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The Science of a Cough: What it Means and When to Worry

March 19, 2020Dr. Jason Becker

There it is again. That pesky scratch in the back of your throat, and congestion in your chest, has persisted non-stop, and is starting to hinder your daily routine. What’s the reason this time?

Coughs have a variety of causes, and while they may seem incredibly annoying, they have an essential purpose: to improve your respiratory function.

“When irritants, such as bacteria or pollen, enter our airways, they trigger our cough receptors. By coughing, the body is doing its best to expel foreign microbes from where they don’t belong,” explained Dr. Jason Becker, Jefferson Health Pulmonologist.

Coughs are commonly categorized by their duration. While most coughs go away within a week or two (acute cough), some persist for three to eight weeks (subacute cough), and others can even last longer than 12 weeks (chronic cough).

Most acute coughs are caused by respiratory infections (viral or bacterial), such as the common cold, influenza, pneumonia, or COVID-19 (coronavirus). Some acute coughs can also be caused by non-infectious allergens.

“Subacute coughs are like ‘leftovers’ of respiratory infections. As you’re recovering, your cough receptors become hyper-reactive, which leads to an ongoing dry and irritating cough,” said Dr. Becker. “The only real remedy for a subacute cough is time. Luckily, these coughs typically aren’t concerning.”

According to Dr. Becker, acute and subacute coughs are more straightforward to diagnosis than chronic coughs.

A chronic cough, nearly 90 percent of the time, is caused by asthma, acid reflux (or GERD), or postnasal drip. However, a lot of patients commonly misconceive their chronic cough as caused by asthma, when it’s actually caused by acid reflux – the coughs of which for both are very dry, explains Dr. Becker.

In some instances, there are distinct characteristics of a cough that can aid in the diagnosis. If your cough isn’t dry, but instead “productive,” meaning it brings up more mucus, it is likely linked to an allergy or infection. A deep, loud “whooping” sound often signifies pertussis, and a cough that sounds like a seal barking is commonly croup.

If you experience any of these coughs described, it is important to seek medical care as soon as possible.

“If you have what you suspect to be a normal subacute cough, you should still get it on a doctor’s radar within four weeks,” said Dr. Becker. “They can take the proper precautionary tests, such as chest X-rays and CAT scans, to rule out any other severe factors. For example, a persistent cough can sometimes be a sign of lung cancer. Even if your risk is small, it’s not one you want to take.”  

It’s also important to contain your coughs – like your sneezes – in the crook of your elbow, as much as possible. When you cough, germs are expelled at upwards of 50-100 mph, and thousands of droplets find their way onto nearby objects and people.

“While treatments and suggested medications vary, depending on the cause, the most effective remedy for a dry cough is actually honey,” added Dr. Becker. “Studies show that honey performs the same way as cough medicine. It improves the hyper-reactiveness of the cough receptors and eases symptoms.”

At the end of the day, coughs are something that we all experience, and, more often than not, they will go away without causing any lasting problems. Always remember, to decrease your chances of developing a cough (and respiratory infection) infection control is a MUST. Wash your hands, avoid touching your face, and try not to be near people who are already sick!

To learn more about Primary & Specialty Care Services at Jefferson Health New Jersey, click HERE, or call 1-844-542-2273 to make an appointment.