My cold is gone, so why am I still coughing?

One of the classic cold symptoms is a cough. When coupled with a runny nose, sneezing, sore throat and fatigue, it can make you feel pretty miserable.

Usually after a week or two, the cold runs its course and most of the symptoms go away. But for some people, the cough hangs around a little longer.

So why do we cough, when will a cough go away on its own, and when is it time to see the doctor? Here are a few things you should know about coughing.

Coughing is a protective reflex

Humans developed the ability to cough over time for several reasons.

One reason is to eliminate things that irritate the lungs. We’ve learned to cough to expel mucus, for example.

Another reason is to protect your airway so you don’t choke. We’ve all had the experience of taking a drink that goes down the wrong pipe. We cough and it comes spraying out of our nose or mouth. That’s a reflex mechanism that we’ve developed to protect our airway.

Coughing could be due to inflammation from an upper respiratory tract infection

Sometimes, there’s some residual airway inflammation in the lungs from typical upper respiratory tract infections. So, even after the real meat of the infection is gone and you’re starting to feel better, you have a cough because you still have some irritation in the lungs. The lungs are quite sensitive, so when they are inflamed and irritated, it doesn’t take a lot to cause a cough.

If you have an infection, drink plenty of fluids. Staying hydrated will help thin out the mucus in your lungs and sinuses. If it’s thick and sticky, it’s hard for you to cough it out of your lungs or blow it out of your nose. If it’s thinner, it’s easier to expel.

Coughing can be worse at night

If you’ve got sinus congestion or runny nose, mucus can drain down the back of your throat when you lie down. This affects the upper airway and leads to coughing.

Coughing at night is more disruptive because you’re trying to sleep. If you’re coughing throughout the day, you cough and continue with your activities. But it’s more irritating for you and, potentially, your bed partner when you’re trying to sleep.

For some patients, their cough is so severe that they aren’t getting any sleep at all, which impacts their ability to function during the day. In that situation, you might consider taking a cough suppressant with codeine to blunt the cough reflex and assist with sleep.

There’s a difference between wet and dry coughs

Wet coughs

Wet coughs, also called “productive coughs,” produce mucus and are usually related to infections of the upper respiratory tract or sinuses. They tend to be short-lived, typically ending in 10 to 14 days.

The common cold, which peaks around early February, is one of the top causes of a wet cough. If you go to the pharmacy or the grocery store, there are dozens of different over-the-counter options to try to treat cold-related coughs. The reality is that those coughs will resolve on their own.

Simple, effective hygiene habits to help prevent spread to other family members:

• Cover your mouth (not with your hand) when you cough or sneeze.
• Wash your hands regularly with soap and water.
• Use antibacterial wipes to sanitize dining tables, kitchen counters and bathroom surfaces.
• Avoid sharing kitchen utensils and hand towels.

Dry coughs

Dry coughs don’t produce any mucus. Some of the most common chronic coughs, lasting more than three weeks, fall into this category.

When to see a doctor about a cough

If your cough — wet or dry — persists for more than three weeks, get evaluated by your primary care doctor. You may undergo a chest X-ray or lung function test or be referred to a doctor who specializes in airway issues, called a pulmonologist.

An exception: If you’re showing signs of the highly contagious whooping cough (pertussis), don’t wait. See a doctor immediately. Whooping cough starts like a cold, but develops to include nausea, vomiting, persistent fever and a severe cough. It can be treated with antibiotics.

A dry, chronic cough is commonly caused by one of several issues

In our cough clinic, the definition of a chronic cough would be a cough that lasts for more than three weeks. That usually will extend past most viral infections or any other respiratory infection. There are several common causes.

Allergies

Uncontrolled allergies, animal and environmental, can be accompanied by constant drainage on the back of your throat from your sinuses. This can lead to a nagging, persistent cough that goes on for quite some time.

Asthma

People with asthma might hear a sound similar to a whistle or a wheeze when they cough. With asthma, your airways become inflamed and swollen, causing shortness of breath. Many people with asthma don’t realize they have it. The condition is diagnosed easily with a lung function test.

Medications

ACE (angiotension-converting enzyme) inhibitors, a class of drugs used to treat high blood pressure, have a well-known side effect of dry, chronic cough. If it’s problematic, the doctor could try an alternative ACE inhibitor or a different type of heart medication. Some non-steroidal medications (NSAIDs), like ibuprofen (Advil, Motrin) and aspirin can also cause coughing.

Acid reflux

Acid reflux, or gastroesophageal reflux, causes acid from the stomach to irritate the upper airway. Patients typically start coughing when they lie down in bed. The painful cough will go away when the acid reflux is treated with medication.

Persistent coughing could be a symptom of a serious illness

There are warning signs that you should seek medical care for a persistent cough before three weeks have passed. It could indicate pneumonia or even cancer.

See a doctor right away if you’re also:

• coughing up blood
• spiking fevers
• experiencing significant shortness of breath

The doctor will examine you to determine the cause of the cough and establish a treatment plan.