CoughCough image by photcapy/flickr

 Cough is a very common and distressing symptom with many causes. By far the most common cause is a viral infection. Asthma, chronic obstructive pulmonary disease and pneumonia are the most common of the non-viral causes. 

Sadly, cough is very difficult to treat. A cough is protective in nature, clearing mucus and foreign materiel from the airways and the body resists efforts to suppress it.

Cough also tends to be worst at night. Increases in blood pressure in the larynx make some coughs much worse on reclining. We are also more aware of cough at night when we or family members are trying to sleep.  Cough caused by mucus dripping from the nose is also worsened by lying down.

Children do not gain benefit from cough syrups.  Some children have been seriously harmed by cough medicines and so most countries, including New Zealand, now recommend that children should not be given cough medicines. We have always advised that children should not be given cough remedies.  Sadly, they simply do not work, no matter what they claim on the bottle.

Adults may gain some small benefit from pholcodine linctus (available without prescription) but this may cause drowsiness and constipation. For cough due to heavy nasal congestion, decongestant sprays (otrivin) and tablets (phenylephrine, sudafedP) may help, but be sure to check that these are safe for you.  Otrivin can be painful in use and phenylephrine causes dry mouth and a fast heart beat.  Neither are particularly effective.

  • Most patients with cough will be better sitting up.
  • Sipping ice water is safe and can provide a little temporary relief.
  • Inhaling damp air can also be soothing - use hot but NOT boiling water in a bowl.
  • Consider turning off dehumidifiers but do keep the room warm.
  • Sugar free lozenges can help a little but have no lasting effect.
  • Distraction can also help - It may be better to sit up and read or watch TV until you are tired enough to fall asleep easily rather than lie in bed coughing.

As cough has so many causes, it is difficult to give general advice on when to see a doctor.  If in doubt, come in to see us.

Cough associated with chest pain, shortness of breath, whooping or wheeze may be serious and you should certainly consult a doctor (usually fairly quickly although it depends on severity) Consider calling healthline on 0800 611 116 or even 111.

Bronchitis, a cough with sputum production (but no deeper infection) often causes green spit.  This does not usually indicate a more serious infection but it is hard to be sure without an examination.  If you are not short of breath, do not have a fever and do not have any chronic illnesses, it is usually safe to wait up to three days before you see the doctor, even if you have green spit.  Bear in mind that if you do feel really ill, you should not delay a visit to see us.

Any cough lasting 2 weeks or more usually warrants examination, especially in children.  Though most longer lasting coughs are viral and need no treatment, the longer things go on, the more likely it is to be something else.

Cough productive of blood usually requires a medical consultation though if you have been coughing very hard it may cause small streaks of blood in your sputum.  Don't worry, but do come to see us!

If you are unsure, it is best to visit us - we are always pleased to examine you and offer appropriate individualised advice on management.

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