New Delhi: This time of year, it feels impossible to escape the chorus of coughs echoing through offices, buses and supermarket aisles. While it’s easy to lump them together as one irritating winter soundtrack, doctors say a cough can take on many different forms — and each variation offers a clue about what’s going on inside your body.
According to Dr Unnati Desai, national GP lead at Nuffield Health, a cough is far more than a noisy nuisance. “It’s a protective reflex controlled by the autonomic nervous system,” she explains. “Every day we breathe in dust, germs and debris. Coughing forces air out of the lungs to try to clear whatever shouldn’t be there.”
Although most coughs settle down once their cause is treated, they can linger. Anything under three weeks is considered acute; those that drag on beyond eight weeks fall into chronic territory. The NHS advises speaking to a GP if a cough lasts more than three weeks, or sooner if there are concerning symptoms such as unexplained weight loss or a weakened immune system.
Here’s a guide to the most common types of cough — and how to spot what might be driving yours.
Infection-related coughs: Coughs caused by viral or bacterial infections often come with other classic sick-day symptoms: fever, tender glands, a blocked nose and sudden coughing fits. Children, in particular, tend to produce distinctive sounds depending on the infection. A harsh, barking cough is characteristic of croup, a viral illness that makes the voice box and windpipe swell. Another tell-tale sound is the sharp, high-pitched intake of breath after a coughing spasm, signalling whooping cough, a bacterial infection that spreads easily among young children.
In winter, a wet, “fruity” cough in babies and toddlers often points to RSV, the virus behind bronchiolitis. While most cases are mild, some children need hospital care due to breathing difficulty. A cough accompanied by wheezing may simply indicate swollen, mucus-filled airways — a common side effect of colds. But if you feel suddenly unwell, develop chest pain, struggle to breathe or notice a racing heart, doctors worry about pneumonia, which can be caused by bacteria, viruses or, less commonly, fungi.
If the cough is productive but you otherwise feel well, bronchitis — inflammation of the major airways — is more likely. Public health officials have also raised concerns about tuberculosis, which has been rising in the UK. TB often causes a cough lasting more than three weeks and can produce blood-tinged phlegm. It requires months of antibiotic treatment.
Clear mucus usually means a viral illness that will pass with fluids, rest, steam inhalation and over-the-counter pain relief. Thick green or yellow mucus persisting for more than two weeks suggests a bacterial infection, which may need antibiotics. Asthma, which often runs in families, is another major cause of coughing. Symptoms tend to flare at night or after exercise and may be triggered by anything from animal fur to cold air. Respiratory infections are well-known for making asthma worse, so using prescribed inhalers is essential.
Coughs tied to nose and sinus problems: Sometimes the problem isn’t the lungs at all. Allergies or infections affecting the nose and sinuses can cause post-nasal drip, where mucus slides down the back of the throat and repeatedly triggers the cough reflex. Rhinitis leads to a runny or blocked nose, while sinusitis causes a deeper build-up of mucus in the air-filled spaces surrounding the nose.
Acid reflux cough: Digestive issues can also be the culprit. In GORD (acid reflux), stomach acid travels upward and irritates the throat, leaving people with heartburn, an unpleasant taste, and often a persistent dry cough as the body tries to guard the airways.
Medication-related coughs: A surprising number of medicines can provoke coughing. Dr Desai points to ACE inhibitors for high blood pressure as one of the main offenders. Other drugs, including beta-blockers, NSAIDs and steroids, can trigger bronchospasm or worsen reflux, both of which may spark a cough.
Coughs linked to smoking or chronic lung disease: Long-term smokers often develop a familiar hacking known as smoker’s cough, which can signal damage to the airways. Conditions such as COPD, emphysema and lung cancer are closely linked with tobacco use, with smoking responsible for the majority of lung cancer diagnoses in the UK. While quitting won’t reverse existing lung damage, it can significantly slow disease progression.
When a cough may be a warning sign
On rare occasions, a cough can be a symptom of a pulmonary embolism, a blood clot lodged in the lung. This is a medical emergency. Shortness of breath, chest pain, coughing up blood or a racing heart — especially after long flights, immobility or starting hormone-based medications — require immediate attention.