In the cold winter months it often seems like everyone is coughing and sniffing.
The reason coughs are more common during winter is because the cold winter air dries the mucous membranes lining the airways – and these membranes are our first line of defence.
“When the airways dry up, we become more susceptible to viruses and bacteria,” says Australian respiratory physician Dr Simone Barry.
“We also spend more time indoors, increasing our chances of catching a cold from others, and we often have heaters on, which creates a good environment for viruses and bacteria to thrive,” she says.
Coughs can be confusing, as there are different kinds. Here respiratory experts tell how to decipher the symptoms of different coughs, and suggest ways to find relief.
What is it?
A dry cough doesn’t produce any phlegm. “The most common trigger is an infection,” says Barry. “But it can also be caused by asthma, gastroesophageal reflux or GORD (caused by acid from the stomach backing up into the oesophagus), post-nasal drip (when discharge from your nose drips down into the back of your throat) and foreign bodies.”
A dry cough often follows a respiratory infection and you may feel a tickling sensation in the throat that sparks coughing.
It usually goes away on its own. Sipping a soothing tea with honey and lemon often helps, as do throat lozenges.
If your dry cough is caused by GORD, antacids can help. “It’s also important to cut back on things that can exacerbate it such as high-fat food and caffeine,” says Barry.
What is it?
“This harsh cough sounds much like a seal’s bark,” says Barry. “It’s usually dry and is often worse during the night.”
The distinctive sound is usually due to swelling of the upper airways and can be quite alarming, especially to parents. “In children it’s associated with croup,” says Barry.
A virus is the most common cause of croup, but it can also be caused by bacteria or allergies. The infection starts in the nose and throat and then moves into the lungs, with swelling affecting the area around the larynx (voice box) and into the trachea (windpipe).
Croup is most often seen in children aged three months to five years old. Younger kids are more affected by it because their airways are smaller and even a small amount of swelling can make it hard for a baby or young child to breathe.
Fluids to stay hydrated and rest so your body can fight off the bug. A humidifier may help as it moistens the air, making breathing easier.
Croup in children usually lasts three to five days. If the symptoms don’t ease up or your child develops a fever, it’s best to see a doctor.
Persistent (chronic) cough
What is it?
This is a cough that lasts longer than a typical illness. “A persistent cough can last for months,” says Barry. “There are a number of causes, including infection after a cold or flu, asthma, GORD, smoking and medication.
There’s a type of blood pressure medication that can cause a chronic cough in certain people. If you suspect this is the case, talk to your GP about prescribing an alternative medication.
A chronic cough can also be a sign of underlying disease or serious lung conditions such as cancer.
Effective treatment depends on the cause so it’s best to see a doctor to get to the bottom of it. If you have asthma and are using an inhaler, it may be worthwhile to try a different bronchodilator to open up your airways.
If you’re prone to chronic coughs, get the flu shot before winter. “The vaccine contains an inactivated form of the virus and it primes your immune system,” says Barry.
Wet (chesty) cough
What is it?
This is also called a productive cough – one that brings up mucous or phlegm. It is usually due to the flu, the common cold or a chest infection and can be painful.
If you have bronchitis, an inflammation of the lining of the bronchial tubes, you are likely to cough up thick phlegm. “It may be associated with a blocked nose and pain behind the breast bone,” says Barry. “People with bronchitis may feel tired and fatigued, and have fever and sweats.”
“Bed rest with plenty of fluids is the best thing to do,” says Barry. “Bronchitis is usually viral, so antibiotics are unlikely to help.” says Barry. Cough syrups for a wet cough may help.
Bronchitis usually lasts for two to three weeks, but the cough may last longer – up to four weeks.
What is it?
This type of cough often happens when you have blocked airways. It can be caused by a viral infection, allergies or asthma..
“The most likely cause of wheezing is asthma,” says Barry. “Asthma can be triggered by a number of things, including a change in the weather, dust, pollen and even certain types of foods.”
A wheezy cough may clear up on its own, but if it’s accompanied by rapid or shallow breathing you should see a doctor. “Your doctor will be able to diagnose asthma after a few tests,” says Barry. “Inhalers that open up your airways are the first line of treatment and in more severe or persistent cases an inhaled steroid medication may also be used.”
Tickly, itchy cough
What is it?
“This is most likely caused by post-nasal drip,” says Barry. “Normally you produce thin mucous from glands that line your nose and sinuses. But if the mucus increases or it becomes very thick, it can irritate the back of your throat and cause a cough.”
Nasal decongestants can bring relief by reducing the swelling. “But these are only for short-term use,” says Barry. “Long-term use is associated with a rebound effect and you actually get worse.”
“The best medication for long-term use is an inhaled nasal steroid, either over-the-counter (ask your pharmacist) or from your GP.”
What is it? This is also called pertussis and is a highly contagious respiratory tract infection. It’s characterised by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop”.
“Whooping cough can be serious and life-threatening, particularly for babies under six months of age,” says Barry. “It's caused by a bacteria and normally begins like a cold, followed by the characteristic cough which occurs in bouts.
“Vomiting at the end of coughing is not uncommon. In children, they may stop breathing and turn blue.”
Treatment “In the early stages antibiotics may help relieve symptoms and immunisation can prevent whooping cough,” says Barry. The whooping cough vaccine is part of the vaccination schedule for babies in SA.
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You should see your doctor urgently if you:
- Are coughing up excessive discoloured phlegm (green, rust coloured or foul smelling)
- Are coughing up blood
- Have a whooping or barking cough
- Have a cough in conjunction with night sweats, fever or loss of appetite, as it could indicate an underlying infection such as tuberculosis
- Have a cough in conjunction with pain and swelling in the calf, or palpitations – it could be an indication of heart problems.