Understand your cough symptoms with Buoy, including 9 causes and common questions concerning your cough.
8 most common cause(s)
Cough symptoms
Your cough mechanism is an ancient inherited safety measure that protects you from inhaling foreign material deep into your lungs. This material may include mucus, smoke, irritants, and toxic vapors. Coughs may be voluntary, like when you have to clear your throat. Coughs may be involuntary and more significant, as with chronic smoking, chronic obstructive pulmonary disease (COPD), colds, flu, allergies, or bronchitis.
Common accompanying symptoms of cough
It's likely to also experience the following with a cough.
- Runny or stuffy nose
- Watery eyes
- Fever
- Heartburn
- Post-nasal drip
- Wheezing
- Mucus/production of mucus
Cough causes
The following details may help you better understand your symptoms and if and when you need to see a physician.
Infectious causes
The following are common causes of cough related to infection.
- Viral infections: The most common cause of a cough is probably the common cold, but many other infections of the upper airways can lead to a cough and require antibiotics to recover. These include bronchitis, sinusitis, and laryngitis. There are also many types of viral pneumonia that cause a cough.
- Bacterial infections: Bronchitis and pneumonia (which is bronchitis gone deeper into the lungs), sinusitis, and laryngitis are also bacterial infections. These infections won't resolve without a doctor's care and medication.
- Influenza: Also a viral infection, the flu can lead to a horrendous cough in some cases.
- Tuberculosis: Fortunately, this infection is relatively rare in America, but is common worldwide and was a leading cause of death in earlier centuries.
- Blood pressure medications: Some blood pressure medications, especially angiotensin-converting enzyme (ACE) inhibitors, can cause a chronic cough.
Inflammatory and allergic causes
The following are the most common causes of cough related to inflammation or allergies.
- Sarcoidosis: This condition is caused by clusters of inflammatory cells that collect in different areas of the body.
- GERD: Gastroesophageal reflux disease (also known as heartburn) causes a cough when acidic fluids rise up into the esophagus from the stomach.
- Post-nasal drip: Coughing can be due to the sinuses dripping into the throat as the body tries to clear the airway.
- Allergies: Allergies are a highly common cause of cough as allergens enter the airways.
- Asthma: This condition often causes wheezing and a cough.
Other cough causes
The following may also cause a cough.
- Foreign bodies: Choking on food or other foreign objects can lead to a violent acute cough.
- Lung cancer: This is a common cause of a persistent cough in smokers, and may also result in blood with your cough.
- Cystic Fibrosis: This genetic disorder of children and young adults leads to recurrent bouts of pneumonia and can cause persistent coughing.
- Chronic obstructive pulmonary disease (COPD): This lung disease is caused by increasing breathlessness and usually causes a persistent, dry cough.
9 cough conditions
This list does not constitute medical advice and may not accurately represent what you have.
Viral throat infection
A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.
Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.
Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.
If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.
Diagnosis is made through physical examination and throat swab.
Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.
The best prevention is frequent and thorough handwashing.
Viral pneumonia
Viral pneumonia, also called "viral walking pneumonia," is an infection of the lung tissue with influenza ("flu") or other viruses.
These viruses spread through the air when an infected person coughs or sneezes.
Those with weakened immune systems are most susceptible, such as young children, the elderly, and anyone receiving chemotherapy or organ transplant medications.
Symptoms may be mild at first. Most common are cough showing mucus or blood; high fever with shaking chills; shortness of breath; headache; fatigue; and sharp chest pain on deep breathing or coughing.
Medical care is needed right away. If not treated, viral pneumonia can lead to respiratory and organ failure.
Diagnosis is made through chest x-ray. A blood draw or nasal swab may be done for further testing.
Antibiotics do not work against viruses and will not help viral pneumonia. Treatment involves antiviral drugs, corticosteroids, oxygen, pain/fever reducers such as ibuprofen, and fluids. IV (intravenous) fluids may be needed to prevent dehydration.
Prevention consists of flu shots as well as frequent and thorough handwashing.
Rarity: Uncommon
Top Symptoms: fatigue, headache, cough, shortness of breath, loss of appetite
Urgency: Primary care doctor
Post-infectious cough
Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.
Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.
Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.
A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.
Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.
Rarity: Uncommon
Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice
Symptoms that always occur with post-infectious cough: cough
Symptoms that never occur with post-infectious cough: fever
Urgency: Phone call or in-person visit
Influenza
Influenza, or "flu," is a contagious respiratory illness caused by viruses. It is spread through the air by coughing, sneezing, or even talking.
Anyone can get the flu, but those who are very young, over 65, and/or have pre-existing medical conditions are most at risk for complications.
Symptoms include fever, chills, cough, sore throat, body aches, and extreme fatigue. The symptoms may appear very suddenly.
Flu can bring on secondary bacterial infections in the lungs or ears. Dehydration is a great concern because the patient rarely wants to eat or drink.
Diagnosis is usually made by symptoms. There are tests that use a swab taken from the nose or throat, but they are not always accurate or necessary.
Treatment consists mainly of good supportive care, which means providing the patient with rest, fluids, and pain-relieving medication such as ibuprofen. Do not give aspirin to children.
Antibiotics cannot help with the flu, since antibiotics only work against bacteria. There are anti-viral medications that a doctor may prescribe.
The best prevention is an annual flu shot.
Rarity: Common
Top Symptoms: fatigue, headache, loss of appetite, cough, muscle aches
Symptoms that never occur with influenza: headache resulting from a head injury
Urgency: Phone call or in-person visit
Common cold
The common cold is a contagious viral infection that can cause cough, congestion, runny nose, and sore throat. Most adults catch two to three colds per year, and kids can get more than eight colds each year.
Rest and drink plenty of fluids. Colds are contagious and can easily spread to other people, so if possible, avoid close contact with others, such as hugging, kissing, or shaking hands. Colds typically resolve within 7 to 10 days.
Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is a progressive inflammation of the lungs that makes breathing difficult. It is caused by long-term exposure to irritating gases and/or dust particles, most often cigarette smoke.
Symptoms may take years to develop. They include a chronic cough with mucus (sputum), wheezing, chest tightness, fatigue, constant colds, swollen ankles, and cyanosis (blue tinge to the lips and/or fingernails.) Depression is often a factor due to reduced quality of life.
Treatment is important because there is a greater risk of heart disease and lung cancer in COPD patients. Though the condition cannot be cured, it can be managed to reduce risks and allow good quality of life.
COPD is commonly misdiagnosed and so careful testing is done. Diagnosis is made through patient history; physical examination; lung function tests; blood tests; and chest x-ray or CT scan.
Treatment involves quitting smoking and avoiding exposure to other lung irritants; use of inhalers to ease symptoms; steroids; lung therapies; and getting influenza and pneumonia vaccines as recommended.
Rarity: Common
Top Symptoms: fatigue, cough and dyspnea related to smoking, cough, shortness of breath, trouble sleeping
Symptoms that always occur with chronic obstructive pulmonary disease (copd): cough and dyspnea related to smoking
Symptoms that never occur with chronic obstructive pulmonary disease (copd): rectal bleeding
Urgency: Primary care doctor
Bronchitis
Bronchitis is an inflammation of the bronchial tubes, the tiny airways in the lungs.
Acute bronchitis, or "chest cold," comes on suddenly and is caused by the same virus that causes the flu or the common cold. Chronic lasts at least three months and recurs over two years. It is caused by cigarette smoking and/or exposure to other pollutants.
Other risk factors are a weakened immune system and gastric reflux (heartburn.)
Symptoms include cough with clear, greenish, or yellowish mucus; fatigue; mild headache; body aches; shortness of breath; low-grade fever; chest discomfort.
Acute bronchitis can lead to pneumonia. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD) and requires medical treatment.
Diagnosis is made with chest x-ray and sputum test.
Acute bronchitis lasts 7 to 10 days and needs good supportive care – rest, fluids, and over-the-counter pain relievers. Antibiotics do not work against viral illness.
Chronic bronchitis is treated with lifestyle changes – especially smoking cessation – and an inhaler or other lung medication.
Flu shots, frequent handwashing, and not smoking are the best prevention.
Bacterial pneumonia
Bacterial pneumonia is an infection of the lungs caused by one of several different bacteria, often Streptococcus pneumoniae. Pneumonia is often contracted in hospitals or nursing homes.
Symptoms include fatigue, fever, chills, painful and difficult breathing, and cough that brings up mucus. Elderly patients may have low body temperature and confusion.
Pneumonia can be a medical emergency for very young children or those over age 65, as well as anyone with a weakened immune system or a chronic heart or lung condition.
Complications may include organ failure and respiratory failure. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through blood tests and chest x-ray.
With bacterial pneumonia, the treatment is antibiotics. Be sure to finish all the medication, even if you start to feel better. Hospitalization may be necessary for higher-risk cases.
Some types of bacterial pneumonia can be prevented through vaccination. Flu shots help, too, by preventing another illness from taking hold. Keep the immune system healthy through good diet and sleep habits, not smoking, and frequent handwashing.
Rarity: Common
Top Symptoms: fatigue, cough, headache, loss of appetite, shortness of breath
Symptoms that always occur with bacterial pneumonia: cough
Urgency: In-person visit
Cough treatments and relief
You should seek care if your cough worsens or persists. You and your physician can determine the best treatment plan.
At-home treatments
There are many home treatments for cough symptoms you can try, such as the following.
- Elevate the head and neck to help prop open airways
- Steam inhalation over a steam bath: Steam helps open the airways and can bring relief.
- Humidifiers: Humidifiers prevent the airways from drying out and can help soothe a cough.
- Hydrate: Fluids help moisturize the airways and can soothe a cough. Staying hydrated can also keep mucus thinner and easier to clear.
- Try hot tea with lemon or honey
- Cough syrups and drops: These can be purchased over-the-counter and bring many people great relief.
- Avoid exposure to allergens and irritants: Close your windows when there is a high content of allergens in your area/environment.
- Antibiotics: In the event you have a viral or bacterial infection, which your doctor can diagnose, a short course of antibiotics or other medications is often needed.
- Cough Syrups: Products like dextromethorphan can help suppress your cough.
- Steam Inhalers: Using a steam inhaler can help soothe your throat and open up your airways.
- Lozenges: Throat lozenges with menthol can provide temporary relief for a sore throat and cough.
When to see a doctor
Any cough that lasts more than a week or two, especially if you have bloody mucus, should be evaluated by a doctor. Your doctor can help you manage a chronic cough, and you may be given antibiotics to clear the bacterial or viral.
When it is an emergency
If you are experiencing a fever, nausea, and vomiting, are experiencing shortness of breath or chest pain, or are coughing up significant amounts of blood, you should seek emergency care. If someone is choking, you need to act fast:
- Call 911 first and immediately
- Perform the Heimlich maneuver: Press your thumb firmly into the area under the ribs and up, hard.
- If necessary, perform CPR
FAQs about cough
What causes a persistent cough?
An acute cough lasts less than three weeks; subacute lasts three to eight weeks, and chronic goes on for more than eight weeks. A persistent cough — one that does not go away — is either subacute or chronic. It may be due to post-nasal drip, acid reflux (also known as GERD), asthma, side effects of certain drugs, especially ACE inhibitors, infections, an aspirated foreign body, a tumor, or a variety of lung disorders.
Why do we cough?
Coughing can be both voluntary and involuntary. Involuntary coughing is an automatic protective reflex intended to clear the large airways. It occurs when receptors in the respiratory tract and, occasionally, other surrounding organs are irritated. The irritant can be an allergy, a foreign body, an infection, a chemical such as acid reflux, or even a change in temperature such as sudden exposure to cold air.
Is excessive coughing dangerous?
Excessive coughing may cause throat irritation, vomiting, and pain in the chest or rib muscles. Less frequently, excessive coughing can cause exhaustion, dizziness, and incontinence. Rib fractures may occur, especially in women with decreased bone density (osteoporosis). If your cough brings up any blood, you need immediate medical attention.
What is a dry cough?
A dry cough is also called a nonproductive cough. Dryness means little or no mucus or phlegm is present when you cough. Causes of dry cough include viral infections such as influenza, allergies, irritants such as tobacco smoke, other air pollutants, acid reflux (GERD), asthma, and other lung disorders.
Questions your doctor may ask about cough
- Any fever today or during the last week?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Does your cough produce phlegm?
- Do you have a sore throat?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
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- Lasserson D, Mills K, Arunachalam R, Polkey M, Moxham J, Kalra L. Differences in motor activation of voluntary and reflex cough in humans. Thorax. 2006;61(8):699-705. NCBI Link
- Bishop S. Cough That Lasts May Be Sign of Underlying Problem. Mayo Clinic News Network. Published April 6, 2012. Mayo Clinic Link
- Cough Symptoms, Causes and Risk Factors. American Lung Association. Updated March 13, 2018. American Lung Association Link
- Dicpinigaitis PV. Angiotensin-converting enzyme inhibitor-induced cough: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):169S-173S. PubMed Link
- Pulmonary Sarcoidosis. Cedars-Sinai. Cedars-Sinai Link
- Overview: Cystic Fibrosis. National Health Service. Reviewed Feb. 13, 2018. NHS Link