Our lungs are in constant contact with the outside world, and dust, microbes, pollen and other contaminants from the environment can easily enter and cause disease or irritation. But when such items do enter the lungs, that often triggers coughing, a reflex that’s intended to protect the body from irritants or pathogens that could cause trouble.
“Cough is our natural reflex to keep things out of the lungs or to get something that’s in the lungs and shouldn’t be there out,” says Dr. Ron Balkissoon, a pulmonologist with National Jewish Health in Denver.
Dry vs. Productive Cough
If you cough and bring up mucus or phlegm, that’s called a productive or wet cough. If you don’t bring up anything, that’s called a dry cough.
“Cough is a reflex that can be normal but can also signify a disease process,” says Dr. Julie Lyou, a pulmonologist with St. Jude Medical Center in Fullerton, California.
Common causes of a dry cough include:
— Postnasal drip. Postnasal drip occurs when an infection in the sinuses causes mucus to drip down behind the nose and into the throat. This can trigger coughing, and sometimes this can result in a dry cough. “Anything that irritates the sinuses, the nasal passages and the lungs” can lead to a dry cough, Balkissoon says.
— Asthma. In people with asthma, “by definition their airways are hyper-reactive and hyper-sensitive,” Balkissoon says, and that means they may be more likely to develop a dry cough in response to anything from pollen or other particles in the air to simply cold air itself.
— Gastroesophageal reflux disease. In this condition, also known as GERD, the contents of the stomach seep past the valve at the base of the esophagus, causing a burning sensation in the chest. This sensation can “send messages to the brain that then sends a message back to the throat triggering someone to cough,” and it’s usually a nonproductive cough, Balkissoon says.
— Medications. Certain medications, such as blood pressure medications, can cause a side effect of dry coughing in some people.
— Smoking. Inhaling anything into the lungs can trigger a dry cough. Smoking is a primary cause of chronic dry cough.
— Chronic obstructive pulmonary disease. COPD is the umbrella term that includes chronic bronchitis and emphysema. Both conditions reduce your ability to breathe and can result in a dry (or sometimes productive) cough.
— Food allergies. Sometimes certain foods can trigger coughing, and this may signal a food allergy. If you cough after eating milk, soy, peanuts, tree nuts, shellfish or eggs, you might have an allergy. Talk to your doctor for help in figuring out if a food allergy is the cause of your dry cough.
— Coronavirus. An early sign that you might be infected with coronavirus is a dry cough, and it’s a common symptom among those with the virus. A dry cough usually starts within two to 14 days of exposure to an infected individual.
Treating a Dry Cough
Often a dry cough, such as may be associated with the common cold or allergies, will resolve on its own in a few days and may not need medical attention or any formal treatment.
“Depending on the cause of the cough, treatment may include diet and lifestyle changes and sometimes may require medications,” Lyou says. Medications to suppress the urge to cough like lozenges or syrup can quiet a frequent dry cough.
Other changes you can make include:
— Avoiding allergens. Common allergens are dust, pollen and pet dander. Avoiding these can help eliminate a dry cough that’s related to allergies.
— Managing acid reflux. If you have frequent heartburn or GERD, talk to your doctor about better managing the situation to alleviate your dry cough.
— Limiting foods that can cause acid reflux. Certain foods are more likely than others to trigger heartburn. Limit your intake of caffeine, alcohol, spices, tomatoes, dark chocolate and citrus fruits to reduce these symptoms.
— Trying speech therapy. Balkissoon says that for some people with a condition called cough hypersensitivity syndrome, in which “the threshold for triggering the cough reflex is much lower” than in most people, using medicines to suppress the cough can help, but so can speech therapy. “Speech therapy can be helpful in suppressing the urge to cough,” he says, because it teaches you how to quell that urge through pursed-lip breathing, throat relaxation exercises, diaphragmatic breathing and other strategies.
— Staying hydrated. “The drier the throat becomes, the more likely that is to trigger a dry cough,” Balkissoon says, so staying hydrated may help alleviate a chronic dry cough.
When to Talk to Your Doctor
Dry cough, such as may accompany seasonal allergies or the common cold, is not usually serious. However, Lyou says you should notify your doctor immediately if the cough is associated with:
— Trouble breathing, shortness of breath or wheezing.
— Chest pain.
— Weight loss.
— Coughing up blood.
— Coughing up green or yellow mucus.
— Weakness or fatigue.
— Loss of appetite.
— Edema or swelling in the legs or feet.
And if your dry cough has lasted for eight weeks or longer without those symptoms, “then it’s time to see someone about it,” Balkissoon says.
A chronic dry cough can be a sign of serious diseases including:
— Pulmonary fibrosis, scarring of the lungs that makes breathing normally very difficult.
— Lung cancer.
— Chronic obstructive pulmonary disease, damage or inflammation in the airways that makes it more difficult to breathe.
Dry cough has also been identified as a symptom of COVID-19 infection, so if you have any doubt about what’s causing your cough or have been in contact with someone who has COVID-19, contact your doctor for guidance about what to do next.
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