A cough is a reflex action to clear the throat of any foreign bodies or particles, such as dust. But when you get a cold, the infected mucus from your nose drips down the back of your throat in a process called post-nasal drip. This post-nasal drip causes a type of cough that is not helpful at all. Essentially there are two types of cough, a DRY or a CHESTY cough. Chesty coughs occur when mucus (also called phlegm or catarrh) builds up in the airways and the cough occurs so your body can clear the mucus.
Chesty cough mixtures such as Viscolex® contain an expectorant which liquefy the catarrh so it can be coughed up easier. There are other chesty cough mixtures that cause drowsiness which can be used at night to help you sleep. Sugar free versions of cough mixtures such as Exputex® are available for diabetics.
Dry cough mixtures contain ingredients such as pholcodeine, codeine and dextromethorphan. Dry cough mixtures come in drowsy or non-drowsy versions. The likes of pholcodeine and codeine should only be used in moderation as they cause side effects like constipation and can cause withdrawal symptoms like headaches and can be addictive even if only using for a few days. There are also combination cough mixtures available which contain decongestants which are effective for cough with congestion.
You should see your doctor if you experience any of the following symptoms with your cough:
- Phlegm which is green, yellow or rusty colour.
- Coughing up blood.
- Cough lasting longer than two weeks.
- Shortness of breath.
- Chest pain on breathing or coughing.
- Unexpected loss of weight.
- Regular night time cough.
- Harsh barking cough in children (croup).
- Whooping sound when breathing in after a fit of coughing (whooping cough).
These can be a sign of more serious symptoms
If you are determined to continue smoking, at least stop for the duration of the cough. This gives the lungs an opportunity to try to clear the infection.
These can be very useful, particularly in productive (chesty) coughs. The steam helps to liquefy lung secretions and the warm, moist air is comforting. Put a towel over your head and inhale the steam from a bowl of steaming (not boiling) water. You can add the likes of eucalyptus oil (inexpensive and available in pharmacies) to help clear the sinuses and give a fresh feeling.
Increase fluid intake
High fluid intake helps to hydrate the lungs so helps clear them quicker and hot drinks can have a soothing effect.
As so many different viruses can cause the common cold, no vaccination against it has yet been developed. Some prevention tips are:
- Wash your hands regularly and properly, especially after touching your nose or mouth and before handling food.
- Always sneeze and cough into tissues prevent spreading infection.
- Do not share cups or kitchen utensils with others. Use your own cup, plates and cutlery.
Could your cough be due to your blood pressure medication?
A type of blood pressure medication called ACE inhibitors can cause a persistent dry cough. Examples include ramipril, perindopril, and lisindopril. About 10 to 15% of people who use this class of blood pressure medication experience a dry cough. The incidence of cough appears to be higher in women. It is a persistent dry cough which is worse when lying down and generally doesn’t start for 24 hours after starting an ACE inhibitor. If the dry cough occurs, the doctor will need to change to another drug. The cough will subside once you stop the drug. There are other safe alternatives can be prescribed if you experience this problem.
Coughs in children
Coughs are more common during school term and are caused by common viruses which are commonly passed from child to child in school. While rarely serious, coughs and colds are an inconvenience and lead to many missed school days. Chesty coughs are especially common as kids return to school. An antibiotic is rarely needed. Only 20% of chest infections are bacterial (green phlegm is a sign) so antibiotics are ineffective for most cases.
New guidelines for children
Guidelines in 2011 restricted sale of coughs and cold remedies to children under 6. The Health Product Regulatory Authority (formally Irish Medical Board) introduced these guidelines not because of safety concerns under 6’s but because they recognised that coughs and colds in children are frequent and normally self-limiting, and there is no real evidence to support use of products in under 6’s. Due to these guidelines, pharmacies no longer sell products containing cough suppressants, decongestants or antihistamines to under 6’s. Therefore, products like Benylin® for children, Robitussin or Sudafed can no longer be given to children under 6. For a child under six, best advice is rest and plenty of fluids. Most coughs and colds in children under 6 will pass quickly but if is not improving or there is signs of a bacterial chest/nasal infection (green mucus is a sign), an antibiotic may be needed, however over 80 % of coughs and colds are viral so no antibiotic is needed. Whelehans Paediatric Soothing Syrup and Nelsons Sootha Cough Syrup or Glycerin Honey and Lemon can be given for coughs in under 6 but are more soothing than cough relieving and therefore may give some relief from dry coughs. Saline drops or spray (eg. Calpol® Salin Spray) are a good and safe option to clear sinuses in children over 6. Decongestants rubs or drops that can be put on the child’s chest or hankie beside the bed can be comforting for the child. Calpol® is still recommended for high temperature. For children over 6, there are many products and there is no one that stands out as best. There are all in products that relieve coughs and unblock sinuses (eg) Benylin® coughs and colds (for dry cough with congestion) or Robitussin® Plus (for chesty cough with congestion). Double check the dose before giving due to different doses for different ages.