What is a Cough?
A cough is the body’s way of expelling irritants from within the body. When something causes irritation to the throat or airway, the body’s nervous system sends an alert to the brain. The brain responds by sending messages to the muscles in the chest and abdomen (stomach region) to squeeze together, forcing out a burst of air which is what we know as a cough.
Coughing is a reflex, meaning that it usually occurs without the person having to tell his or her body to do so. This reflex aids in protecting the body from irritants such as mucus, smoke, and allergens, such as dust and mould. Occasionally, coughing may also occur due to an obstruction blocking the airway. This could lead to choking, and is typically accompanied with bluish skin, wheezing, and panic.
Coughing can also be a symptom of many different kinds of illnesses. An occasional cough is normal and healthy. However, a cough which lasts for several weeks, or brings up discoloured or bloody mucus from the insides of the body, may indicate a more severe condition which would require further medical attention.
How a cough appears can help to identify its cause. A cough can be described by the following:
- Characteristics: How does the cough sound and feel?
- Timing: Does the cough happen at night, after eating, or during exercise?
- When and why the cough happens: This could help identify a pattern behind the cough and find out the cause of it.
- Length of duration of cough: How long does the cough last?
- Co-occurring symptoms: Is the cough accompanied by any other symptoms?
- Grade of cough: How severe is the cough?
What Causes Cough?
Most coughs are caused by colds or flu, which are viral and bacterial infections. Sometimes they can be caused by allergies or environmental irritations like cold air or smoke.
Depending on the length of duration of how long the cough persists, coughs can be categorised into acute (less than three weeks) or chronic (more than eight weeks, or more than four weeks in children). Some causes of acute or chronic coughs are as below:
- Common cold Influenza (flu)
- Inhaling an irritant (such as smoke, dust, chemicals or a foreign body)
- Whooping cough
- Asthma (most common in children)
- Gastroesophageal reflux disease (GERD)
- Postnasal drip
There are other causes of cough, but are more unlikely as compared to the causes listed above. Do check with a doctor if there are any concerns with coughing.
- Acute sinusitis (nasal and sinus infection)
- Bronchiectasis (a chronic lung condition in which abnormal widening of bronchial tubes inhibits mucus clearing)
- Bronchiolitis (especially in young children)
- Choking: First aid (especially in children)
- Chronic sinusitis
- COPD (chronic obstructive pulmonary disease) exacerbation — worsening of symptoms
- Coronavirus disease 2019 (COVID-19)
- Croup (especially in young children)
- Cystic fibrosis
- Heart failure
- Lung cancer
- Medications called angiotensin-converting enzyme (ACE) inhibitors
- Neuromuscular diseases that weaken the coordination of upper airway and swallowing muscles
- Pulmonary embolism (blood clot in an artery in the lung)
- Respiratory syncytial virus (RSV) — especially in young children
- Sarcoidosis (collections of inflammatory cells in the body)
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Types of Cough
There are several types of cough, based on their characteristics. Knowing the different types of coughs could help to inform about possible causes and conditions for the cough. This would help in seeking appropriate treatment.
This cough does not bring up mucus, and may feel like tickling at the back of the throat. It usually happens due to inflammation in the respiratory tract, but with no excess mucus to cough it up. It usually happens in upper respiratory tract infections. Dry cough can be a symptom of COVID-19 as well.
This is a cough which brings up mucus, and is also known as a productive cough. This type of cough is commonly seen in colds and flus.
A whooping cough is caused by a bacterial infection, which results in a violent coughing fit. The lungs release all the air from within, and this results in sharp inhalations causing the ‘whooping’ sound. Whooping coughs could lead to paroxysmal coughing, which is characterised by intermittent attacks of violent, uncontrollable coughing.
Caused by a viral infection known as croup, a croup cough has a ‘barking’ quality, making it sound like a seal. Croup is a viral infection which normally affects children below five years, and it causes the upper airway to become irritated and swollen, making it difficult to breathe.
Coughing may occur if someone has something stuck in their airway, and the body is trying hard to get rid of the object. Severe choking will result in a coughing without sound.
Chronic cough (cough for prolonged period)
A cough which lasts longer than eight weeks may signal an underlying disease and medical advice should be promptly sought.
When to See a Doctor?
Usually, a cough does not warrant a trip to the doctor. Going to the doctor for a cough would depend on the type of cough and how long it has lasted, and a person’s age and health. If a child or adult has any of the below symptoms with their cough, it is advisable to bring them to see a doctor, either at a clinic or from the comfort and safety of home.
- Coughing up thick, greenish-yellow phlegm
- Shortness of breath or difficulty breathing
- Ankle swelling or weight loss
- Change in skin colour, like bluish or pale skin
- Cough is interfering a lot with child’s sleep or daily life
Seek emergency care if the person is:
- Choking or vomiting
- Having difficulty breathing or swallowing
- Coughing up bloody or pink-tinged phlegm
- Experiencing chest pain
The doctor will try to find out the cause of the cough by asking questions about how the cough started, when it started, and any other symptoms. A physical examination will usually be done.
For a persistent cough which lasts longer than a few weeks and is caused by a viral infection, the doctor may order some tests, such as a chest x-ray or blood tests to determine whether there may be anything present in the lungs, or any infections contributing to the cough.
If the cause of the cough is a common cold or flu, the general medical advice given is to rest, drink lots of fluids, and let the cold or flu run its course. There may also be some medicines prescribed for cold or flu to relieve the illness. Usually such cases clear up after one to two weeks without medical intervention.
If the cause of the cough is something other than cold or flu, treatment will focus on treating the underlying cause of the cough. For example, if the cough is caused by an allergic reaction, treatment may focus on avoiding such allergens.
Self Remedies for Cough: Cough Medications and General Care Tips
Over-the-counter cough and cold medication are intended to treat the symptoms of coughs and colds, and not the actual cause of what is causing them in the individual. Also, they may cause serious side effects in young children, including fatal overdoses in children younger than two years. Over-the-counter medicine should be used only for children older than six years old. For children under six, fever reducers and pain relievers to treat coughs and colds can be used if appropriate. Always consult a doctor if unsure whether the over-the-counter medication is suitable for a child.
Cough medication is used only when cough causes a lot of discomfort and interferes with sleep. If cough occurs with any of the symptoms as mentioned above in When To See A Doctor, it is advisable to see a doctor and have it examined. Make sure to follow the dosage instructions when taking cough medications. Medications such as cough suppressants, which suppress the cough reflex and are usually prescribed for a dry cough, or cough expectorants, which help to bring up mucus and other substances from the respiratory tract to clear the body, can be prescribed as well depending on the type of cough. Such cough medications are available online and can be delivered to home.
Try some of the below tips to help ease coughing:
Suck Cough Drops or Hard Candies
These could ease a dry cough or soothe an irritated throat. Do not give them to a child under six, as they may choke.
Consider Taking Honey
A teaspoon of honey may help loosen a cough. Honey is not suitable for infants younger than one years of age as honey can contain bacteria which is harmful to infants.
Moisturize the Air
Use a cool mist humidifier or take a steamy shower.
Liquid helps thin the mucus in your throat. Warm liquids, such as broth tea or lemon juice, can soothe your throat.
Avoid Tobacco Smoke
Smoking or breathing secondhand smoke can make your cough worse.
Avoiding Potential Triggers
If the cause of the cough is allergies or asthma, it is advisable to remove potential allergens, like keeping pets out of bedrooms, or using an air filter to filter out possible allergens in the air. There may not be immediate effects, but gradually, the frequency of coughing may reduce as one decreases the exposure to allergens.
Now that you know the different remedies for cough and the different care tips, it is always safe to be more aware of the signals that your body is giving. Even as simple as a cough, is something that one should not ignore. Be more aware of your body signals and if it’s telling you something else, don’t hesitate to see a doctor. Remember, health is always a source of wealth.
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- Government of Singapore (n.d.). Cough. Cough – Baby Bonus. Retrieved June 3, 2021, from https://babybonus.msf.gov.sg/parentingresources/web/Babies/BabiesIllness/BabiesAllergies/Babies_Cough?_adf.ctrl-state=65mg46v6g_4&_afrLoop=63692458776500820&_afrWindowMode=0&_afrWindowId=null#%40%3F_afrWindowId%3Dnull%26_afrLoop%3D63692458776500820%26_afrWindowMode%3D0%26_adf.ctrl-state%3Duj7dqzq74_4
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- WebMD. (2012, August 6). Why You Cough. https://www.webmd.com/cold-and-flu/overview