A cough is not a disease but a reflex act, part of the protective and cleansing reactions of breathing: this is how the body removes mucus, dust and irritants from the airways. So the question is not how to suppress it, but where it comes from and how long it lasts. Below — about the difference between acute, prolonged and chronic cough and about the signs with which you should not wait.
Why the body needs a cough
The cough reflex is controlled by the central nervous system — the cough center in the medulla oblongata. The trigger is irritation of receptors in the nose, pharynx, trachea, bronchi and pleura: inflammation with swelling of the mucosa, mechanical irritation, chemicals, fever. Then comes a deep breath and a sudden short forced exhalation: the very push that we hear as a cough. The most sensitive areas are the posterior pharyngeal wall, the glottis, the trachea and the pleura. The cough push begins with the glottis closed, and then it opens. If the cough has a central origin, the irritation comes from the cerebral cortex.
Duration: acute, subacute, chronic
The easiest way to orient yourself is by weeks. An acute cough most often accompanies acute respiratory viral infections: such a cough usually goes away on its own within 3–4 weeks. By duration, a cough can be acute, subacute, chronic, recurrent; by character — paroxysmal spasmodic (in whooping cough), superficial, hacking. The clinical assessment of cough is based on the duration of the symptom, the cause and the response to therapy. The International Classification of Primary Care assigns cough to the "Respiratory system" category and considers it as a reason for visiting a doctor — a symptom or a complaint.
A prolonged and frequent cough does not pass without a trace — it can lead to pulmonary emphysema and respiratory failure.
Dry and wet: the difference by ear and by meaning
A dry, or non-productive, cough occurs without sputum: it happens in the initial stages of bronchitis or pleurisy. A wet, productive one — with sputum discharge. It is also described by timbre — barking, dull, hoarse, chesty, ringing. For a doctor these are not details: the characteristic helps determine the localization of the lesion.
Most common causes
Most coughs start with a cold or flu. Among other causes:
- acute respiratory viral infections, bronchitis and COVID-19 — the infectious group;
- smoking;
- heartburn (acid reflux);
- allergies, in particular hay fever;
- mucus dripping down the back of the nose.
A cough is rarely a sign of something serious, such as lung cancer. A cough sometimes also occurs with pathology of the digestive or circulatory organs. Occasionally it occurs in healthy people, in particular with anxiety (the so-called nervous cough), or when foreign bodies enter the airways. Infectious diseases in which cough is the leading symptom: flu and other acute respiratory viral infections, whooping cough, measles, pulmonary tuberculosis. A cough also accompanies rhinitis, tonsillitis, pharyngitis, laryngitis, bronchitis, pneumonia and oncological diseases of the respiratory organs.
When it's no longer a cold
Routinely to a family doctor — if the cough lasts more than 3 weeks, weight decreases without a reason, or immunity is weakened, for example due to chemotherapy or diabetes. The doctor will listen to the chest with a stethoscope, take a sputum sample if needed, refer for an X-ray, an allergy test or a lung function study. If the cough is very severe or rapidly worsening, and the lymph nodes on the side of the neck are painful and swollen — see a doctor the same day. Also see a doctor the same day if you cough up blood or feel very unwell.
Call 103 or 112 immediately if breathing is so difficult that the person is gasping, choking and cannot say a word; chest pain squeezes or presses and radiates to the arm, neck or jaw; the lips or skin are pale, blue or gray; the person has fainted.
This material is for reference: it does not replace a consultation with a doctor who will assess your particular cough.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer