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Guide Health: That dry, hacking cough

No wonder they hurt… coughs can eject air from your lungs at 500 m.p.h.!

A cough is your body’s attempt to rid itself of something that is irritating your airways.

You will be familiar with coughs associated with the common cold and the flu, but there are many other reasons for coughs.

Other infections including pneumonia, tuberculosis and whooping cough can certainly cause coughs. But so can allergies, gastro-intestinal reflux disease (i.e. GERD), smoking, asthma, bronchitis, and even chronic obstructive pulmonary disease or COPD.

Parkinson’s disease weakens the muscles that co-ordinate breathing and swallowing, thereby increasing the risk for coughing. Cystic fibrosis has cough as one of its symptoms. Choking, laryngitis, and even smoke from a fire can cause coughing.

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A cough can be acute, that is, it occurs for example with a cold or the flu but then disappears because the cause is resolved. Conversely chronic coughs continue, perhaps because of ongoing exposure to an irritant such as smoking or underlying damage to airways.

A cough that lasts for more than three weeks is considered chronic, which includes about half of all cases.

Coughs can also be wet (i.e. you cough up mucous) or dry, in that they do not produce any phlegm. More chronic coughs are considered dry, hacking coughs.

Coughs can disturb your sleep, cause headaches, result in urinary incontinence, and in some extreme situations increase your risk for broken ribs. When you consider that a cough expels air from your body at up to 500 miles per hour, you can appreciate the broken-rib risk.

About 20 per cent of people taking the type of blood pressure medication known as angiotensin converting enzyme (i.e. ACE inhibitors) experience cough as a side effect. The cough does not affect the way the drugs work, but can be very disturbing. Sometimes the body will become accustomed to the side effect, and the coughing is reduced or disappears. If the coughing continues to be a problem, switching to another class of blood pressure medication is usually recommended.

Obviously, the first step in getting rid of a persistent cough is to find out what may be causing it. Then, by solving the underlying problem, you may become “cough-free.”

Sometimes, this may mean quitting smoking, better controlling any medical condition you may have, such as asthma or COPD, or even changing to another blood pressure medication.

Cough syrups and lozenges are generally not considered effective, and for young children they are not even recommended. Cough syrups often contain multiple ingredients, some of which are associated with their own problems. For example, decongestants can elevate blood pressure and cause urinary retention; antihistamines can cause drowsiness meaning an increase in risk for falls and broken bones.

Narcotic-containing cough syrups are effective in that they target the cough centre in the brain, but they do require a prescription and can lead to dependency, sedation, and constipation.

Non-drug approaches usually work best. Sucking a sugar-free candy or sipping a warm beverage keeps your throat and mouth moist, reducing irritation and cough.

Increasing moisture will also help. You can use a humidifier in your home or even drink plenty of fluids. But if you can’t identify a cause, or if your cough has become chronic, or if you are coughing up phlegm that looks green or yellow, get it checked.

Yes, your cough may be bothersome, but don’t ignore it.

About the author


Marie Berry is a lawyer/pharmacist interested in health and education.



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