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Causes And Treatment Of Cough

Updated on October 22, 2011

Coughing is a reflex action started by stimulation of sensory nerves in the lining of the respiratory passages - the tubes we use to breathe.

When a person coughs, there is a short intake of breath and the larynx (the voice box) closes momentarily. The abdominal and chest muscles used for breathing contract, which in turn increases the pressure needed to drive air out the lungs when the larynx re-opens. The resulting blast of air comes out at high speed, scrubbing and clearing the airway of dust, dirt or excessive secretions. Cough is a common symptom when the airways are ‘tight', as in asthma.

The cough reflex is a vital part of the body's defense mechanisms. Normally, the lungs and the lower respiratory passages are sterile. If dust or dirt gets into the lungs, they could become a breeding ground for bacteria and cause pneumonia or infection in the breathing tubes.

What causes cough?

Cough usually means there is something in the respiratory passage that should not be there. This can be caused by breathing in dust particles in the air or when a piece of food goes down the wrong way. It could also be a sign that an infection in the lungs is making the respiratory passages produce phlegm.

Cough can be provoked by:

  • The common cold, which is a frequent cause of acute cough that usually settles in less than three weeks.
  • Sucking material into the breathing tubes from your mouth.
  • More severe illnesses, such as pneumonia, acute heart failure or pulmonary embolism (a clot in the blood vessels of the lung).
  • Smoking, which often causes chronic cough (smoker's lung).
  • Asthma - particularly in children who may only cough and show no wheezing.
  • Stomach acid coming back up the gullet and spilling over into the windpipe (gastro-oesophageal reflux).
  • Bacterial or viral infections in the lungs, e.g. acute bronchitis, pneumonia, whopping cough, etc.

Coughing is more efficient when preceded by a full intake of air. For this reason, patients with weak muscles, poor coordination of airway closure and re-opening, or who have airflow obstruction will have a poor cough and be susceptible to complications including infection in the lower respiratory tract and pneumonia.

How can cough be treated?

Cough is a symptom, not a disease. It is the underlying cause of the cough that needs to be treated. A physician must be consulted if any of the following symptoms accompany a cough, so that possible underlying causes can be investigated and treated where necessary:

  • Coughing up phlegm that is green, rusty brown, yellow, bloodstained or foul smelling.
  • Chest pain.
  • Shortness of breath or wheezing.
  • Pain and swelling in the calf.
  • Recurrent nighttime cough.
  • Whopping cough.
  • Worsening smoker's cough.
  • Sudden weight loss.
  • Fever and sweating.

If one can't cough but needs to, problems soon arise, especially, when coughing is painful (for example, because of a broken rib), patients try not to cough and this can be dangerous.

Ineffective clearance of the airway can lead to a chest infection and possible pneumonia. In these circumstances, pain-relieving medicine can be useful to permit an efficient cough.

Airways infection

Both bacteria and viruses can cause infections in the breathing tubes, although the most common cause in children is a virus. Bacterial infections can be treated with antibiotics, but viral infections cannot.


Asthma may cause coughing without wheezing. This tends to be worst through the night, disturbing sleep. It may be the first sign of asthma in children, or a warning sign that asthma is worsening or not controlled properly. Conventional asthma treatment with inhaled anti-inflammatory preventative medicines and relievers will usually relieve a cough that is due to asthma.


Giving up cigarettes will lessen or abolish smokers' cough in 94 per cent of people within four weeks.


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