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 two types of cough:
A chronic cough can be caused by many factors. Common examples include:
A risk factor is something that increases your chance of getting a disease or condition.
The main risk factor for cough is being exposed to irritants, for example:
Exposure to viral and bacterial infections affecting the respiratory tract also increases the risk of cough. Smoking is a major risk for serious conditions linked to chronic cough including lung cancer and chronic bronchitis .
A cough may sometimes be worse when waking up and during the night while lying down.
Acute and chronic coughs are symptoms of an underlying condition or disease. Many acute coughs do not require medical attention unless they fail to resolve or become progressively worse. A chronic cough, however, is a sign that you should seek medical care.
More serious symptoms that may require prompt medical attention include coughs accompanied by:
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Acute cough is usually diagnosed by its accompanying symptoms.
In the diagnosis and assessment of chronic cough, your doctor will look for symptoms and signs that suggest an underlying cause. Tests may include:
The best treatment for a cough is to treat the responsible underlying condition. A cough can also be treated with medications that either:
In a Public Health Advisory, the Food and Drug Administration (FDA) recommends that over-the-counter (OTC) cough and cold products should not be used to treat infants or children less than two years old. Rare but serious side effects have been reported, including death, convulsions, rapid heart rates, and decreased levels of consciousness. OTC cough and cold products include decongestants, expectorants (to make cough more productive), antihistamines, and antitussives (cough suppressants). The FDA is still reviewing data concerning the safety of these products in children aged 2-11 years. There have been serious side effects reported in this age group as well. * 1
A wet cough, which produces sputum, is an important way for your body to clear secretions from the airways. Wet coughs should not be suppressed, but may need to be made more productive. They may be treated with expectorant medications. These medications help thin bronchial secretions and make them looser and easier to cough up.
Guaifenesin is the best known expectorant and is found in a variety of over-the-counter cough and cold products (Robitussin, for example).
Moisture therapy also helps make secretions looser and easier to cough up. This therapy involves adding moisture to air with a steam vaporizer or cool-mist humidifier.
Medications are used to suppress a cough when it is:
Examples of cough suppressants include:
Honey has also been studied. This natural remedy appears to improve nighttime cough and sleep disruption in children. Note: Do not give honey to infants younger than 12 months because of the risk of infant botulism. * 2
If you are diagnosed with a cough, follow your doctor's instructions .
To help avoid a cough:
American Academy of Family Physicians
American Lung Association
The Canadian Lung Association
American Academy of Family Physicians website. Available at: http://www.aafp.org .
American College of Chest Physicians website. Available at: http://www.chestnet.org .
The Merck Manual of Medical Information (online version). 2nd ed. 2005.
* 1 1/30/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 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/cder/drug/advisory/cough_cold_2008.htm . Accessed January 30, 3008.
* 2 1/30/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 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.
Last reviewed November 2008 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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