Coughing is one of the most frequent reasons for people to visit their doctors. A cough is the sudden expelling of air from the lungs, often involuntarily. It is the body's way to keep the throat and airways clear. Secretions and foreign substances are expelled by the rush of air and can be projected a great distance. The droplets may contain viruses or bacteria, so always cover your mouth when coughing and wash your hands frequently.

Coughs usually go away by themselves in a few days; they may also linger for weeks or months. Coughs can make your throat feel scratchy, disrupt your sleep and make it difficult to rest. You need to know some facts before looking for cough relief.

1. Why do I cough?

A cough is only a symptom, not a disease. Occasional coughing prevents foreign materials and secretions entering the lungs; however, a persistent and uncontrollable cough usually means there is an underlying health problem. Possible causes for coughing are extensive:

Infections such as colds & flu, sinusitis, bronchitis, pneumonia and tuberculosis; Irritations such as smoke, strong odors and fumes; Allergies such as pollen, animal products and dust; Tumors in the chest such as lung cancer; Psychological or habitual such as when you are nervous; Miscellaneous conditions such as heart disease, gastro-esophageal problem and medications.

The lung system and the distribution of cough receptors.

The importance of a persistent cough can only be determined along with other symptoms. See a doctor in the earliest possible so as to prevent the development of an irreversible lung condition.

2. What can I do when coughing?

People with upper respiratory infections often have a protracted cough even after the infection has cleared, because the airways may still be inflamed and sensitive. This cough is generally harmless, but sometimes it may severe enough to disturb your sleep, make you breathless, and interfere with daily life. The following tips help you to feel more comfortable:

• Rest as much as you can , even if you don't feel sick;
• Drink fluids to keep your throat wet; warm beverages like broth or tea bring added relief to an irritated throat;
• Gargle frequently with warm salt water, this helps to ease a scratchy throat;
• Suck a cough lozenge or hard candy, which can soothe an irritated throat;
• Massage the chest and throat regions with aromatic rubbing ointments or creams;
• Steam helps relax the airways, so increase the air moisture of the room or take a hot steamy shower;
• Quit smoking and avoid irritants that can worsen the cough, such as dust, fumes or aerosol products;
• Sleep with extra pillows and on your side if you cough at night;
• Consider an over-the counter cough medicine for temporary relief, but not more than two weeks.

3. Coughing is a simple problem, nothing to worry about?

You may cough because of a cold, an allergen, tobacco smoke or live in a polluted environment, these coughs are all about protecting your airways and lungs, and are regarded as normal responses of the body. But for certain coughs, you need to pay special attention. They may indicate an underlying illness that requires proper diagnosis and treatment. Persistent coughing is a key feature of respiratory diseases such as bronchitis, asthma, emphysema, cancer or tuberculosis. Coughs in children may due to causes that are less likely seen in adults, such as whooping cough, bronchiolitis (infection of the smallest airways of the lungs), inhaled objects, exposure to secondhand smoke or emotional problems. You better see a doctor if a cough triggered by common cold or other known reasons that fail to get better within three weeks. More importantly, a persistent cough of unknown origin should definitely be seen by a medical practitioner.

4. What are the health risks of coughing?

Coughing can injure you directly. Occasionally, the physical action of coughing may be so vigorous that it causes other health complications to the body. Chronic coughs are associated with fatigue, headache, dizziness, sweating, chest pain, incontinence, and even fractured ribs. In serious cases, it may lead to medical emergencies such as pneumothorax (a collapsed lung), abnormal heart beats, syncope, ruptured bronchial tubes or esophagus. Persistent coughing often causes unavoidable social interruptions, leaving you stressed and frustrated.

5. Do coughs always come from the lungs?

Not necessarily, other than lung-produced cough, postnasal drip and acid reflux are common causes of a chronic cough. Allergies and sinusitis produce excessive mucus that causes constant irritation to the throat. People tend to complain of a trickling sensation or sinus drainage at the back of the throat, which they have to clear frequently. Gastro-esophageal reflux (GERD), in which stomach acid flows back into the esophagus, people will typically experience heaviness in the chest or a feeling of something being stuck there, or heartburn after a big meal, when bending over or lying down. Sometimes coughing is the only symptom in GERD patients, it usually worsens at night and disturbs their sleep. Drug effects can also be the cause, angiotensin-converting enzyme (ACE) inhibitors that are prescribed for hypertension and heart failure patients are well known to cause a dry hacking cough, affecting about 20% of users.

6. I cough and might have a infection, should I take antibiotics?

Many coughs are caused by viral infections which do not respond to antibiotics. Unnecessary use of antibiotics put you at risk of side effects like nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous drug-resistant bacteria. Your doctor will check your sputum to determine if a bacterial infection is present or not. When the sputum is thick and yellowish-green in color and you have a fever, then you probably require antibiotics.

7. Can over-the-counter products cure my cough?

Over-the-counter (OTC) drugs are medicines that you can buy without a prescription from doctors. OTC cough medicines help relieve coughs but cannot cure them. They are aimed at suppressing the coughing reflex, facilitating you to spit out the sputum, or soothing your throat, they cannot treat the underlying conditions that caused the cough. Generally, coughs that come with colds and flu usually clear on their own without any treatment; if a cough persists for an extended period of time, it may indicate some other internal problems, such as asthma, postnasal drip and acid reflux. The only way to cure these coughs is to fix the underlying causes, cough medicines cannot resolve them. Moreover, some coughs should not be treated with cough medicines, because the cough helps keep the airways clear so you can breathe, such as for coughs from smoking, emphysema, asthma or chronic bronchitis.

8. How do I choose OTC cough medicines?

OTC products such as cough capsules, tablets, syrups and lozenges are available to help control coughs. Cough medicines are divided into two categories: suppressants and expectorants; you should first find out what ingredients are in the products before using such medicines.

Cough suppressants block the coughing reflex in throat, which work for dry hacking cough, just look for the active ingredient "dextromothorphan" on the product label. Since coughing is beneficial to clean the lungs and prevent infections, make sure to use cough suppressants properly.

Coughing sometimes brings up sputum (also called phlegm), a mixture of mucus, debris, and cells expelled by the lungs. Cough expectorants are for this wet coughs, they make the sputum thinner so as to cough it up easier. You'll see "guaifenesin" in the active ingredient section. Use an expectorant if you have thick sputum and have difficulty in coughing it up. Drink plenty of water when taking this medicine.

Many cough medicines contain more than one active ingredient. Manufactures like to combine cough medications with cold medications. The combination products may therefore have ingredients like cough suppressants, pain reliever, decongestants or antihistamines, in order to relieve the multiple cold symptoms with one pill. Read the labels carefully, make sure to choose a product that fits your specific symptoms. If you have taken a medicine that already covers problems such as runny nose, sneezing, and coughing, don't take extra cough medicine. If you only have a cough, you don't need a medicine with a pain reliever too.

Generally, doctors don't recommend using OTC cough medicines in chronic coughs, as they do not treat the underlying causes. If your cough doesn't clear up or returns after you stop taking OTC medications, see a doctor.

9. What are the side effects of cough medicines?

Studies show that OTC cough medicines don't work very well. However coughing is such an annoying symptom, it makes sense for people to look for something to ease it.

If you are taking the cough medicine as instructed, they should be harmless. The problems are usually due to their misuse. People tend to take more than one OTC product at a time, and so double up on ingredients thus causing an accidental overdose. Always keep in mind that taking more medication will not provide any additional benefits and may increase side effects. For example, cough syrups and common cold medicines may all contain dextromethorphan (a cough suppressant); excessive consumption of this ingredient can lead to euphoria, constipation, dizziness, drowsiness, panic attacks and even psychosis. When coughing is your main symptom, a multi-symptom medicine that contains other ingredients like antihistamines and decongestants can make your sputum thicker and harder, and your cough may become worse.

Side effects may be a concern for those with health problems, such as asthma, heart failure, hypertension, glaucoma and urinary problems. Cough medicines also cause problems with other medicines such as sedatives and certain antidepressants. If you have a chronic respiratory problem, pregnant or breast feeding or are older than 60, use the medicine with caution. Always read the "Warning" section on the label to see the possible side effects. Some cough preparations are rich in sugar; diabetic patients should look for a sugar-free one.

10. Can children use the same cough medicine as adults?

A productive or nonproductive cough is a frustrating symptom in children. They become irritable and are kept awake at night. Cough medicines are only for symptom relief; they will not make children get well faster. There is some debate on the use of cold and cough medicines in children, because little evidence can prove their efficacy.

Children and adults are not the same in both physiological and pathological conditions, and so are treated differently. In children, the respiratory system is under development and over 70% of their coughs are productive, parents should help them expel the sputum instead of suppressing the cough. Moreover, be cautious about how much and how often these kind of medicine are given to children. In United State, the Food and Drug Administration (FDA) of the Health Department does not recommend OTC cough and cold products for children under two years of age. A FDA review has showed that these medications were among the top ten reasons for childhood poisoning in those under the age of six.

Talk to your doctor before giving any OTC medicines to your child, even if it is labeled for children. Don't use cough medicines as a way to help them to sleep, and don't give other cough and cold medications that might contain the same or similar ingredients.

Teenagers abuse of cough and cold medicines is a big concern nowadays, and parents should be alert to the risks and how to prevent them from intentionally overdosing.

11. When should I see a doctor for cough?

Most coughs tend to go away by themselves. However, you should see a doctor if you experience an atypical cough longer than ten days, or accompanied by followings:

• A previous cough that changes in nature
• The cough is very painful, or makes you difficult in swallowing
• The sputum turns thick, or yellow, green or tan in color
• Cough up blood
• Breath shortness and wheezing
• Heartburn or a sour taste in the mouth
• Have a fever or night sweats
• Unexplained weight loss

Through a medical history and physical exam, the doctor is able to find the cause of your cough, and then suggest various courses of treatment. Certainly, if you see a doctor as early as possible, it will be easier to treat your cough.

12. What diagnostic tests should I have for my chronic cough?

Doctors rely on physical examination and diagnostic tests to decide a treatment for your cough. A chest X-ray is routine which can reveal lungs problems like emphysema or lung cancer. Based on your medical history, you doctor may have to look at your nose, esophagus, stomach or deep in the lungs through endoscopy. Other tests that may include a CT scan, a lung function test, allergen tests and sputum analysis.

13. Why should I stop smoking?

Smoking is the most common cause of chronic cough. A loud, hacking, early-morning cough usually occurs in heavy and long-term smokers. This is a serious warning sign that your throat and lungs can no longer tolerate the toxins in cigarette smoke.

Smoke not only irritates the airways but also damages the lining of the airways, especially the hair-like projections (cilia) that are responsible for brushing out harmful particles. Dysfunction of the cilia leads to mucus and toxins building up in the lungs overnight, so when smokers wake up in the morning, they hack and cough to expel these excess irritants. More seriously, this productive cough can occur throughout the day, and the sputum is dark in color.

Most smokers are so used to this smoker's cough that they may ignore it. You should be alert to any change in the pattern of coughing, such as increased frequency, of longer duration, or being more productive, which means that something else may be wrong. This is the time to consult a professional.

Toxins in cigarette smoke also damage the entire lung system and affect the efficacy of air exchange; smokers easily get out of breath even in a mild degree of activity. Heavy smokers are more prone to respiratory infections, and take longer to get over a common cold.