It may feel awful, but cough is good for you - Henley Standard

IT’S that time of year again. And no, I’m not talking about chaos on the roads or the appearance of all of these cold blue lights that seem to be the trend these days. No, I am of course talking about the cough season.

It would seem that everyone and their dog has a cough at the moment. And while the cough is not just a winter phenomenon, the chillier weather does tend to make our noses run more, so our natural defence against viruses takes a bit of a hit.

The cough (not to be confused with the sneeze or the burp) is a natural reflex that helps clear your airways of mucus and of irritants like dust or smoke.

Each one requires input from various muscles including your abdominal muscles, intercostal muscles (the ones between your ribs) and your diaphragm. It’s a normal process that happens in your body. If you cough too much, however, there is likely a cause outside the ordinary.

Most often, particularly at this time year, this will be a cold or an upper respiratory tract infection (inflammation of the throat, larynx or sinuses caused by a virus).

These viruses are spread by airborne droplets. Each time someone coughs they will, on average, expel around 3,000 droplets of moisture in the area two or three metres ahead of them (a sneeze produces a whopping 40,000).

In someone with a cold, each cough may, depending on where they are in the infective process, expel around two hundred million virus particles. Most of these will be in the heavier particles that drop to the floor quite quickly but some will remain in droplets that are small enough to hover in the air for a prolonged period. Bear in mind though that the heavier particles can still be wafted into the air by, for example, the opening of a door.

Luckily, most cold viruses will survive only around six hours on most surfaces (although some have been known to last for up to a week) and they last less than an hour on our skin. The flu virus is even less hardy.

So why do we cough when we have a virus? Well, it is mostly part of our response to fight the infection. When the body realises it is infected, it begins to produce more mucus in order to cart away the infected material. This is what causes our noses to run more and our noses to block. This mucus, we either swallow or cough out.

Very often after a cold our cough will evolve into more of a dry, tickly cough. This is due to the raw irritation that remains after infection and is known as a post-viral cough, which can sometimes go on for weeks.

I often have people come in telling me that they are worried their cough has “spread to their chest”. While this is a valid concern (sometimes, although very rarely, one can develop a secondary pneumonia from an initial illness), most of the time it means that the mucus is loosening up, giving the illusion that it is all coming up from the lungs. This actually means things are probably on the mend. Bear in mind that green mucus doesn’t mean we should automatically reach for the antibiotics.

Coughs caused by a cold will usually last one to three weeks and there is really not a lot your GP can do about them.

The first port of call is your pharmacist, although even the over-the-counter remedies are there just to mask symptoms. Honey and warm lemon drinks will probably do just the same as any other remedy you can buy. Only your body’s own natural immune system can actually fight the infection.

So far, I have focused on the cold as a cause for coughing. There are, of course, many other culprits. Bronchitis and pneumonia will also cause coughing but will most likely cause you to feel more ill and short of breath. If you are worried that this might be the case, it is best to get your GP to check you over.

For coughs not getting better after a few weeks, we start to look at other potential causes. Typically, more chronic coughs that are present whatever time of year are caused by one of three things:

• Allergy to something.

• Post-nasal drip (where mucus from a blocked nose or sinus drips down the back of your throat, making you clear your throat constantly)

• Gastro-oesophageal reflux, in which case a large curry may be a trigger.

There are various treatments for all three but it is worth seeing your GP anyway if your cough is going on for this long — around five or six weeks.

Rarely, it can be a sign of something more serious like lung cancer (you may also find that you are coughing up blood, feeling breathless or losing weight if that is the case and you’ll probably be a smoker).

The other big group to suffer from longer term coughs are those who have asthma or Chronic Obstructive Pulmonary Disorder. For these people, there are steroid inhalers available that help to widen the airways as their coughs most often originate from the narrowing of airways or, in the case of COPD, from obstruction of the lower respiratory tract with excessive mucus from chronic damage (most often smoking).

As you might gather therefore, however annoying this sounds if you have one right now, the cough is something we need. If we couldn’t cough, we couldn’t clear our airways of the blockage cause (including foreign objects like toy soldiers or peas!)

So what to do to ease it if it is becoming a bit excessive?

• Drink plenty (water, not alcohol — whisky is not good for a cough, whatever anyone says)

• Keep the air humidified to reduce irritation from dry air

• Warm drinks thin the mucus and sooth the throat

• Sleep with extra pillows at night to avoid the mucus piling up in the sinuses or irritating your throat even more

• Stay indoors where the air is warmer

• Finally (and sorry to bang on about it) but stop smoking!

Happy Christmas!

• Next time: Hiccoughs and other strange quirks of the body.

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