What your cough might be telling you

An irritating cough that just won’t go away is easy to dismiss as a mild inconvenience, but in some cases, it can be subtle sign of something more serious.

We spoke to Dr Andy Whittamore, GP and clinical lead at Asthma + Lung UK, to find out about the common triggers and underlying conditions that could be causing a persistent, nasty cough, and he also outlined some red flags that indicate that it’s time to seek medical advice.

What are the most common triggers for a cough?

“Coughing is a very natural and protective reflex that helps us clear mucus, irritants and infections from getting into our lungs, so that we can then keep breathing and using our lungs as normal,” explains Whittamore.

“There are multiple reasons why our bodies are trying to protect us by coughing, but the most common of those is viruses. Coughs can also be caused by mucus dribbling down from the back of the nose, acid coming up from the stomach, infections, or irritants in the air such as smoke or pollution.”

When should you go to a GP about a cough?

“If a cough has been going on for more than three weeks, we encourage people to get it checked out by a healthcare professional,” says Whittamore. “The reason for that is that viruses cause most coughs, and viruses tend to only last one to two weeks maximum. So, any cough that has lasted longer than three weeks, prompts doctors to think about other potential causes.

“In addition, if you feel breathless, have got a fever or confusion, or have got other symptoms that are making you feel unwell alongside your cough, then you should definitely come forward and seek a review.”

What are some examples of lung conditions that can cause coughing?

Asthma

“One of the most common causes from the lungs of coughing is asthma,” says Whittamore. “Asthma is a condition where the airways are overreacting to things in the air to try and protect us from harm. That causes narrowing of the airways, coughing, wheezing, breathlessness, and that comes and goes, depending on those things in the air that are irritating us.”

People only tend to cough from asthma when they’ve got inflammation in their airways caused by particular triggers, says the GP.

“For example, somebody might only cough when they do exercise or only when they’re exposed to cold air or exposed smoke or certain types of pollution,” says Whittamore.

“People with asthma are also typically more likely to be coughing and wheezing, and have a tight chest at night or first thing in the morning.”

COPD

“A cough caused by COPD (Chronic obstructive pulmonary disease) isn’t always set off by triggers and is more of a chronic cough, which is there all the time – but can be worse in certain weathers during certain times of the year,” says Whittamore. “As a GP, I will look at the risk factors to see if it’s likely that a patient has COPD. For example, people who have smoked for a long time or have been exposed to chemicals, whether through work or socially, are at greater risk.”

Whooping cough

“Whooping cough is due to a very particular infection called pertussis which spreads very rapidly into quite a virulent infection,” says Whittamore.

“Children with a pertussis infection can get a type of cough which causes long coughing fits, and because they’re coughing so much, they have to almost gasp for breath. And that gasp for breath is a whoop, which makes it sound very different to a lot of the other coughs that we see.”

Pneumonia

“Pneumonia usually presents with a similar type of cough to viral bronchitis, but the person is usually much more unwell,” says Whittamore. “They might be a bit breathless, might have pains in their chest, might have a fever, might be coughing up lots of dark mucus.

“If somebody has got cough and are feeling unwell or are breathless, they should seek medical help quickly.”

Lung cancer

“A lot of lung cancers present with people who have had a cough for three weeks or more, and sometimes they cough up blood or are getting pains in their chest,” says Whittamore. “Anybody coughing up blood or getting pain in their chest with a cough needs urgent medical assessment.”

How to treat and manage a cough:

“Firstly, all coughs get better if somebody stops smoking or isn’t exposed to smoking,” says Whittamore. “Secondly, as long as you aren’t concerned about pain in your chest, aren’t coughing up blood, aren’t breathless and aren’t feeling unwell or feeling tight in the lungs, then treating a simple cough with fluids, rest and paracetamol is usually sufficient.

“You can also speak to a pharmacist about over the counter remedies which won’t cure the cough, but might make you feel more comfortable. Simple things like honey can also be a really good way soothing a cough to make you feel better.”

Asthma + Lung UK has a free Winter Wellness Guide to help people stay well this winter. Sign up here: asthmaandlung.org.uk