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Definition

A 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

Causes

An 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:

  • Exposure to an irritant or an allergen
  • Aspiration of a foreign body
  • Acute bronchitis
  • Pneumonia

Subacute cough is often a cough that follows a respiratory infection. It can also be caused by exposure to irritants or to anything that can cause chronic cough.

A chronic cough has many causes. Common examples include:

Alveoli (Air Sacs) of Lung
Chronic Bronchitis
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Risk Factors

Factors that may increase your risk of developing a cough include:

  • Infection
  • Tobacco smoke
  • Noxious fumes
  • Allergens, such as pollen and dust
  • Smog and other environmental pollutants

Smoking is a major risk for serious conditions linked to chronic cough, including lung cancer and COPD.

Symptoms

A 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 your cough is accompanied by:

  • Pink or frothy sputum
  • Trouble breathing
  • Chest pain
  • Rapid heartbeat
  • Swelling in the legs

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Acute cough is usually diagnosed by its accompanying symptoms.

During the diagnosis, your doctor will look for symptoms that suggest an underlying cause. Tests may include:

  • Blood test to check for infection
  • Skin tests if allergies are suspected
  • Analysis of a sputum sample
  • Skin test for tuberculosis
  • Pulmonary function tests—to test lung function and capacity
  • Bronchoscopy—insertion of a long, thin instrument to view the interior of the airways and collect samples

Imaging tests take pictures of internal body structures. These can be done with a chest x-ray or a chest CT scan.

Treatment

The best treatment for a cough is to treat the underlying condition.

Medication

There are many over-the-counter (OTC) cough and cold products available. These include decongestants, expectorants, antihistamines, and antitussives.

Note: Cough and cold medicines in 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 medicines in children ages 2-11 years. Rare, but serious side effects have been reported.

Lifestyle Changes

Consider 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.

If you are diagnosed with a cough, follow your doctor's instructions.

Prevention

To reduce your chances of developing a cough:

  • Talk to your doctor about strategies to quit smoking. Smoking affects your lung function and increases your risk of many diseases.
  • Get proper treatment for the underlying condition.
  • When working in areas where noxious fumes or airborne substances are present:
    • Be sure the area is properly ventilated.
    • Wear a protective mask or respirator.

Revision Information

  • Reviewer: David Horn, MD
  • Review Date: 08/2013 -
  • Update Date: 00/82/2013 -
  • American Academy of Family Physicians

    http://www.familydoctor.org

  • American Lung Association

    http://www.lung.org

  • The Canadian Lung Association

    http://www.lung.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Chronic cough in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated June 10, 2013. Accessed August 26, 2013.

  • Cough. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/cough.html. Accessed August 26, 2013.

  • Coughlin L. Cough: Diagnosis and management. Am Fam Physician. 2007;75(4):567-575.

  • 1/30/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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 19, 2013. Accessed August 26, 2013.

  • 1/30/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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 https://dynamed.ebscohost.com/about/about-us: 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.