What helps a cough?

The best approach to a cough depends on its cause and the person’s age. Rest, adequate fluids, reducing smoke exposure and trying honey in people older than one year may relieve some symptoms. However, a persistent or worsening cough, or one accompanied by breathing difficulties, should not be managed solely with home remedies. This article provides general information; personal diagnosis and treatment require assessment by a health professional.

Causes of cough and ways to find relief at home

1. What causes a cough? Coughing is a reflex that helps clear the airways. It commonly occurs with infections such as colds and flu. Postnasal drip, allergies, asthma, reflux and cigarette smoke can also trigger it. Less commonly, serious lung conditions may be involved. Because one syrup cannot treat every cause, the duration, accompanying symptoms and medicines being taken are assessed together. 2. Dry versus productive cough A dry cough does not bring up noticeable mucus and may cause a tickling sensation. A productive cough brings up secretions. This distinction alone cannot establish a diagnosis. Having phlegm does not automatically mean antibiotics are needed; examination and overall health matter. 3. Adequate fluids and rest Drinking water throughout the day and choosing warm drinks you tolerate may soothe the throat. Fluids may help mucus come up more easily. Very hot drinks can burn the mouth and throat. People given a fluid restriction because of heart or kidney disease should follow their treatment plan. Rest during fatigue and fever may make recovery more comfortable. 4. Honey and warm drinks People older than one year can try a small amount of honey or a warm honey-and-lemon drink. Evidence of benefit is limited; it is not a definitive treatment and may not stop the cough completely. Never give honey to babies younger than one year. Do not offer hot drinks to young children. Lemon is optional; stop drinking it if it causes discomfort. 5. Smoke, dry air and humidifiers Avoid smoking and other people’s cigarette smoke. If the air is very dry, a properly used humidifier may reduce throat dryness. Choose a cool-mist device, especially around children. Follow the manufacturer’s instructions for water and cleaning; dirty devices may spread germs, while excessive humidity may increase mould and mites. Leaning over a bowl of boiling water to inhale steam risks burns. 6. Lozenges Age-appropriate lozenges may briefly relieve a dry, tickling cough. Hard sweets and lozenges pose a choking risk for young children and should not be given to those under three. Follow the product’s age restriction. These products do not treat the underlying illness.

Nighttime cough, children, medicines and when to seek medical care

7. What might nighttime cough indicate? A cough that gets worse at night may warrant investigation for postnasal drip, asthma or reflux. Assessment is needed if a child also coughs while running or playing, or has wheezing. It is inappropriate to assume every nighttime cough is reflux and start medicines independently. A cough that worsens when lying down, together with leg swelling, is also important in someone with heart disease. 8. Are cough syrups or antibiotics necessary? Some syrups may reduce symptoms to a limited extent; they are not appropriate for every person or cough. Tell a pharmacist or doctor about other medicines, pregnancy and chronic conditions. Do not exceed the label dose. Do not combine multiple products containing the same active ingredient. NICE does not recommend routine bronchodilators or corticosteroids for cough due to an upper respiratory infection or acute bronchitis unless there is an underlying airway condition such as asthma. Mucus-thinning medicines are not a routine solution in these situations either. Antibiotics do not treat viral infections, but may be necessary if a clinician identifies a bacterial infection or a high risk of complications. 9. Precautions for children and babies A mild cough may be monitored if the child is breathing normally, can drink and is otherwise well. Do not give young children cough and cold medicines without consulting a doctor or pharmacist; some products are unsuitable for children under 12. Seek early medical assessment for a cough in a baby under three months. Do not wait if feeding becomes difficult, breathing is laboured or the child is unusually lethargic. A child’s cough lasting more than three weeks also requires examination. 10. How long can it last? An acute cough starting with an infection improves within three to four weeks in most people. This does not mean every cough can safely be watched for that long. Book an appointment if it exceeds three weeks, repeatedly returns or accompanies unexplained weight loss. Seek care earlier with a suppressed immune system, significant heart or lung disease, or worsening symptoms. 11. Emergency symptoms Call 112 for severe breathing difficulties, bluish skin, altered consciousness or sudden difficulty breathing after choking on something. Coughing up a large amount of blood, or blood with breathlessness and chest pain, is also an emergency. Even small streaks of blood need medical assessment. Seek same-day medical help for a rapidly worsening cough, chest pain or a marked deterioration in general health. 12. Preparing for an appointment Note when the cough started, phlegm, fever, its relationship to nighttime and exertion, and your medicines. Some blood pressure medicines, particularly ACE inhibitors, can cause a dry cough; do not stop the medicine or change its dose yourself. After examination, a doctor may request a chest X-ray or lung function test if needed. Treatment depends on the cause found. Source basis: NHS “Cough”, “Colds, coughs and ear infections in children” and “Coughing up blood”; NICE NG120 acute cough recommendations; MedlinePlus “Cough”, “Humidifiers and health” and “ACE inhibitors”.