What your cough is trying to tell you
I had a cold last week, and now have a cough that won’t go away. Do I have anything to worry about?
A cough is the body’s way of clearing out mucous or foreign material (like dust, hair or pollen) from your airways. The forceful muscular contraction of your diaphragm and chest wall muscles propels a blast of air out of your lungs, thereby moving the unwanted substance up and out of your chest.
A variety of illnesses and conditions can cause a cough. The most common of these include viral and bacterial infections that may result in bronchitis or pneumonia, or non-infections like asthma, allergies, post-nasal drip and Gastro-Esophageal Reflux Disease (GERD).
Viruses are the most common cause of infections that cause coughing. The symptoms of a common cold (aka a viral upper respiratory infection) may include a sore throat, nasal congestion, fever and cough. Viral illnesses do not require antibiotics and usually last seven to 14 days following the time of onset of symptoms. A cough accompanied by shortness of breath, chest tightness, wheezing or blood-tinged mucous may suggest bronchitis or pneumonia. It may be difficult to tell the difference between a viral and bacterial illness, so consult your doctor if your symptoms are more serious than your usual cold. Antibiotics are not effective in treating viral infections, but are useful in fighting bacterial infections. A doctor can help you decide if you need a prescription for antibiotics.
A cough may be dry or produce mucous or phlegm. The presence or absence of mucous and its color are not indications of the seriousness of illness. It is better to cough mucous out of your chest and an expectorant like guaifenesin (Robitussin, Mucinex) may be useful. A dry cough may, however, benefit from a prescription cough suppressant. Again, ask your doctor or pharmacist what to do if you are not certain.
Asthma, allergies, post-nasal drip and GERD may all result in the airway irritation that causes coughing. A cough that lasts more than a few weeks may have multiple causes. These conditions are often overlapping and may require a period of trial and error in both evaluation and treatment of symptoms. You may need a chest X-ray if your exam reveals abnormal breath sounds when your physician listens to your chest. Don’t be alarmed if your doctor wants to try treatment that could help a wide range of ailments. He or she may try antibiotics, inhalers, allergy pills, antacids, steroid nasal sprays and/or systemic anti-inflammatory steroids.
A cough causes extra water vapor losses in your breath, and mucous is easier to cough out if it is more liquid than thick, so remember to stay well hydrated and drink plenty of water if you are ill.
— Mark Melrose, DO, is a board-certified emergency physician at Urgent Care Manhattan. E-mail him your questions at firstname.lastname@example.org.
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