We all know we shouldn’t be traipsing to the GP with every sniffle, but coughs can be a bit tricky.
Some sound worse than others, some last longer than others, and all cause us to try self-diagnose to save the embarrassment of a trip to the doctors, only to find out an over-the-counter remedy was the solution all along.
But learning the differences between types of cough really is useful, and could benefit us all in the long-run.
Is it lingering irritation after a cold, or could that stubborn cough be a sign of something worse? What if you’re hacking up phlegm, or also getting breathless?
Here, experts explain what different coughs might mean, and when to get to the doc pronto.
It’s not unusual for a cough to linger longer than the rest of your cold symptoms, and they can sound bad.
“Common cold coughs generally fall into two types – dry or chesty,” says Kathryn Granleese, Superdrug Pharmacist and Clinical Development Manager (superdrug.com), “and don’t freak out if you’re coughing up thick phlegm or mucus too.
“It is important to stop panicking. If you are coughing up a lot of phlegm, it sounds like a chesty cough and it can be normal for it to last a while.”
Similar coughs can occur with flu, although flu generally makes people feel very unwell for around a week and in need of some proper rest at home.
What to do: Antibiotics don’t work on viral infections, so head to your pharmacist rather than the GP for advice on managing symptoms.
“Staying hydrated is very important, as well as ensuring you get plenty of rest. Drinking hot drinks can also aid congestion and steaming clears the airways,” says Kathryn. If your cough’s accompanied by a sore/irritated throat, she suggests trying “lozenges or throat sprays and, for congestion, a decongestant can help”.
And “try sleeping with an extra pillow” if a phlegmy cough is keeping you up at night.
While it is horrible, most people can self-manage flu and recover after a good rest. But flu jabs are recommended and available free for groups who might be more prone to complications (including over-65s, pregnant women and people with pre-existing conditions), or they cost from £6.99 to have one privately.
“Smokers commonly develop a cough due to the negative impact smoking has on the airways, whereby movement of natural mucus can be slowed down causing us to need to cough to move this along. This type of smoker’s cough is often worse in the mornings,” says Dr Phelan.
People with a history of smoking can be more at risk of other conditions that might be associated with coughs too, such as chronic obstructive pulmonary disease (COPD), a group of conditions including emphysema and chronic bronchitis.
Coughs can be a sign of heart problems such as heart failure too, “particularly in older adults, due to fluid gathering in the lungs,” says Dr Phelan, “along with other symptoms such as swelling of the ankles.”
This applies to people who don’t have a history of smoking too.
What to do: If you smoke, it’s never too late to quit. Speak to your GP about support services and products that might be available to help.
If you have a chronic cough that’s getting worse and/or you’re also experiencing breathlessness, or swelling of the ankles, get things checked.
Coughs are extremely common and rarely serious – but if you spot any worrying or potential “red-flag” symptoms, get things checked as soon as possible.
“Most of the time coughs will pass within a few weeks. However, if you can’t shake off your cough, or it seems to be getting worse, such as you’re bringing up coloured mucus, phlegm or blood, it’s best to get it checked out so your doctor can rule out the possibility of a chest infection, or more serious diagnoses such as lung cancer,” says Dr Luke James, Medical Director at Bupa UK Insurance (bupa.co.uk).
“Other lung cancer symptoms to be aware of include chest pain, recurrent chest infections, tiredness, swelling in the neck or face, or losing weight for no obvious reason. It can be hard to remember all of these symptoms, and recent research from Bupa UK found at least a third of people couldn’t identify potential signs of lung cancer.
“To simplify things, I always advise people to do a ‘check-CUP’ for cancer and seek medical help if you’ve experienced a ‘Change’ in your health that is ‘Unexplained’ or ‘Persistent’.”
What to do: It probably won’t be cancer. But if it is, the earlier the disease is detected, the easier it is to treat – so check in with the doc without delay.
Coughs are actually a fairly common symptom of asthma.
“A reoccurring cough which may or may not be accompanied by wheezing (a high-pitched or course whistling sound when you breathe) could be a symptom of asthma,” says Dr Andy Whittamore, Clinical Lead at Asthma UK, a charity which offers health advice to sufferers through its website and nurse-staffed helpline (asthma.org.uk, 0300 222 5800).
“Anyone with a persistent or reoccurring cough, or a cough which particularly bothers them at night or early morning, should see their GP. While many people think asthma starts in childhood, it is also common for people to be diagnosed as adults. Other symptoms include chest
tightening and breathlessness.”
Another indication of asthma is noticing a pattern with your symptoms: Do they flare up around certain triggers?
Common examples, says Dr Whittamore, include “pollen, dust, cigarette smoke, cold air or pets”, while colds and flu can also make asthma worse, or trigger asthma attacks.
What to do: If you or your child experience symptoms that could be asthma, see your GP. Asthma can quickly become very serious, but can be well managed with the right treatment and advice.
Knowing when to be concerned about a persistent cough can be tricky, says
Dr Alexandra Phelan, a GP with the NHS and Pharmacy2U, the UK’s largest
But if it’s lasted three weeks or longer and you also have any of the following symptoms, then there might be a more serious lung infection going on, or maybe pneumonia or bronchitis.
“If you’ve noticed an increase in shortness of breath, pain on breathing, wheezing, hoarseness of the voice that persists for more than a few days, swollen ankles, heartburn, unexplained weight loss, difficulty swallowing or chest pain, these may be signs of a more serious infection that requires medical treatment.
“Or equally if you have a cough with
a fever and shortness of breath, any evidence of blood in your phlegm or signs of confusion.
“Lung infections, such as pneumonia, are a common cause of coughs and may require treatment such as antibiotics.”
What to do: Your GP will be able to assess the symptoms and arrange tests if needed, so make an appointment. If it is a lung infection, most people will make a full recovery at home – but it’s important to get appropriate treatment and advice.
As well as asthma, a number of cough conditions might affect children.
Dr Alexandra Phelan explains: “Most coughs in children are simple viral infections requiring no treatment. If there’s a fever, paracetamol liquid (e.g. Calpol) can be used.
“Coughs associated with shortness of breath, high fevers or confusion should be seen by a GP,” she adds. “However, it’s worth bearing in mind cough medicine is not routinely recommended for young children.”
If your child’s cough sounds like any of the below, seek a GP assessment.
If they’re struggling to breathe or they lose consciousness, dial 999.
Lots of children are routinely immunised against whooping cough, but if yours aren’t, it’s important to know the signs.
“Whooping cough is quite dramatic,” says Dr Phelan. “Its main characteristic is repeated coughing fits that last for a long period of time and end with a ‘whoop’ as the sufferer desperately tried to get air back into their lungs. These episodes can occasionally lead to loss of consciousness or collapse.
“Any cough that fits this pattern requires a GP assessment. If it is determined to be whooping cough, antibiotics can be used, but symptoms can still last for a prolonged period.”
“Younger children can get this condition, which is more common in the winter months. This has a characteristic barking type cough and is easily spotted by experienced parents or health professionals.
“Sometimes this needs treatment with steroid medication, but often only management of the associated fever is required.”
“Younger children can also get this condition, and, again, it’s more common over winter. This is a widespread lung infection and can cause quite a marked cough and wheezes. Often there is a rattly cough, and it can cause shortness of breath in some children. Occasionally this can be so significant that hospital admission for oxygen is required.”
“Children can get pneumonia which involves a significant infection of one part of the lung. This can cause high fever and shortness of breath. It is difficult for parents to spot this type of infection and, therefore, if symptoms are significant, children need assessment by a GP.”
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