What type of cough do you have?

Why is it important to tell what kind of cough you have?

Some of the most common questions asked on our helpline each week relate to coughs.

Coughing is a natural body reflex and we have all experienced this symptom. All of us will have one or two normal coughs a day to help clear the throat and respiratory passages – but there are many health conditions giving rise to this symptom. So when does your cough need attention? What should you look out for? What types of cough are there? How can you tell each apart?

Answering these questions is important because it helps you choose the right kind of treatment for your cough.

Follow our handy infographic below to help you decide which type of cough you have.

What type of cough do you have?

Tickly cough

This is perhaps the most common type of cough. In general, it is caused by irritation coming from above the neck. Tickly coughs can be most annoying as, sometimes, no amount of coughing seems to clear the cause.

A tickly cough is described by doctors as ‘non-productive’ as it brings up very little or no phlegm. The main cause is something doctors call a post-nasal drip.

The lining of our nose and sinuses produces a small amount of mucus. However, when this tissue become inflamed, mucus production increases and the excess drips down the back of the nasal passages and into the throat. This is known as a post-nasal drip and triggers the cough reflex.

The most common reasons for a post-nasal drip are:

• Viral infections – colds or flu

• Allergies – hayfever or allergic rhinitis

If your tickly cough is the result of the common cold or other viral infection, try taking a tablespoon of honey mixed in warm water. If this does not help, use the extract of young pine needles. If the cause is hayfever or allergic rhinitis, try an anti-allergy remedy.

Chesty cough

Chesty coughs, as the term suggests, appear from below the neck or in the chest. Each cough usually produces a clump of mucus and is the reason that doctors term chesty coughs ‘productive coughs’.

Inflammation in the air passages in the chest leads to an increased production of mucus. As mucus collects, the cough reflex is triggered, clearing out phlegm. Chesty coughs can be worse in the morning. This is because you tend to cough less as you sleep and mucus that is allowed to collect during the night has to be expelled when you wake.

The main causes of a chesty cough are colds or flu. Symptoms can appear at the start of the infection but, equally, may linger long after the viral infection has resolved.

Another cause of a chesty cough is, of course, smoking. These smokers' coughs tend to appear only after a number of years and the phlegm that is produced can be tinged black by the tar.

Lung infections such as pneumonia or bronchitis can lead to a chesty cough. Seek help urgently if the phlegm you produce is blood stained or foul-smelling, if you are short of breath, experience chest pain or have a fever.

If you suffer from a chesty cough resulting from a cold, avoid passive exposure to cigarette smoke. Light exercise can be beneficial, as is inhaling steam which can assist in thinning and loosening mucus. Herbs such as ivy, thyme and liquorice have been used traditionally for the relief of chesty coughs, mucus coughs and catarrh.

Dry cough

A dry cough arises from the chest (below the neck). It is a non-productive cough, bringing up little or no mucus.

Whereas chesty coughs come about because of over-production of mucus, dry coughs are the result of other irritants in the upper respiratory passages. These include:

• Viruses – yes, colds and flu can lead to tickly, dry and chesty coughs
• Allergies - hayfever can contribute towards a dry, tickly cough
• Atmospheric factors such as smoke, dust and dry cold air
• Acid reflux – this is when the acidic contents of the stomach travel up to the back of the throat. This can irritate the throat, or small amounts of acid can be inhaled causing further irritation
• Asthma
• Other lung or chest conditions (e.g. Bronchitis)
• Prescribed medication – certain classes of medicines, especially high blood pressure medicines, can lead to a persistent dry cough.

Treatment of a dry cough will depend, as the underlying condition should first be treated, or a change in medication prescribed.

A dry cough left over from the cold or flu can be treated with the herbs Mullein and Marshmallow.

Nervous cough

A nervous cough is a non-productive cough. Unlike the other coughs we have described, no physical irritants are present. Doctors will only make the diagnosis of a nervous cough after excluding other causes.

Nervous coughs tend to worsen when you are feeling anxious or stressed and improve when stress levels are reduced. In a way, this is an exaggeration of normality – most of us will have experienced a nervous cough in a ‘normal’ way. Another feature is that nervous coughs tend to disappear when you are sleeping.

Many theories have been proposed for the causes of nervous coughs. These range from over-sensitivity of the vagus nerve to alterations in the way youbreathe.

The key to managing a nervous cough is to address the stress and anxiety issues.

Persistent cough

This term can be applied to any type of cough if it lasts for more than eight weeks in an adult or four weeks in a child.

If you have an unexplained persistent cough, seek help from your doctor. It is important to find the reason for your cough and exclude a serious health condition. This is especially important if you are a smoker or have a family history of lung disease, such as asthma.

Whilst it is important to exclude treatable conditions, most persistent coughs do not indicate a serious health problem. Any of the minor health issues described can lead to long-standing coughs – the most common reasons are post-nasal drip, allergies, acid reflux and, of course, smoking.

Coughing at night

Some coughs are worse at night. Whilst this can be useful from the doctor’s point of view in helping form a diagnosis, losing sleep because your cough is worse at night can create havoc during the day.

Reasons for coughing at night include:

• Viral infections – the extra mucus that results from cold and flu infections can pool in the wrong parts of your respiratory passages when you lie down.
• Acid reflux – the acidic contents of your stomach are more likely to travel in the wrong direction, into the back of your throat, when you are lying flat in bed.
• Sinusitis – a change in posture might change the way mucus drains from your sinuses, worsening a cough when you lie down.
• Asthma – characteristically, coughs resulting from asthma are made worse during exercise and coughing fits in the middle of the night.

What should I look out for?

Finally, there are some things that you should look out for. Seek help from your doctor if:

• A child has a cough that sounds like a bark.
• You cough up blood.
• You have pain in your chest when you cough.
• You cough up green or foul-smelling sputum.
• You are short of breath or wheezing.
• You have a persistent cough that is unexplained