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Types Of Cough

Understanding Symptoms Of A Cough

Dr. Melody Hartzler Profile Photo

Written by Dr. Melody Hartzler on June 29, 2021

One of the most common symptoms of many illnesses is a cough. The disruptive, hacking feeling associated with a cough can be painful, keep you up at night, or even make it difficult to breathe. Coughs are often accompanied by chest congestion and nasal congestion in general. While most go away on their own, you may need to use over the counter medications to relieve your symptoms or receive prescription medications from a qualified healthcare professional.

While a cough might seem like a simple symptom that is easy to treat with cough medicine or a throat lozenge, a cough can occur for many different reasons and may require different treatments depending on the root cause.

Therefore, it is very important to identify the type of cough you are experiencing in order to evaluate possible causes and treatment options. There are four main types of coughs that you should be familiar with.

What is a Cough?

A cough, sometimes referred to as tussis, is an action in which air is rapidly expelled from the lungs, clearing the throat and breathing passage of microbes, mucus, fluids, irritants, and foreign particles.

Coughing can be voluntary, occurring when a person intentionally coughs to clear their throat, or involuntary, which typically occurs as a result of an underlying cause or condition. People experience a coughing reflex as a way to clear their airways and improve their breathing.

There are three separate parts to a cough:

  • Inhalation, or breathing in
  • Pressure builds in the throat and lungs with the vocal cords closed
  • An explosive release of air that occurs as the vocal cords open, causing the sound that is commonly associated with the cough.

Coughs can occur for a number of different reasons and may be associated with and accompanied by a variety of symptoms. However, some symptoms are often experienced at the same time as a cough.


What Symptoms Are Commonly Associated With a Cough?

Coughs can occur as a result of an infectious disease, such as the common cold or flu, but there can also be other conditions that can cause a cough. However, a chronic cough that occurs over an extended period of time is often a sign of disease.

Coughs can be dry, meaning they do not produce any mucus or phlegm, or wet, meaning they do produce mucus or phlegm.

Symptoms that may occur at the same time as a cough commonly include:

  • A runny or stuffy nose
  • Frequent throat clearing
  • Sore throat
  • Wheezing
  • Shortness of breath
  • A feeling of liquid running down the back of your throat (postnasal drip)
  • Hoarseness
  • Heartburn or a sour taste in your mouth
  • In rare cases, coughing up blood

What are the different types and causes of coughs?

There are several different types of coughs, each of which has different possible causes. The first step in identifying the possible cause of your cough is to determine what type of cough you have based on the descriptions below.

The four primary types of coughs include dry cough, wet cough, croup cough, and paroxysmal cough.

Dry Cough

A dry cough is a cough that is not productive, meaning it doesn’t cause you to produce mucus or phlegm. As a result, you might not be able to pinpoint exactly why you are coughing besides feeling like something is triggering your coughing reflex. A dry cough can feel like a tickly or irritating sensation in the back of the throat.

One of the most frustrating aspects of dry coughs is that they can be tough to calm, and you might find yourself coughing for long periods of time without being able to stop. Dry coughs occur when the respiratory tract becomes irritated or inflamed, as often occurs with common medical issues like the cold, flu, or other upper respiratory infections.

However, unlike wet coughs, there is no extra mucus in your respiratory tract that is produced by the cough. Unlike coughs that produce mucus, which typically resolve once the excess mucus has cleared from your respiratory system, a dry cough may persist long after the point at which you are feeling better.

Common causes of dry cough include:

  • Cold
  • Flu
  • Laryngitis
  • Croup
  • The use of certain medications
  • Sore throat
  • Tonsillitis
  • Asthma
  • Sinusitis
  • Allergies
  • Acid reflux or gastroesophageal reflux disease (GERD)
  • Exposure to irritants in the air, including smoke, pollution, or dust

Recently, the COVID-19 virus has also been identified as a possible cause of dry cough. A dry cough is one of the most common symptoms associated with the virus, which is known to be highly contagious.

While there are many reasons why people could experience a dry cough, a dry cough caused by COVID-19 may also occur alongside other symptoms, including:

  • Fever
  • Shortness of breath
  • Loss of taste or smell
  • Difficulty breathing
  • Muscle or body aches
  • Sore throat
  • Nausea or vomiting
  • Chills
  • Fatigue
  • Headache
  • Congestion or runny nose
  • Diarrhea

If you’re exhibiting symptoms of COVID-19, it is important that you take as many precautions as possible to avoid spreading the virus to others. Make sure you abide by the following guidelines from the Centers for Disease Control and Prevention (CDC):

  • Stay home unless you need to get medical care. Avoid public areas.
  • Get plenty of rest and drink lots of fluids to stay hydrated. Use over the counter medications to treat your symptoms as needed.
  • Communicate with your doctor about your symptoms and seek immediate medical attention if you are having difficulty breathing.
  • Avoid all forms of public transportation, taxis, and ride-sharing.
  • Quarantine away from other people in your home if possible, preferably by using a different bedroom and bathroom.
  • Notify anyone that you may have come into contact with while infected that they may have been exposed to COVID-19.

Seek medical attention if you experience any of the following:

  • Trouble breathing
  • New confusion
  • Skin, lips, or nail beds that are pale, grey, or blue in color
  • Persistent pain or pressure in the chest
  • Inability to wake or stay awake

Wet Cough

Sometimes referred to as a productive cough, a wet cough is the type of cough that most people commonly associate with an illness.

Usually characterized by the production of mucus or phlegm, wet coughs are most often experienced as a result of illnesses that include:

  • Common cold
  • Chronic bronchitis
  • Asthma
  • Pneumonia
  • Flu
  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Acute bronchitis

People experiencing a wet cough commonly feel like they have mucus, phlegm, or saliva in the back of their throat or in their chest that needs to be coughed up. Wet coughs are distinguishable from dry coughs because they produce mucus that may be brought up from the chest or throat into the mouth, allowing you to spit out the fluid.

This type of cough typically occurs as a result of the body attempting to expunge mucus that is bogging down the respiratory system and making it difficult to breathe. Mucus may be found in all parts of the respiratory system, including the throat, airways, nose, mouth, and lungs.

If you’re suffering from a wet cough, you may also experience symptoms like fatigue, postnasal drip, or a runny nose.

Depending on the specific medical issue that is causing your wet cough, the cough can be characterized as acute or chronic. Acute wet coughs typically last three weeks or less, while chronic coughs last four weeks or longer in children and eight weeks or longer in adults. Children experiencing a wet cough that lasts less than three weeks are most likely experiencing a cough due to a cold or flu.

Croup Cough

Croup is an infection of the upper airway that most commonly occurs in younger children, including those ages five and under. Croup is caused by a virus that causes the passages of the upper airway to become irritated and swollen, making it difficult to breathe. The infection is characterized by difficulty breathing and is perhaps most recognized by a characteristic cough that sounds like a barking seal.

In addition to the distinctive cough, croup commonly causes the following symptoms:

Swelling around the larynx (voice box), bronchial tubes, and windpipe (trachea) that causes the distinctive barking sound when air is forced through the airway during a cough

  • Hoarse voice
  • Noisy or labored breathing
  • Rapid breathing
  • A high-pitched whistling sound that occurs during inhalation
  • Fever

Croup can be scary for parents and children, but the infection is usually short-lived, with most children recovering from their symptoms in three to five days. The worst symptoms typically occur at night.

While most children recover from croup quickly, severe cases can occur. Be sure to seek medical attention for your child if any of the following issues occur:

  • Symptoms persist for more than three to five days
  • Your child starts making noisy, high-pitched sounds while inhaling and exhaling
  • Your child makes high-pitched breathing sounds when not crying or agitated
  • Your child seems fatigued and listless or anxious and agitated
  • Your child struggles to breathe
  • Your child begins drooling or has difficulty swallowing
  • Your child is breathing at a faster rate than normal
  • Your child develops grayish or blue skin around the nose, nail beds, or mouth

Paroxysmal Cough

A paroxysmal cough is an exhausting type of cough that is characterized by fits of violent, uncontrolled coughing that may make it difficult to breathe. This type of cough is painful and can cause people to vomit if they are unable to breathe properly.

Paroxysmal coughs can be caused by a number of different conditions, including:

  • Asthma
  • COPD
  • Tuberculosis
  • Whooping cough (pertussis)
  • Pneumonia
  • Choking

The most common cause of paroxysmal cough in children is whooping cough, or pertussis. Whooping cough is a highly contagious bacterial infection of the respiratory tract that is characterized by a severe, painful cough that is followed by a sharp breath intake that is marked by a high-pitched “whoop” sound. This sound occurs because the lungs release all of the air that they hold during the coughing fit, causing the patient to need to take a large breath after finishing coughing.

Whooping cough is a preventable illness, as children should receive vaccinations for the condition. Babies can start to get vaccinated beginning at two months of age.

Today, whooping cough most commonly occurs in babies who are too young to be vaccinated and adults and teenagers who find that their immunity has faded. The disease can be fatal, particularly in infants, so vaccination is incredibly important for both children and all of the people who come in close contact with an infant.

The symptoms of whooping cough typically begin within seven to ten days of infection and often start out as mild. Early symptoms include:

  • Cough
  • Nasal congestion
  • Fever
  • Runny nose
  • Red, watery eyes

After about one to two weeks, the symptoms start to get worse as mucus accumulates in the airways, making it difficult to breathe and causing uncontrollable coughing. These coughing attacks can cause vomiting, extreme fatigue, and difficulty breathing. Infants may not cough at all and instead may simply struggle to breathe or even stop breathing, which is an emergency.

How Can You Treat a Cough?

With so many different conditions linked to the four types of coughs, it can be difficult to treat a cough without knowing the exact cause of the patient's symptoms. However, there are some remedies that work for each type of cough depending on the age of the patient experiencing the symptoms.

Dry Cough Remedies

The age of the person experiencing a dry cough plays a large role in determining how to treat their symptoms.

Babies and toddlers may not need any treatment at all for a dry cough. Because cold and cough medicines can be very dangerous for young children, it is usually best to make them more comfortable by using a humidifier, bringing them into a steamy bathroom, or taking them outdoors into cool air, all of which can help to make them more comfortable and soothe their symptoms.

Babies and toddlers under the age of two should never be given over the counter cough or cold medicine, according to the U.S. Food and Drug Administration (FDA).

Children over the age of two may benefit from child-specific over the counter cough medications or prescription drugs depending on the cause of their cough.

Additionally, like younger children, using a humidifier may help your child to feel better because it prevents the respiratory system from drying out. When your child is old enough to use a cough drop safely, they may be able to take a throat lozenge to reduce the discomfort of a sore throat.

If your child experiences a dry cough for more than three weeks, talk to your child’s doctor about possible causes for the cough, as your child may need medication.

Adults with a chronic dry cough may be experiencing a number of different conditions, some of which can be serious. If you notice that your dry cough is accompanied by symptoms like pain or heartburn, or it lasts for more than eight weeks without resolution, talk to your doctor. You may need to receive further testing and take over the counter medications or prescription drugs to treat your condition.

Wet Cough Remedies

Wet cough remedies vary depending on the condition causing the cough, some of which can be bacterial infections. As a result, wet coughs should not be allowed to persist for as long as a dry cough.

Babies and children under the age of two should not be given over the counter cough or cold medicine.

Instead, use a cool-mist humidifier in your child’s room, especially at night. If your child is experiencing nasal congestion, you can use nasal saline drops and sprays to help soothe the nasal passages and loosen and thin mucus. Then, the mucus can be cleared out of the nasal passages with a bulb syringe.

Children over the age of one who are suffering from a wet cough may find relief when given 1.5 teaspoons of honey within 30 minutes of bed time. Young children can also benefit from the use of a humidifier, particularly at night, which moistens the air and helps soothe the airways. Over the counter kids’ cough and cold formulas may be used in older children, but it’s best to talk to your child’s doctor to determine the best treatment option.

Adults with a wet cough often find relief from using over the counter cough and cold medications. However, a wet cough can be a sign of a serious medical issue, so they should not be allowed to persist for longer than three weeks. A wet cough that persists for longer than three weeks may require prescription antibiotics or other treatments.

Croup Cough Remedies

Although croup can be scary for both children and their parents, the experience is typically short lived and often passes without any treatment at all. However, there are home remedies that you can try to make your child more comfortable.

Home remedies for croup cough include:

  • Using a cool-mist humidifier to help moisten the air in your child’s bedroom
  • Taking your child out to breathe the cool night air
  • Giving your child acetaminophen if they are experiencing a fever and your child’s doctor directs you to do so
  • Taking your child for a ride in the car with the windows slightly open to expose them to cool air
  • Giving your child plenty of fluids
  • Ensuring that your child gets lots of rest
  • Taking your child into a steam-filled bathroom for ten minutes at a time to help moisten the airways
  • If directed by your child’s doctor, using a nebulizer breathing treatment or a prescription medication to reduce the inflammation of the airways


Remedies for a Paroxysmal Cough

There are a number of different reasons why paroxysmal cough can occur, but all of them are serious. Therefore, it is important that any person experiencing paroxysmal cough receive medical attention.

Of all of the reasons why paroxysmal cough can occur, the most common cause is whooping cough. Whooping cough must be treated with antibiotics in all people regardless of their age. The infection is very contagious, so anyone caring for a person who is infected with whooping cough must also receive antibiotic treatment. Whooping cough can be fatal, but earlier treatment helps to ensure a positive outcome.

What Active Ingredients Are Commonly Used in Cough Medicines?

Depending on your age and the cause of your cough, you may benefit from taking an over the counter cough medicine to help find relief from your symptoms.

Cough medicine should never be given to children under the age of two, but older children may benefit from cough medicine if your child’s doctor gives the OK.

Most adults can safely use cough medicine. There are several common active ingredients that you might find in over the counter cough medicine the next time you’re sick:

  • Dextromethorphan
  • Guaifenesin
  • Acetaminophen

Dextromethorphan

Dextromethorphan is an over the counter medication that is characterized as a cough suppressant. Cough suppressants like dextromethorphan work by decreasing the feeling of needing to cough by acting on certain chemical receptors in the brain.

Medications containing dextromethorphan are intended for use in children ages six and older and adults who are suffering from a cough caused by certain types of infections of the upper respiratory system, including the common cold and sinusitis.

Products containing dextromethorphan should not be used to suppress a chronic cough that occurs as a result of smoking or long-term breathing problems, such as emphysema or chronic bronchitis.

Dextromethorphan is generally considered safe for use and is offered as an over the counter drug; however, there are some side effects associated with the use of this medication.

The most common side effects associated with dextromethorphan include drowsiness, nausea, dizziness, and vomiting. Although it is rare, some people can experience an allergic reaction to dextromethorphan. Symptoms of an allergic reaction may include a rash, swelling of the face, tongue or throat, dizziness, difficulty breathing, itching, or hives.

Guaifenesin

Guaifenesin is an over the counter medication that is classified as an expectorant. Guaifenesin is the only expectorant available for use in the United States, so you’re likely to see it listed on many different medication labels.

Expectorants like guaifenesin work to help relieve the symptoms of a cough by thinning and loosening the mucus that lines the lungs and airways, which makes it easier to cough up. As a result, guaifenesin is most appropriately used to treat coughing and chest congestion associated with a wet cough and caused by illnesses like the common cold, the flu, sinusitis, or bronchitis.

The use of guaifenesin is generally considered safe and the drug is sold over the counter.

However, some side effects may occur. Drowsiness, dizziness, lightheadedness, nausea, constipation, facial flushing, and vomiting can all occur as a result of guaifenesin use.

Like dextromethorphan, the use of guaifenesin can rarely cause an allergic reaction. Symptoms of an allergic reaction may include a rash, swelling of the face, tongue or throat, dizziness, difficulty breathing, itching, or hives.

Acetaminophen

Acetaminophen is an over the counter medication that is used as a pain reliever and fever reducer. While it does not work to suppress a cough or make coughing mucus up easier, like suppressants and expectorants, the drug is commonly used in many cough and cold medications, particularly combination products that are designed to address a variety of symptoms.

Acetaminophen can help in reducing pain associated with a cough and can also help bring a fever down, which can help relieve discomfort associated with an illness. While taking acetaminophen on its own will not help to improve cough symptoms, it can be effective when combined with other drugs like dextromethorphan or guaifenesin.

Acetaminophen is not commonly associated with any side effects, but it is still important to use this over the counter medication as directed. When too much acetaminophen is consumed in a short period of time, it can cause serious health effects that require immediate medical attention, including liver damage.

While using products that contain acetaminophen, make sure to watch out for the following side effects and seek medical treatment immediately if any are observed:

  • Bloody or cloudy urine
  • Fever with or without chills that was not present prior to starting treatment with Tylenol and is not caused by the condition being treated
  • Blood or black, tarry stools
  • Sharp or severe pain in the lower back and/or side
  • Skin rash, hives, or itching
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Pinpoint red spots on the skin
  • Sore throat that was not present prior to starting treatment with Tylenol and is not caused by the condition being treated
  • Sudden decrease in the amount of urine
  • Unusual bleeding or bruising
  • Yellow eyes or skin
  • Unusual tiredness or weakness

When Should You Talk to a Doctor About Your Cough?

While many coughs disappear on their own and don’t require medical attention, there are some situations in which a trip to the doctor’s office might be necessary. Factors to consider when deciding to seek medical attention include the type of cough a patient is experiencing, how long the cough has lasted, and the age and overall health of the patient.

People who are experiencing other medical conditions that can affect their breathing and lung capacity, such as COPD or asthma, may need to seek medical attention sooner than other people.

Adults who are experiencing a cough should seek medical attention if they:

  • Have a cough for more than eight weeks
  • Have a fever above 100.4°F (38°C)
  • Are severely dehydrated
  • Are wheezing in addition to coughing
  • Cough up blood
  • Are too weak to walk or talk
  • Make a whooping noise during a violent coughing fit
  • Have daily stomach acid reflux or heartburn, or a cough in general, that interferes with sleep

Adults should seek emergency medical attention and call 911 if a person experiencing a cough loses consciousness, is too weak to stand, or cannot be woken up.

  • Children with a cough should be seen by a doctor if they:
  • Have a cough for more than three weeks
  • Become so out of breath that they can’t talk or walk
  • Are dehydrated or unable to swallow food
  • Make a “whoop” noise during violent coughing attacks
  • Have a fever above 102°F (38.89°C) or any fever in children ages 2 months and younger
  • Turn bluish or pale
  • Are extremely fatigued
  • Are wheezing in addition to coughing

Adults should seek emergency medical attention and call 911 if their child loses consciousness, is too weak to stand, or cannot be woken up while experiencing a cough.

Summary

If you are experiencing a cough, there could be many different causes for your symptoms. The first step in determining the best course of treatment for your cough is to determine whether you are experiencing a dry cough, wet cough, croup cough, or paroxysmal cough based on your specific symptoms.

Once you have determined what type of cough you have, it is easier to determine a possible cause of the cough. Adults and older children may be able to successfully treat a cough using over the counter medications containing active ingredients like dextromethorphan, guaifenesin, and acetaminophen.

If your cough lasts for more than a few weeks, is accompanied by shortness of breath, is accompanied by a high fever, causes weakness or dehydration, or causes wheezing, make sure to seek medical attention from a qualified healthcare professional, as you may need other treatments to resolve your symptoms.



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