Cough: Causes

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Exploring the causes of cough

Cough is a common symptom of colds and flu,1,2 and in some cases can be severe.3,4 Here we take a closer look at the various causes behind cough.

Coughing Reflex image

Coughing is a natural and necessary reflex

Coughing is a physiological defensive response of the respiratory system in an attempt to keep the airways clear.

As sensory cough receptors contained in the lungs and airways are stimulated by irritants, signals are sent to the brain’s cough centre and cerebral cortex and then onwards to the brain stem. From here, effector neurons communicate with the diaphragm and intercostal muscles to contract.5 The subsequent coordinated action of the larynx and abdominal muscles force air from the larynx at speed, causing the typical coughing motion.5,6

  • Classification of Cough

    Cough icon

    Identifying the type of cough

    Coughs may be acute or chronic, and wet or dry. As appropriate treatment is guided by the type of cough, it is important to classify the patient’s cough.

    Acute coughs last for less than 3 weeks,7 with the sub-acute classification covering coughs with durations between 3 to 8 weeks. A chronic cough lasts for longer than 8 weeks.8

    A dry cough, also known as an unproductive cough, involves little or no mucus. Coughing fits may be unexpected and unpredictable, triggered by a ticklish, burning sensation in the throat. A wet, or productive, cough, is a purposeful, intentional cough aimed at loosening mucus stuck in the chest.8-10

  • Triggers

    Cough triggers

    Different classes of cough are associated with different causes. The list of cough causes is extensive but includes:

    Women touching nose

    Upper respiratory tract infections

    This is the main source of acute or sub-acute coughs, and includes both viral and bacterial infections, the most frequent agent being rhinovirus.11

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    Allergy

    Allergic rhinitis may cause acute cough.

    Women coughing in pharmacy

    Retronasal drip/upper airway cough syndrome

    Along with bronchial asthma and gastroesophageal reflux, these conditions constitute around 80% of chronic cough causes.11

  • Other causes

    Women coughing

    Other serious causes of cough

    Other conditions that should be considered in acute cough include pneumonia, lung cancer, and tuberculosis.11

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