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  9. What to Expect: Viral colds cause a cough that lasts 1-3 weeks. Sometimes you may cough up lots of phlegm. The phlegm can be white, gray, yellow, or green.
  10. Call Your Doctor If:
    • Trouble breathing
    • Cough lasts more than 3 weeks
    • Fever lasts more than 3 days
    • You think you need to be seen
    • You get worse

Cough with Cold Symptoms

  1. What You Should Know:
    • Colds are very common and may make you feel uncomfortable.
    • Colds are caused by viruses. They cannot be cured with a drug or shot. Antibiotics do not help.
    • Colds are usually not serious. Most colds can be treated at home.
    • Here is some care advice that should help.
  2. For a Stuffy Nose - Use Nasal Washes:
    • Salt water washes are a good way to treat a stuffy nose. You can pour, spray, or squirt salt water into your nose. Then let the water run back out.
    • How It Helps: The salt water rinses out mucus, dust, and allergens. It also keeps the nose moist.
    • Methods: There are a few ways to do nasal washes. You can use a:
      • Saline nasal spray bottle (sold at drugstores)
      • Rubber ear syringe
      • Medical syringe without the needle
      • Neti Pot
    Step-By-Step Instructions:
    • Step 1: Lean over a sink.
    • Step 2: Gently squirt or spray warm salt water into one of your nostrils.
    • Step 3: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water, it will not hurt you.
    • Step 4: Blow your nose to clean out the water and mucus.
    • Step 5: Repeat steps 1-4 for the other nostril. Do this 2 or 3 times a day if it helps you.
    How to Make Salt Water Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add ½ tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.
  3. For a Very Runny Nose: Blow the Nose.
    • Runny noses help to wash viruses and bacteria out of the nose.
    • Blowing the nose is all that is needed.
    • The skin around your nostrils may get irritated. You can rub a tiny amount of petroleum ointment on it 1 to 2 times a day.
  4. Medicines for a Stuffy or Runny Nose:
    • Most cold drugs that are sold over-the-counter (OTC) are not helpful.
    • Antihistamines are only helpful if you also have nasal allergies.
    • If you still think you need medicine, try using a nasal decongestant.
  5. Nasal Decongestants for a Very Stuffy or Runny Nose:
    • Nasal decongestants can help you breathe better. They reduce the amount of nasal drainage. They may be taken as pills by mouth or as a nasal spray.
    • Most people do NOT need to use these medicines.
    • Pseudoephedrine (Sudafed): This is sold OTC, but it is kept behind the drug store counter. You will need to ask the pharmacist or clerk for it. Normal adult dose is two 30 mg tablets every 6 hours.
    • Phenylephrine (Sudafed PE): This is sold OTC in pill form. Normal adult dose is one 10 mg tablet every 4 hours.
    • Oxymetazoline Nasal Drops (Afrin): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Phenylephrine Nasal Drops (Neo-Synephrine): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Read the instructions on the package insert for all medicines you take.
  6. Caution - Nasal Decongestants:
    • Do not take these drugs if you have high blood pressure, heart disease, an enlarged prostate, or an overactive thyroid.
    • Do not take these drugs if you are pregnant.
    • Do not take these drugs if you have taken a MAO inhibitor drug in the past 2 weeks. Life-threatening side effects can happen. Examples of MAO drugs include isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
    • Do not use nasal decongestants for more than 3 days.
  7. Fever and Pain Medicine:
    • For fever above 101° F (38.3° C) or pain you can take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
    • They are over-the-counter (OTC) drugs. You can buy them at the drugstore.
    • The goal for treating fever is to bring it down to a comfortable level.
    • Fever medicine usually lowers fevers by 2° F (1 - 1.5° C).
    • Use the lowest amount of a drug that makes your fever or pain feel better.
    • Acetaminophen is safer than ibuprofen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  8. How It Is Spread:
    • The cold virus is in your nasal secretions.
    • Cover your nose and mouth with a tissue when you sneeze or cough.
    • Wash your hands often with soap and water.
    • You can return to normal activities after your fever is gone. This includes work and school.
  9. What to Expect:
    • Fever may last 2 to 3 days.
    • Runny nose may last 3 to 7 days.
    • Cough may last 2 to 3 weeks.
  10. Call Your Doctor If:
    • Trouble breathing occurs
    • Fever lasts more than 3 days
    • Runny nose lasts more than 10 days
    • Cough lasts more than 3 weeks
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 7/24/2017 1:11:36 AM
Last Updated: 5/7/2017 1:36:01 PM

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