Overview: What does coughing feel like?
If there’s one symptom people can easily identify, it’s coughing. Coughing is our constant companion. Everyone coughs between 18 and 19 times each day, on average. It’s a natural reflex that keeps the airways clear of secretions and irritants. Sometimes, coughing is a symptom of some other problem. First, it’s more frequent: hundreds of coughs per day rather than a handful. A problem cough can be stronger and more forceful than everyday coughing. Then there are coughing fits—repeated, uncontrolled coughing. Finally, the coughing may bring up unpleasant junk like thick mucus or phlegm. Worst of all, frequent coughing can sometimes never go away. Often, a cough is nothing to worry about, but sometimes it may be a sign of a serious medical issue.
What causes coughing?
The causes of coughing are numerous and varied. However, they can be roughly grouped into irritants, infections, lung problems, and other causes.
The most common irritants or allergens that cause coughing include:
Dry air
Smoking
Second-hand smoke
Pollutants
Dust, pollen, mold, pet dander, and other particulates in the air
Chemicals
Food going down the windpipe (aspiration)
Choking
The most common upper respiratory tract infections or conditions that cause coughing include:
The common cold
Flu (can also affect the lower respiratory tract)
Hay fever or runny nose (rhinitis)
Sinus infections/sinus drainage/postnasal drip
Respiratory syncytial virus (RSV)
COVID-19 (can also affect the lower respiratory tract)
Laryngitis (swollen vocal cords)
Croup
Whooping cough (pertussis)
Lower respiratory infections tract that cause coughing include:
Lung conditions that produce coughing include:
Other coughing causes include:
Should I be worried about coughing?
Coughing is usually not a sign of a serious problem. Instead, it’s often due to a temporary infection, postnasal drip, dry air, irritants, or allergies.
However, violent coughing or any cough that persists beyond three weeks should be brought to the attention of a healthcare provider. Chronic and severe coughing can result in complications such as sleeplessness, fatigue, vomiting, headaches, lightheadedness, and sweats. The worst possible complication is breaking one or more ribs.
More importantly, other symptoms may be cause for worry. See a healthcare professional if you are experiencing other symptoms such as fever, difficulty breathing, shortness of breath, chest pain, heartburn, coughing up blood, or any other concerning symptoms.
How is the cause of coughing diagnosed?
When seeing a healthcare professional, be prepared to answer several questions about yourself, the cough, and other symptoms:
When did the coughing start?
What makes the coughing better?
What makes the coughing worse?
Does the cough bring up mucus or phlegm?
Is there blood in the cough?
Does it happen during the day, the night, or day and night?
Are there other symptoms like fever or shortness of breath?
Have you experienced weight loss?
What do you do for a living?
Do you or another family member smoke?
What prescription drugs do you take?
Diagnosis will depend on how long a person has been coughing
An acute cough lasts for a few seconds to no more than three weeks. Most causes of acute coughing are irritants, allergies, postnasal drip, or viral infections. However, acute coughing could be due to serious medical conditions like pneumonia or heart failure. The clinician’s primary diagnostic goal is to ensure that one of these more serious problems isn’t the reason. A medical history, other symptoms, and a physical exam are usually all needed to rule out serious conditions.
A subacute cough lasts for longer than three weeks but less than eight. In these cases, the primary cause of the cough is the lingering effects of an infection, such as postnasal drip or airway hypersensitivity. If there’s no evidence of this, the clinician will try to figure out the cause through a medical history, other symptoms, a physical exam, and possibly a throat culture.
A chronic cough lasts for longer than eight weeks. Chronic coughing has many potential causes—and more than one cause may contribute to a person’s cough. Some causes could be obvious, like smoking, asthma, allergies, postnasal drip, or certain blood pressure medications. If there’s no evidence of a more severe condition, the next diagnostic step is to fix the most evident cause and see if that works. Other chronic cough causes are harder to pin down. In those cases, the clinician will likely order a chest X-ray, depending on the symptoms. Other tests may include:
A CT scan
Bronchoscopy (visual examination of the airway passages through a camera and long tube)
PET scan
Heart exam
Echocardiogram (real-time ultrasound imaging of heart function)
Endoscopic examination of the esophagus
Acid level testing of the esophagus
Sputum testing
Is coughing contagious?
If coughing is due to an infection, then that infection may be contagious. Coughing is the most effective way to spread many infections. To prevent spreading infections through coughing, the Centers for Disease Control and Prevention (CDC) advise people to:
Cover the mouth and nose with a tissue (or your elbow) when coughing
Immediately wash your hands after coughing
Stay at home until the cough improves
Maintain a safe distance from other people when out and about
How long does coughing last?
Coughing is usually a temporary problem. Coughing and other symptoms resolve in less than three weeks for most infections. Sometimes, the coughing can persist for up to two months, even after the infection is resolved. This is mainly due to the lingering effects of the infection, most commonly postnasal drip.
Chronic cough can last for months or years. Depending on the cause, it can be resolved in one or two weeks with treatment or persist for a lifetime.
How to stop coughing
A temporary cough that lasts only a few days or weeks can usually be managed with home remedies or over-the-counter (OTC) symptom-relief medications that include an antitussive (cough suppressant), usually dextromethorphan, and/or an expectorant (which helps to break up mucus), usually guaifenesin. Severe, subacute, and chronic coughs can be managed by prescription antitussives such as benzonatate, promethazine-dextromethorphan, or promethazine-codeine. These prescription drugs can dramatically reduce coughing after the first dose.
Chronic coughing has many causes. Some of them are easily fixed. If coughing is caused by smoking, talk to your doctor about smoking cessation. Stopping smoking will help the cough go away. Or, if your cough is due to an angiotensin-converting enzyme inhibitor (ACE inhibitor) medication, ask your healthcare provider if they can switch you to a different medication. Coughing should improve or go away entirely in a week or two.
Otherwise, treatment for chronic cough will be based on the underlying cause. Additionally, people can relieve coughing symptoms with over-the-counter or prescription cough medicines and the home remedies listed below.
RELATED: The best cough medicine for fast results
Living with coughing
It’s unnecessary to just live with a cough, even temporarily. Coughing can often be reduced or minimized without cough syrups or prescription medications by using these home remedies:
Avoid smoking—including secondhand smoke and vaping
Use a humidifier
Use an air purifier
Drink plenty of fluids/warm fluids
Eat a teaspoon of honey (adults and children one year or older) or mix it into a drink
Suck on cough drops or hard candy—cough relief is about the same for both
RELATED: 6 ways to treat your child’s cough naturally
FAQs about the causes of coughing
What makes a cough worse?
Coughing has many causes. Some are environmental, like dry or cold air, dust, pollen, pollution, cigarette smoke, and chemicals. So if someone has an infection or other problem that causes coughing, any of these environmental causes will worsen it.
What triggers coughing fits?
Coughing fits (called paroxysmal coughing) have many causes. These include croup, whooping cough, asthma, allergies, GERD, or COPD.
Does a cough always mean you're sick?
There are many harmless reasons people cough more than usual. Dry or dusty air, for instance. Instead of worrying about the cough, pay attention to other symptoms to determine whether you’re sick. See a healthcare provider for a diagnosis if you have a severe or persistent cough, especially if you have other symptoms of illness.
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