Coughs, Age 12 and Older
Coughing is the body's way of removing foreign material or mucus from the lungs and upper airway passages or of reacting to an irritated airway. Coughs have distinctive traits you can learn to recognize. A cough is only a symptom, not a disease, and often the importance of your cough can be determined only when other symptoms are evaluated.
For information about coughs in children, see the topic Coughs, Age 11 and Younger.
A productive cough produces phlegm or mucus (sputum). The mucus may have drained down the back of the throat from the nose or sinuses or may have come up from the lungs. A productive cough generally should not be suppressed—it clears mucus from the lungs. There are many causes of a productive cough, such as:
- Viral illnesses. It is normal to have a productive cough when you have a common cold. Coughing is often triggered by mucus that drains down the back of the throat.
- Infections. An infection of the lungs or upper airway passages can cause a cough. A productive cough may be a symptom of pneumonia, bronchitis, sinusitis, or tuberculosis.
- Chronic lung disease. A productive cough could be a sign that a disease such as chronic obstructive pulmonary disease (COPD) is getting worse or that you have an infection.
- Stomach acid backing up into the esophagus. This type of coughing may be a symptom of gastroesophageal reflux disease (GERD) and may awaken you from sleep.
- Nasal discharge (postnasal drip) draining down the back of the throat. This can cause a productive cough or the feeling that you constantly need to clear your throat. Experts disagree about whether a postnasal drip or the viral illness that caused it is responsible for the cough.
- Smoking or other tobacco use. Productive coughs in a person who smokes or uses other forms of tobacco is often a sign of lung damage or irritation of the throat or esophagus.
A nonproductive cough is dry and does not produce sputum. A dry, hacking cough may develop toward the end of a cold or after exposure to an irritant, such as dust or smoke. There are many causes of a nonproductive cough, such as:
- Viral illnesses. After a common cold, a dry cough may last several weeks longer than other symptoms and often gets worse at night.
- Bronchospasm. A nonproductive cough, particularly at night, may mean spasms in the bronchial tubes (bronchospasm) caused by irritation.
- Allergies. Frequent sneezing is also a common symptom of allergic rhinitis.
- Medicines called ACE inhibitors that are used to control high blood pressure. Examples of ACE inhibitors include captopril (Capoten), enalapril maleate (Vasotec), and lisinopril (Prinivil, Zestril, or Zestoretic).
- Exposure to dust, fumes, and chemicals in the work environment.
- Asthma . A chronic dry cough may be a sign of mild asthma. Other symptoms may include wheezing, shortness of breath, or a feeling of tightness in the chest. For more information, see the topic Asthma in Teens and Adults.
- Blockage of the airway by an inhaled object, such as food or a pill. For more information, see the topic Swallowed Objects.
Many coughs are caused by a viral illness. Antibiotics are not used to treat viral illnesses and do not alter the course of viral infections. Unnecessary use of an antibiotic exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria.
A careful evaluation of your health may help you identify other symptoms. Remember, a cough is only a symptom, not a disease, and often the importance of your cough can only be determined when other symptoms are evaluated. Coughs occur with bacterial and viral respiratory infections. If you have other symptoms, such as a sore throat, sinus pressure, or ear pain, see the Related Topics section.
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Coughing is your body's way of removing foreign substances and mucus from your lungs and upper airway passages. Productive coughs are often useful, and you should not try to eliminate them. Sometimes, though, coughs are severe enough to impair breathing or prevent rest. Home treatment can help you feel more comfortable when you have a cough.
Home treatment for adults
- Prevent dehydration. Fluids may help thin secretions and soothe an irritated throat. Dry, hacking coughs respond to honey in hot water, tea, or lemon juice.
- Elevate your head with extra pillows at night to ease a dry cough.
- Try a cough drop to soothe an irritated throat. Expensive medicine-flavored cough drops are no better than inexpensive candy-flavored drops or hard candy. Most cough drops have no effect on the cough-producing process.
- Quit smoking and do not use other forms of tobacco, especially while you have a cough. For more information on quitting smoking, see the topic Quitting Smoking.
- Avoid exposure to inhaled irritants, such as smoke, dust, or other pollutants, or wear a face mask that is appropriate for the exposure. Many kinds of face masks are available. Check with your doctor or pharmacist to determine which type of face mask will provide you with the most benefit.
- If you suspect problems with stomach acid may be contributing to your cough, see the topic Heartburn.
Cough preparations may help your cough. Avoid cold remedies that combine medicines to treat many symptoms. It is generally better to treat each symptom separately. There are two kinds of cough medicines: expectorants and suppressants.
Expectorants help thin
the mucus and make it easier to cough mucus up when you have a productive
- Use an expectorant if you have a cough that produces thick mucus and you are having difficulty coughing the mucus up. Don't depend entirely on an expectorant to thin the mucus. Drink plenty of water also.
- Look for expectorants containing guaifenesin, such as Robitussin, Mucinex, and Vicks 44E.
Suppressants control or
suppress the cough reflex and work best for a dry, hacking cough that keeps you
- Use cough suppressants wisely. Don't suppress a productive cough too much, unless it is keeping you from getting enough rest. Coughing is useful because it brings up mucus from the lungs and helps prevent bacterial infections. People with asthma and other lung diseases need to cough.
- If you have a dry, hacking cough, ask your doctor about an effective cough suppressant medicine.
- Look for suppressant medicines containing dextromethorphan, such as Robitussin-DM or Vicks Dry Hacking Cough. Studies show that over-the-counter cough medicines do not work very well. And some of these medicines can cause problems if you use too much of them. It is important to use medicines correctly and to keep them out of the reach of children to prevent accidental use.
Cough preparation precautions
- Cough preparations can cause problems for people with other health problems, such as asthma, heart failure, high blood pressure, glaucoma, or an enlarged prostate. Cough preparations may also interact with other medicines, such as sedatives and certain antidepressants. Read the package carefully or ask your pharmacist or doctor to help you choose one.
- Use cough preparations with caution if you are older than 60 or if you have chronic respiratory problems.
- Read the label so you know what you are taking. Some cough preparations contain a large percentage of alcohol; others contain codeine. There are many choices. Ask your pharmacist to advise you.
- Do not take someone else's prescription cough medicine.
For more information on home treatment of respiratory problems, see the Home Treatment section of the topic Respiratory Problems, Age 12 and Older.
|Try a nonprescription medicine to help treat your fever or pain:|
|Be sure to follow these safety tips when you use a nonprescription medicine:|
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:
- Other symptoms develop, such as moderate to severe chest pain with coughing, difficulty breathing, a productive cough, or fever.
- You start coughing up blood.
- A cough lasts longer than 2 weeks without other respiratory symptoms.
- Symptoms become more severe or more frequent.
There is no sure way to prevent a cough. To help reduce your risk:
- Wash your hands frequently during the cold and flu season. This helps prevent the spread of a virus that may cause a cold or influenza.
- Avoid people who have a cold or influenza if possible.
- Don't smoke or use other forms of tobacco. A dry, hacking "smoker's cough" means your lungs are constantly irritated. For more information, see the topic Quitting Smoking.
- Avoid exposure to secondhand smoke, both at home and in the workplace.
- Increase your fluid intake. This helps keep the mucus thin and helps you cough it up. It also helps prevent dehydration.
- Get a flu shot (influenza vaccine) each autumn if you are older than 50 or have a health risk that increases your risk for a serious problem. For more information, see the topic Influenza.
- Get a pneumonia shot (pneumococcal vaccine(What is a PDF document?) ) if you are older than 65 or if you have chronic lung disease, such as asthma or chronic obstructive pulmonary disease (COPD); you smoke; or you have a health risk that increases the seriousness of your symptoms.
- Make sure your immunizations are current, such as pertussis to reduce your risk of getting whooping cough. For more information, see the topic Immunizations.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- How long have you had the cough?
- How often do you cough?
- Does the cough have a pattern, such as worsening at night or becoming more frequent in the morning?
- What situations increase your coughing?
- Are you exposed to any irritants, such as smoke, dust, or chemicals, in your home or workplace?
- Is the cough productive (brings up sputum) or unproductive (dry and hacking)? Be prepared to describe the color (bloody, rusty, white, yellow, or green), amount, and consistency of any sputum.
- Do you have other symptoms that may be related to your cough, such as nasal drainage, fever, shortness of breath, wheezing, or other suspected cold symptoms?
- What home treatment have you tried? Did it help?
- What prescription and nonprescription medicines or other treatments have you tried? Did they help?
- What prescription and nonprescription medicines do you take regularly?
- Have you ever been diagnosed with allergies or asthma? Does anyone else in your family have allergies or asthma?
- Have you traveled recently?
- Do you have any health risks?
|Author||Jan Nissl, RN, BS|
|Editor||Susan Van Houten, RN, BSN, MBA|
|Associate Editor||Tracy Landauer|
|Primary Medical Reviewer||David Messenger, MD|
|Specialist Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Last Updated||February 25, 2010|