Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder.
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Some coughs are dry. Others are productive. A productive cough is one that brings up mucus. Mucus is also called phlegm or sputum.
Coughs can be either acute or chronic:
Causes
Common causes of coughing are:
- Allergies that involve the nose or sinuses
- Asthma and COPD (emphysema or chronic bronchitis)
- The common cold, flu, and other viral infections
- Lung infections such as pneumonia or acute bronchitis
- Sinusitis with postnasal drip
- Gastroesophageal reflux disease (GERD)
Other causes include:
- ACE inhibitors or less often ARB medicines used to treat high blood pressure, heart failure, or kidney diseases
- Cigarette smoking or exposure to secondhand smoke (or smoking other substances like marijuana)
- Lung cancer
- Lung disease such as bronchiectasis, cystic fibrosis, or interstitial lung disease
- Sometimes no specific cause is found
When to Contact a Medical Professional
Call 911 or the local emergency number if you have:
- Shortness of breath or difficulty breathing
- Hives or a swollen face or throat with difficulty swallowing
Contact your provider right away if you have a cough and any of the following:
- Heart disease, swelling in your legs, or a cough that gets worse when you lie down (may be signs of heart failure)
- Have had contact with someone who has tuberculosis
- Unintentional weight loss or night sweats (could be tuberculosis)
- An infant younger than 3 months old who has a cough
- A cough that lasts longer than 10 to 14 days
- A cough that produces blood
- Fever (may be a sign of a bacterial infection that requires antibiotics)
- A high-pitched sound (called stridor) when breathing in
- Thick, foul-smelling, yellowish-green phlegm (could be a bacterial infection)
- A violent cough that begins rapidly
What to Expect at Your Office Visit
The provider will perform a physical exam. You will be asked about your cough. Questions may include:
- When the cough began
- What it sounds like
- If there is a pattern to it
- What makes it better or worse
- If you have other symptoms, such as a fever
The provider will examine your ears, nose, throat, and chest.
Tests that may be done include:
- Chest x-ray or CT scan
- Lung function tests
- Blood tests
- Tests to check the heart, such as an echocardiogram
- Gastroesophageal reflux evaluation tests (for example barium swallow)
- Vial swabs
- CT scan of the sinuses
Treatment depends on the cause of the cough.
References
Chung KF, Mazzone SB. Cough. In: Broaddus VC, King TE, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 37.
Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 77.
Review Date 5/3/2023
Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.