Cough

Overview

A cough is a protective reflex that clears the airways of irritants, mucus and secretions. It is one of the most common reasons people see a doctor, and almost everyone has a cough with a cold at some point. Most coughs are short-lived and harmless, but a cough that persists, changes in character, or comes with other symptoms can be a sign of an underlying problem that needs assessment. This page is the central overview for cough; the pages below cover the specific patterns — acute, chronic, persistent, dry and productive — in more detail.

How cough is classified

• Acute cough — lasting less than three weeks; most often a viral upper respiratory infection.
• Persistent (subacute) cough — lasting three to eight weeks; often follows a viral infection.
• Chronic cough — lasting beyond eight weeks; needs systematic investigation.
• Dry cough — no phlegm; often viral, allergic, reflux or medicine-related.
• Productive cough — brings up phlegm; suggests infection, bronchitis or chronic airway disease.

Common causes

• Viral upper respiratory infections and the common cold.
• Post-viral cough that lingers after an infection.
• Asthma and allergic airway disease.
• Acute and chronic bronchitis.
• Acid reflux (gastro-oesophageal reflux) and post-nasal drip.
• Smoking and COPD.
• Certain blood-pressure medicines (ACE inhibitors).
• Pneumonia, tuberculosis and other lower respiratory infections.

When a cough needs assessment

• Lasting beyond three weeks without improvement, or beyond eight weeks (chronic).
• Coughing up blood or rusty, coloured phlegm.
• With breathlessness, chest pain, wheezing or fever.
• Interfering with sleep or daily life.
• In a smoker or someone with a long-term lung condition.

Evaluation

Evaluation is guided by the duration and character of the cough. A short cough after a cold often needs no tests. A persistent or chronic cough is assessed with a chest examination and, where indicated, a chest X-ray, spirometry (lung function), and review of medicines and reflux. Sputum examination or further imaging is ordered when infection or tuberculosis is suspected.

Management

Management treats the cause rather than just suppressing the cough. Viral and post-viral coughs are managed supportively; asthma is treated with inhalers; reflux and post-nasal drip are addressed directly; medicine-related cough is resolved by switching the offending drug. Unnecessary antibiotics are avoided for simple viral coughs.

Warning signs — seek urgent care

• Coughing up blood.
• Severe breathlessness, chest pain or bluish lips.
• High fever with a productive cough and confusion.
• Sudden worsening in someone with asthma or COPD.

How we help

Dr. Nayak identifies the pattern and cause of a cough, orders the right tests, and treats specifically — while watching for warning signs. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Acute Cough
• Chronic Cough
• Persistent Cough
• Dry Cough
• Cough with Phlegm
• Post-Viral Cough
• Fever with Cough