What is cough?

Cough is a normal and necessary event. It is part of our body's normal cleaning routine for the lungs. Cough is needed to clear unwanted mucous or phlegm from the breathing tubes, and to remove potentially dangerous particles such as dust.

The most common cause of cough is a viral upper respiratory tract infection best treated with medications from your local pharmacist. Cigarette smoking is a common cause of cough in adults; the more a person smokes the greater there is likely to be a cough. When smokers stop smoking, most will see their cough disappear usually within a month or so.

When is cough a problem?

Cough becomes a problem when it is persistent (say more than three weeks) or when it results in complications such as pain, fatigue and trouble sleeping. For some people, cough causes concern about an underlying serious illness.

Cough is a very common symptom of a viral respiratory infection or cold. Usually, the cough caused by a cold clears up within three weeks. When cough lasts longer than this, it is called chronic or persistent cough.

When should I see the doctor?

You may wish to call your doctor under the following circumstances:

• If a chronic cough lasts more than three weeks.
• Any concern you may have about the cause of the cough.
• Coughing up blood.
• Severe pain or fainting caused by coughing bouts.
• Trouble sleeping at night because of coughing.
• Any worrying symptom such as breathlessness or chest pain.

What causes chronic cough?

Chronic cough is a symptom of several different conditions. Occasionally there can be an underlying serious lung disease present, such as lung cancer. For this reason, it is important to see your doctor to check out why you may be coughing. Your doctor can evaluate these things by examining your chest and ordering a chest X-ray.

Chronic cough is most often caused by several common conditions. These include:

Asthma

Cough can be one of the early warning symptoms of asthma. Cough due to asthma generally responds well to inhaled preventer treatment.

Rhino-sinusitis

Rhinitis causes sneezing and stuffiness of the nose. Many people with rhinitis also have an oversensitive voice-box which causes cough. Dripping of nasal material from the nose into the back of the throat (post nasal drip or catarrh) is a common cause of cough and throat clearing and the feeling of a tickle in the back of the throat.

Gastroesophageal Reflux (stomach acid in the gullet)

Cough is caused when acid from the stomach washes back into the gullet and even up to the larynx. Sometimes coughing itself is enough to cause reflux and continue the cycle of chronic cough.

Certain Medicines

ACE inhibitors are medicines which are used for blood pressure and heart problems. These cause cough in up to 20% of people. Make sure you tell your doctor all of the treatment you are taking, even if it is not for your chest, when you visit for evaluation of chronic cough.

Anxiety

Many people experience anxiety in association with chronic cough. Sometimes it is because the cough is so frustrating that it causes worry. At other times, being anxious for any reason can result in cough. When this happens, it is important to try and manage both the cough and anxiety symptoms.

Infections

Most often chronic cough is not contagious. It very frequently follows a viral upper respiratory tract infection. Occasionally, however, it can be caused by whooping cough which is contagious. Some clues to this are a whistling noise which occurs at the end of a bout of severe coughing, and a cough which develops after you have been in contact with someone with whooping cough. Whooping cough can occur in adults as well as children. Adult whooping cough is a distressing problem which can last for many weeks. It has little effective treatment.

What problems does cough cause?

Coughing is a very vigorous activity. Consequently, it can cause some problems such as fractured ribs, torn muscles, hoarse voice, fainting, exhaustion and fatigue, headache, trouble sleeping, incontinence or soiling of urine, wheezing (in people with asthma), and an irregular heartbeat.

How is chronic cough treated?

Treatment for chronic cough is most successful when it is directed at a specific cause. For this reason it is important to see your doctor if you develop chronic cough. Cough suppressants can be used for severe cough, but are not advised for regular use. Anything that moistens the throat (such as cough lozenges, syrups, water) gives relief from cough that lasts several minutes. Frequently, more than one reason for coughing can occur in one person. For most people, a chronic cough will settle given enough time and patience. Specific medications can be given only after a proper diagnosis has been made.

Please Note: This information is intended by The Australian Lung Foundation to be used as a guide only and is not an authoritative statement. Please consult your family doctor or specialist respiratory physician if you have further questions relating to the information provided here.

A printed brochure of this fact sheet is available free of charge for members of the community.  To order a copy contact 1800 654 301 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it

For details of patient support groups in Australia please call 1800 654 301

Content updated March 10, 2008