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A complete guide to coughs

Everyone has suffered from a cough. However, not every cough justifies a visit to the urgent care for examination by doctors. Understanding why and how you cough can help you know what to do to relieve your cough on your own and recognize when your cough signifies something serious.

Why do we cough?

Coughing is a natural reflex by your body to irritation in your respiratory system. When it coughs, your body is attempting to use a burst of air to dislodge the source of the irritation. In this respect, a cough is similar to a sneeze.

The source of the irritation could be foreign substances, such as particulates from polluted air, dust or smoke. However, during cold and flu season, the irritation is most likely mucus or cold, dry air.

Both colds and flu are caused by viruses. The cold virus, called rhinovirus, causes congestion, sore throat, cough and runny nose. The flu virus, called influenza, causes fever, body aches, congestion, fatigue, cough, sore throat and runny nose. Between the two, the flu is much more serious. For some vulnerable patients, such as the elderly, infants and people with compromised immune systems, the flu can be fatal.

Whether your cough is caused by a cold or the flu, the congestion, sore throat and runny nose will irritate your respiratory system into coughing. Compounding the situation, winter air dries out the tissues in the nose, throat and lungs.

While coughing is intended to clear your respiratory system of irritants, coughs can cause other complications. Coughing expels germ-laden saliva and mucus into the air, spreading contagious diseases like tuberculosis, cold, flu or whooping cough. A violent cough can strain muscles in the chest, cause fainting from reduced blood flow to the brain, trigger vomiting from abdominal muscle spasms, rupture blood vessels in the eyes, and induce headaches. Coughing can result in fatigue and insomnia when it deprives you of sleep.

What are some tips for treating a cough?

There is no cure for the cold or flu virus. Rather, treatment of colds and mild cases of the flu usually focuses on reducing symptoms. As noted above, coughs are caused by irritation of the lungs and throat. Most cough medicines and natural cough treatments fall into three categories:

  • Desensitize the throat with a topical anesthetic
  • Block the cough reflex with an antitussive
  • Thin out the mucus with an expectorant

Both over-the-counter cough treatments and natural cough remedies are discussed in greater detail later.

Other approaches for treating a cough include:

Prevention: The best way to treat a cough is not to catch the cough in the first place. Prevention includes simple steps such as getting a flu shot around October every year and washing your hands thoroughly before eating or touching your mouth, nose, or eyes. Also, be courteous to others by covering your mouth when you cough. You should also plan on staying home, if possible, when you have a contagious virus. This will prevent spreading your cough to others.

Hydration: Doctors recommend drinking lots of fluids, such as water, juice and soup when you have a cough. This thins out the mucus and helps you to cough it out.

Steam: Like fluids, steam can help loosen mucus. Equally importantly, steam can moisturize the lining of your throat and lungs. This makes them less prone to irritation from cold, dry or dusty air. A hot shower or bath, for example, can relieve muscle aches and chills from the flu and reduce coughing.

Clean: Pollen, dust, animal fur and other allergens can cause or worsen a cough. Vacuuming and dusting your home can reduce the irritants that reach your respiratory system. Cleaning surfaces such as light switches, doorknobs and countertops with sanitary wipes can reduce the transmission of viruses. Cold and flu viruses can survive on surfaces for several hours.

What is the difference between cough suppressant and expectorant?

For over-the-counter cough remedies, you have several options. Topical anesthetics, such as throat sprays and mentholated cough drops, suppress the cough reflex by numbing the throat to irritants. You should just keep in mind that some cough drops contain sugar, which can lead to tooth decay when they are held in the mouth as they dissolve. Look for sugar-free cough drops if you plan to use them.

Antitussives, the medical name for cough suppressants, stop the cough reflex within the brain stem. In other words, the irritant in your respiratory system is still there, but your brain is dulled from reacting to it by triggering a cough.

You can usually identify antitussives because they include -tussin or -tussive in their name and contain dextromethorphan, often abbreviated DM. Dextromethorphan is derived from opiates and should be avoided when driving or engaging in other activities that become dangerous when your thinking and reflexes are dulled.

Expectorants do not directly stop coughing. However, they increase the moisture content of mucus so you can cough it up. After you cough up the mucus irritating your lungs, you will naturally cough less because the irritant is gone. Be aware, however, that this only works with wet coughs that produce phlegm. Dry coughs will not be helped by expectorants and must be treated with suppressants or anesthetics.

Is it OK to give cough syrup to kids?

Over-the-counter cough medicines should not be given to children under two years old, except under the direction of a physician. In fact, most cough and cold medications designed for children include directions not to give them to children under four years old, because of the risk of overdose. Thus, for infants, toddlers and preschool-aged children, you should avoid any over-the-counter cold or cough medicines unless directed by a doctor.

Older children (school-aged children and teenagers) can use over-the-counter cough medications. However, the FDA recommends vigilance about any prescription cough medication that includes opiates, such as codeine and hydrocodone, for anyone under the age of 18 because of the risks of overdose and addiction.

What are some natural remedies for cough?

Natural cough remedies can be effective. There are many natural substances that create the same effects as over-the-counter cough medications. For example:

  • Mint: Mint tea, mint candies and mint leaves can desensitize the throat to irritation, thereby reducing coughing.
  • Honey: Honey coats the throat and reduces throat irritation. Honey is also an antimicrobial agent.
  • Hot drinks: As mentioned above, steam moisturizes the respiratory system, reducing irritation by cold, dry or dusty air. Steam also loosens mucus, making it more likely to dislodge through coughing.

When should I see a doctor about a cough?

Coughs usually improve after about seven days and clear up completely after about two weeks. If a cough persists for more than two weeks, you may want to visit an urgent care facility to be seen by one of its doctors. Urgent care doctors are accustomed to diagnosing coughs. In fact, according to the Urgent Care Association, respiratory illnesses -- acute upper respiratory infection, acute sinusitis, acute pharyngitis, cough and acute bronchitis -- are the most commonly treated conditions at urgent care clinics across the country.

Other signs that you may need to visit urgent care for a cough include:

  • Wheezing, shortness of breath or difficulty breathing
  • Bloody phlegm
  • Thick, yellow or green mucus
  • Chest pain or tightness in the chest
  • Fever that persists for more than a few days

These symptoms may be a sign of something more serious than a cold or flu. Examples of serious illnesses that can cause a cough include pneumonia, lung infection, bronchitis or asthma. A cough may be a sign of a potentially fatal condition, such as tuberculosis, whooping cough, lung cancer or cystic fibrosis.

For mild cases, you should be aware that coughs can worsen or improve based on many factors. On a cold day, you may experience a worsening of your cough because cold air is naturally less humid than warm air and dries out your nose, throat and lungs.

Why is my cough worse at night?

You may find your cough seems worse at night. Lying down can cause mucus to drain from your nose and sinuses into your throat, irritating it. Moreover, your nose and throat tend to dry out while you sleep. These factors can combine to exacerbate a cough. To avoid a worsening cough at night, doctors often recommend using a humidifier to keep your respiratory system moist and sleeping with your head elevated.

A cough is a natural, even healthy response to mucus in your respiratory system. However, coughing spreads disease and can make a cold or flu more miserable through sleeplessness, muscle strains and cough-induced vomiting. Relieving a cough using natural remedies or over-the-counter drugs can help minimize complications from coughs.



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