Cough

Common causes of coughing are:

• Allergies that involve the nose or sinuses
• Asthma and COPD (emphysema or chronic bronchitis)
• The common cold, flu, and other viral infections
• Lung infections such as pneumonia or acute bronchitis
• Sinusitis with postnasal drip
• Gastroesophageal reflux disease (GERD)

Other causes include:

• ACE inhibitors or less often ARB medicines used to treat high blood pressure, heart failure, or kidney diseases
• Cigarette smoking or exposure to secondhand smoke (or smoking other substances like marijuana)
• Lung cancer
• Lung disease such as bronchiectasis, cystic fibrosis, or interstitial lung disease
• Sometimes no specific cause is found

Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder.

Some coughs are dry. Others are productive. A productive cough is one that brings up mucus. Mucus is also called phlegm or sputum.

Coughs can be either acute or chronic:

• Acute coughs usually begin rapidly and are often due to a cold, flu, or sinus infection. They usually go away after 3 weeks.
• Subacute coughs last 3 to 8 weeks.
• Chronic coughs last longer than 8 weeks.

Chung KF, Mazzone SB. Cough. In: Broaddus VC, King TE, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 37.

Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 77.

The provider will perform a physical exam. You will be asked about your cough. Questions may include:

• When the cough began
• What it sounds like
• If there is a pattern to it
• What makes it better or worse
• If you have other symptoms, such as a fever

The provider will examine your ears, nose, throat, and chest.

Tests that may be done include:

• Chest x-ray or CT scan
• Lung function tests
• Blood tests
• Tests to check the heart, such as an echocardiogram
• Gastroesophageal reflux evaluation tests (for example barium swallow)
• Vial swabs
• CT scan of the sinuses

Treatment depends on the cause of the cough.

Call 911 or the local emergency number if you have:

• Shortness of breath or difficulty breathing
• Hives or a swollen face or throat with difficulty swallowing

Contact your provider right away if you have a cough and any of the following:

• Heart disease, swelling in your legs, or a cough that gets worse when you lie down (may be signs of heart failure)
• Have had contact with someone who has tuberculosis
• Unintentional weight loss or night sweats (could be tuberculosis)
• An infant younger than 3 months old who has a cough
• A cough that lasts longer than 10 to 14 days
• A cough that produces blood
• Fever (may be a sign of a bacterial infection that requires antibiotics)
• A high-pitched sound (called stridor) when breathing in
• Thick, foul-smelling, yellowish-green phlegm (could be a bacterial infection)
• A violent cough that begins rapidly