Coughing is a natural reaction by the body to expel fluid or foreign bodies from the lungs. It is also a reaction to irritation of the respiratory system such as a "tickle" in the throat or post-nasal drip.
It may not have occurred to you that different causes produce different coughs. The dry cough from a dusty room is different from the wet cough that results from a cold or flu infection. Here are some different coughs, ways to recognize them and what they mean:
A dry, hacking cough is a cough that is "non-productive." This means that you do not produce any phlegm or mucus as you cough.
Dry coughs can be caused by a variety of different conditions including:
- Irritation: A tickle in the throat may be caused by an actual foreign body in the nose, throat or lungs. For example, inhaling dust, pollutants or chemical vapors in the air can trigger a dry-sounding cough reflex to expel the irritant from the lungs.
- Dry respiratory tissues: If your throat or lungs dry out from cold air, dry air, dehydration, tobacco smoke or low mucus production, they can become irritated. This irritation may produce a dry cough.
- Inflammation: The throat and lungs can become inflamed from bacterial or viral infection, physical strain or environmental conditions. For example, after recovering from a cold or flu, your mucus production may have returned to normal, but inflammation in the lungs and throat (including the larynx and tonsils) may produce a dry, post-viral cough. Similarly, overuse of your voice common in sports spectators, singers and stage performers, may strain your throat causing inflammation and a dry cough. Likewise, asthma triggers can cause an asthma attack that includes inflammation in the lungs and a dry cough.
Treatment of a dry cough depends on the underlying cause. Sometimes a drink of water, throat lozenge or humidifier can reduce the irritation, rehydrate the tissues and resolve the cough. Cough suppressants (but not expectorants) can help to calm the brain's cough reflex.
For mild inflammation, rest and avoidance of any triggers can help the body heal, thereby eliminating the cause for the cough. However, for severe inflammation, such as a serious asthma attack, examination and treatment by doctors at urgent care clinics may be necessary to avoid any complications.
Also referred to as a chest cough, a wet cough sounds low and heavy. These coughs are also referred to as "productive" coughs because they produce mucus. These coughs are, in fact, the body's attempt to expel the mucus from the lungs. There are many possible causes of excess mucus including chest congestion from a cold or flu, pneumonia or allergies. Although many people complain of the "flu" every year, most cases of the "flu" are actually colds. On average, only 5% to 20% of Americans contract the flu virus each year.
Treatment of a wet cough is usually part of treating the underlying cause for the cough. That is, reducing the mucus will reduce the coughing. As part of this treatment, you can use expectorants to loosen and hydrate the mucus so that it is more easily coughed up. A humidifier can also moisten the mucus and make wet coughs more productive, thereby reducing the mucus in the lungs.
Most doctors do not recommend using cough suppressants for wet coughs because they merely suppress the brain's cough reflex so the mucus remains inside the lungs rather than being coughed up. The mucus sitting in the lungs can lead to infections and pneumonia in extreme cases.
A whooping cough is a violent cough that causes the lungs to expel so much oxygen that you gasp or "whoop" between coughs. Whooping cough is so characteristic of pertussis, a bacterial infection, that it has become the common name for the disease. However, other conditions can also cause a "whooping" cough such as pneumonia, severe asthma attacks, emphysema, chronic obstructive pulmonary disease (COPD) and tuberculosis.
Most of the causes of a whooping cough are serious enough to justify an exam by a certified provider to diagnose the cause of the cough and prescribe a course of treatment.
In the case of pertussis, prevention is the best strategy to avoid contracting the infection. A whooping cough vaccine is available and is recommended as part of a standard course of vaccinations for children.
A barking cough sounds like the barking of a seal. The barking sound results from inflammation of the upper airways, particularly the airways surrounding the larynx. A barking cough is also referred to as a croup cough because it is characteristic of croup.
Croup is a viral infection that causes swelling around the bronchial tubes, trachea, and larynx. As a result, patients have difficulty breathing and develop a severe cough. The inflammation and cough may be so severe that the patient may gasp for air or even turn blue.
Most patients recover from croup at home without medical treatment. In severe cases, doctors prescribe anti-inflammatories such as steroids to reduce the swelling of the airways.
If you experience burning in your throat or chest as a result of your cough, you may be coughing up stomach acid. This is a symptom of gastroesophageal reflux disease, also called GERD, acid reflux or heartburn. In GERD, the muscle at the base of the esophagus fails to seal the stomach completely, thereby allowing stomach acid to flow up the esophagus.
The stomach acid irritates the esophagus. This irritation is felt as a burning sensation and can trigger a cough that can push the stomach acid up the throat and into the mouth and nose. In severe cases of GERD, the irritation and cough may even trigger regurgitation or vomiting.
Over-the-counter medications are available to control GERD. Most of these medications are referred to as "acid reducers" because they reduce the volume of acid produced by the stomach. Additionally, antacids can neutralize the acid in the stomach so that the acid is less irritating to the esophagus.
Serious cases of GERD that result in regurgitation or vomiting may require a visit to the doctor.
Phlegm is slightly different from mucus. Mucus is produced by the body to protect tissues from foreign particles and disease-causing microbes and to prevent tissues from drying out. Phlegm is mucus that has done its job. That is, phlegm is mucus with foreign particles, microbes and immune system cells embedded in it.
Mucus is typically clear since it is composed primarily of water. Phlegm can take on many colors that can indicate what your body is battling:
- Yellow or green phlegm usually indicates a viral or bacterial infection. The color comes from white blood cells in the phlegm.
- Pink phlegm comes from fresh blood.
- Brown phlegm comes from old blood.
- Black phlegm usually results from particulates in your lungs from smoke or coal dust.
A common cause of phlegmy coughs is bronchitis. Bronchitis is caused by an infection in the lungs. Although it is easy to read too much into the color of the phlegm, yellowish phlegm is usually suggestive of a viral infection, while green phlegm usually suggests that the infection is bacterial. In either case, bronchitis will often clear up on its own with proper home care, including drinking fluids, using a humidifier, and taking expectorants to loosen and hydrate phlegm so it can be coughed up.
Some coughs signify serious problems and may require medical attention from a doctor. Some signs that a cough is serious include:
Gasping or difficulty breathing
- Pale or blue skin from lack of oxygen
- Bloody mucus or phlegm
- High or persistent fever
- Cough that lasts longer than a few weeks
- Whooping or wheezing sounds
- Frothy pink phlegm
- Persistent cough that interferes with sleep
While these symptoms do not necessarily mean that you are suffering from a serious illness, they sometimes accompany life-threatening conditions such as pneumonia, congestive heart failure, lung cancer, pulmonary embolism or tuberculosis. Visiting a doctor for examination and diagnosis can help to identify, or eliminate, these conditions as a cause of your cough.
Different types of coughs can signify different illnesses and conditions as well as the seriousness of your illness or condition. Learning the differences can help you discern when you can treat your cough at home or require a visit to the doctor's office or urgent care clinic. Moreover, understanding and recognizing when a cough is serious can help you to avoid a tragic situation in which you miss the signs of a serious illness.
From dry coughs to wet coughs and anything in-between, MultiCare Immediate Clinic has a friendly team ready to help. We’ll get you diagnosed and treated promptly. You can even use our online scheduler to make an appointment at the location most convenient for you.