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IT’S that time of year where we’re greeted by a cacophony of coughs, sneezes and sniffles wherever we go.
You might think a cough is a cough, but different conditions will produce a different kind of hacking.
For example, an infection like a cold will produce a different-sounding cough to ones triggered by asthma.
Dr Unnati Desai, national GP lead at Nuffield Health, says coughs can be dry, phlegmy, wheezy, whooping or barking.
She tells Sun Health: “A cough is a spontaneous reflex of the autonomic nervous system that is important for keeping our lungs and lower airways clear.
“On a daily basis, particles enter the respiratory system as we inhale, including dust, pathogens and foreign bodies.
“Coughing will forcefully try to expel these particles by propelling air out of the respiratory system.”
Coughs can last a number of weeks depending on their cause.
They’re considered acute if they last for less than three weeks and chronic if they’re still going after eight.
They should go away on their own once an underlying cause has been addressed – whether that’s an infection or allergy.
The NHS recommends you see a GP if you’ve been hacking away for more than three weeks.
It’s also important you see someone about a cough if you’re losing weight for no reason or your immune system is weakened by things like chemotherapy or diabetes.
Here are seven different types of cough, how to recognise them and tips to ease each one.
1. Infections
Coughs caused by infections – either viral or bacterial – tend to last less than three weeks and can make you feel unwell, raise your temperature and leave you with swollen glands.
You’ll probably be struck by coughing fits throughout the day if that’s the case, while also noticing you’re snottier than usual.
Dr Desai says: “If the cough sounds ‘barking’, then this suggests it’s croup – this is common in young children.”
Croup is a contagious respiratory infection that tends to spread in babies and young kids.
It causes swelling of your child’s voice box and windpipe, resulting in a distinctive barking cough and raspy breathing.
Dr Desai says: “If the cough is a violent, hacking cough with a high-pitched ‘whooping’ sound on inspiration then this suggests whooping cough.”
Which cold and flu remedies actually work?
Sun Health reporter Isabel Shaw put nine well-known cold and flu remedies when she was struck with a lurgy.
Over a week, she tried products that targeted all symptoms associated with cold and flu, as well as treatments that only aimed to get rid of specific issues.
These included:
- Hot honey and lemon
- Steam inhalation and Vicks Vaporub
- Echinacea
- Chicken soup
- A spicy curry
- Beechams All-in-One Oral Solution
- Strepsils
- Lemsip Max
- Sudafed Blocked Nose Spray
She took into account pain reduction, and how quickly and for how long they worked.
This is another common infection among young children that’s especially contagious, though this one is caused by bacteria.
“If the cough is ‘fruity’ and wet with mucus production, and occurs in the winter months, especially in children under two years, then this suggests respiratory syncytial virus (RSV), which is a specific viral infection that causes bronchiolitis,” the GP says.
This is inflammation of small airways in children’s lungs.
The infection is usually mild and can be treated at home, but it can turn serious – requiring hospital treatment.
If you are making a whistling sound as you exhale along with coughing, this may suggest that inflammation and extra snot caused by an infection is narrowing the smaller airways in your lungs and making you wheeze.
Nobody feels especially well if they have a cough.
“But if your cough is associated with significant symptoms (other than being unwell and having a temperature) such as a fast heart rate, sharp chest pain, shortness of breath or difficulty breathing, this could be a sign of pneumonia”, Dr Desai warns.
Pneumonia is commonly triggered by bacteria infecting lung tissues, a virus, or fungus.
“If a mucousy cough occurs without the above specific symptoms, this tends to be called bronchitis – inflammation of the larger bronchial airways,” the GP adds.
Recent data also suggests that tuberculosis (TB) is on the rise in the UK.
Cases of the bacterial infection, which can cause a number of symptoms including a persistent cough lasting more than three weeks, rose 11 per cent in the year to 2023, according to the UK Health Security Agency (UKHSA).
You may cough up blood tinged mucus if you have TB.
Treating infection-related coughs
If your snot is clear, this suggests your cough and other symptoms are caused by a virus, Dr Desai says.
You can treat it by staying hydrated, taking fever-reducing meds like paracetamol and ibuprofen and inhaling steam to loosen mucus.
If you’re wheezing, use your prescribed inhaler to open up your airways.
If the snot you’re blowing out is green or yellow-tinged for over two weeks and you’re getting more and more unwell, a bacterial infection may be to blame.
In this case, you’ll probably need antibiotics, the GP adds.
As for TB, the infection is treatable with a six-month course of antibiotics.
2. Asthma
Another common culprit of coughs is asthma – a lung condition that often runs in families that’s triggered an immune response in the respiratory system which causes inflammation of the lower airways.
Symptoms include a cough – which may be worse at night or after exercise – wheezing and chest tightness.
These can be triggered by dust, dust mites, mould spores, animal fur, pollen, or even cold air or dry air.
“Infections often exacerbate asthma symptoms,” Dr Desai warns.
Treating asthma-related coughs
Asthma is generally treated with inhalers, which either open up the airways, or to prevent inflammation, in the case of steroid inhalers.
Oral steroids or immune-modulating medications might be needed in patients if inhalers aren’t enough.
“It is important to try to avoid the triggers if possible, but patients should be taught how to step up on their medications if triggers cannot be avoided or when infections start,” Dr Desai says.
“This is known as the Personal Asthma Action Plan.” For more information, speak to your GP.
3. Nasal and sinus cough
Conditions that affect the nose and sinuses can result in acute or chronic coughing – and the culprit might actually be mucus dripping down your throat.
Dr Desai says: “Mucus that often drips down the back of the throat is known as a ‘post-nasal drip’.
“This dripping of the mucous results in a build up at the back of the throat which will trigger the cough reflex to clear the airway.”
Rhinitis – inflammation of the mucosal tissue in the nose – will result in a runny or bunged up nose due to increased snot production, often triggered by allergies.
Sinusitis – inflammation of the sinus passages – can cause more mucus to accumulate, resulting in increased mucus production in the sinus passages, which are the deeper air-filled cavities in the skull and bones around the nose.
Allergies can be seasonal – think hay fever or allergic rhinitis – or chronic if they’re triggered by dust, mites, or animal fur.
Meanwhile, sinus infections tend to be acute.
Dr Desai says: “Chronic sinusitis is where there is no infection and no acute triggers, so symptoms persist for most of the year.
“Chronic sinusitis may be a symptom of nasal polyps, non-cancerous growths of the tissues that line the nose and sinuses.
Treating nasal-related coughs
Dr Desai says: “Coughs related to conditions that affect the nose and sinuses tend to be treated with steroid nasal sprays to keep the inflammation under control.”
If allergies are the issue, you can take antihistamines.
Using steam to loosen the snot clogging up your nose or rinsing out the nasal passages with sterile saline water can also help.
You’re more at risk of developing a secondary infection if you’re struggling with chronic sinusitis. This may need to be treated with antibiotics if it’s bacterial.
Different types of cough require different treatments[/caption]
4. Acid reflux cough
Believe it or not, stomach issues can also be the culprit behind your persistent sputtering.
If you have what’s known as gastro-oesophageal reflux disease (GORD), the acid in your stomach can travel up the oesophagus towards the throat, resulting in acid reflux.
“The main symptoms of GORD include a burning sensation behind the chest bone which comes up to the throat and leaves an unpleasant taste in the mouth,” Dr Desai explains.
But the condition can also leave you with a dry cough.
“It is thought that this cough reflex is to protect the airways from micro-droplets of acid entering in,” the GP adds.
Treating GORD-related coughs
If you suspect your hacking is caused by acid reflux, treating your gastrointestinal condition can sort it out.
Avoiding acidic trigger foods like coffee, chocolate, tomatoes and spicy stuff may help, as well as eating smaller and more frequent meals, avoiding tight clothing, maintaining a healthy weight and keeping smoking and stress to a minimum.
You can also take over-the-counter medications like antacids. Speak to a pharmacist about what would be best and see a GP if these don’t help and you’re having severe symptoms several times a week.
5. Medication side effects
Some medications can result in a dry cough that tends to stick around for the duration of using them.
“The most common medications that can cause coughs are ACE inhibitors that are used to control high blood pressure,” according to Dr Desai.
“Other medications can cause a cough by triggering bronchospasm, which is a narrowing of the airways.
“These include beta-blockers that are used by heart patients or to manage anxiety, and non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin.
“Other medications can cause a cough by triggering GORD such as oral steroids, NSAIDs, calcium supplements, calcium antagonists that are used to control high blood pressure and bisphosphonates that are used to manage osteoporosis.”
Symptoms should clear up after you stop taking the medication. If you experience any problems, speak to your GP.
6. Smoker’s cough and chronic lung conditions
Certain medical conditions that affect the respiratory tract can saddle you with a persistent cough.
They include chronic obstructive airway disease, which is often a result of long term inflammation of the airways – emphysema, long-term damage to the lung tissue, and lung cancer.
COPD will also often result in shortness of breath, frequent chest infections and wheezing.
But there’s a reason many smokers have what’s known as smoker’s cough.
WHAT IS LUNG CANCER?
LUNG cancer is the most deadly common cancer in the UK.
It is considered a common cancer alongside prostate, breast and bowel, which together make up more than half of all new cases.
Around 49,000 people are diagnosed with lung cancer every year and 35,000 die from it.
Just one in 10 patients survive for a decade or more after being diagnosed and lung tumours make up 21 per cent of cancer deaths in the UK but only 13 per cent of cases.
The main reason that it is so deadly is that symptoms are not obvious in the early stages.
When signs do appear they may include:
- A cough that lasts three weeks or more, and may hurt
- Repeated chest infections
- Coughing up blood
- Breathlessness
- Unusual tiredness
The NHS does not routinely screen for lung cancer but is rolling out more tests to smokers and ex-smokers at high risk, in a bid to catch it earlier. Testing may involve X-rays and chest CT scans.
Smoking is the number one risk factor for lung cancer and accounts for about 70 per cent of cases.
Risk may also be higher for people who have inhaled other fumes or toxic substances at work, such as asbestos, coal smoke or silica.
“Smoking is one of the main causes for these medical conditions, so as far as possible it is best to not to start smoking,” Dr Desai says.
UK stats show that smoking is responsible for 75 to 85 per cent of lung cancer diagnoses, the GP noted.
“Stopping smoking is key in managing these conditions, and although stopping will not improve these conditions, it can halt the progression of COPD and emphysema,” she adds.
Treating COPD and emphysema coughs
Dr Desai notes: “Generally, with these conditions, it is very hard to fully alleviate the cough with treatment, and treatment is focused on preventing further progression.”
You should see a GP if you have persistent symptoms of COPD, particularly if you’re over 35 and smoke or used to smoke.
Treatment may include inhalers and medicines to make breathing easier and specialised exercise.
But if the condition is very far along, you may need surgery or a lung transplant.
7. Blood clots
In some cases, a cough might be a sign of a blood clot.
Dr Desai says: “Pulmonary embolism is a clot that occurs in a vein of the lungs and may be secondary to a deep vein thrombosis (DVT) in the leg, or may arise spontaneously.
“It tends to be associated with a history of specific risk factors for developing a venous thromboembolism, such as a long haul flight, immobility, starting hormone treatments like the contraceptive pill or HRT or certain underlying medical conditions.”
Symptoms of the health emergency include a cough, shortness of breath, sharp chest pain and fast heart rate.
You may also cough up blood.
If you also have DVT, you may notice pain, redness and swelling in one of your legs – usually the calf.
Treating pulmonary embolism
If you suspect you’re suffering a pulmonary embolism, you need to go to A&E urgently.
“This can be a life-threatening condition,” Dr Desai warns.
