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Coughs (cont.)

Cough Symptoms

What differentiates the cause of a cough are the associated signs and symptoms. Another important factor in determining the cause of the cough is whether it is acute or chronic.

Acute coughs have been divided into infectious and noninfectious causes.

  • Signs and symptoms that point to an infection include fever, chills, body aches, sore throat, nausea, vomiting, headache, sinus pressure, runny nose, night sweats, and postnasal drip. Sputum, or phlegm, sometimes indicates an infection is present, but it is also seen in noninfectious causes.
  • Signs and symptoms that point to a noninfectious cause include coughs that occur when a person is exposed to certain chemicals or irritants in the environment, coughs with wheezing, coughs that routinely worsen when an indivdual goes to certain locations or do certain activities, or coughs that improve with inhalers or allergy medications.

The signs and symptoms of the chronic cough can be hard for doctors to assess, because many causes of chronic cough have overlapping signs and symptoms.

  • If a cough is related to environmental irritants, it will worsen when exposed to the offending agent. If a person has an environmental allergy, the cough may improve when using allergy medications. If a person has a smoker's cough, it may improve if they stop smoking and worsens with increased smoking.
  • If a person has a chronic lung disease such as asthma, emphysema, or chronic bronchitis, they may have a persistent cough or a cough that worsens with certain locations or activities. An individual may or may not have sputum with a cough, and often have improvement with the use of inhaled or oral steroids, or other inhaled medications.
  • If a cough is caused by chronic sinus infections, chronic runny nose, or chronic postnasal drip, the person will often have the signs and symptoms associated with these conditions. A person may also notice that the cough worsens when his or her problem worsens, and often the cough will improve when the underlying problem is treated.
  • If a cough is associated with medications, such as angiotensin converting enzyme (ACE) inhibitors, the cough often begins after starting the medication in question, but can come on at any point during the use of the medication. The cough is often dry and improves when the medication is stopped.
  • A cough associated with GERD is often associated with a sensation of heartburn. This type of cough worsens during the day or when lying flat on the back. Furthermore, a sizable minority of people with a cough caused by GERD will note no symptoms of reflux, but most people will report improvement in their cough when GERD is treated properly.
  • If a cough is a warning sign of an underlying cancer, the person may have a group of symptoms. If lung cancer or a cancer of the air passages is present, the person may cough up blood. Other signs and symptoms that may warn of a cancer include worsening fatigue, loss of appetite, unexplained loss of weight, or decreased ability to swallow solid or liquid foods.
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