Coughing Overview and Remedies

Coughing can be a reflex, or an involuntary response. It is your body's way to clear your airways and lungs of fluid, food, particles, or irritants. Coughing also moves mucus up to your throat so you can spit it out, helping to clear your chest.

Most of the time, coughing is not something to worry about. It can, however, be a sign that you need to see a doctor.

This article discusses how and why your body coughs, and what it means if your cough won't go away. It also covers treatments your doctor may prescribe and ways you can remedy your cough at home.

Illness young woman coughing in the street.
nensuria / Getty Images

How Coughing Works

The cough reflex consists of two components: a sensory component, in which your central nervous system (CNS) senses something that shouldn't be in your airways, and a motor component, in which your muscles expand and contract to remove it.

Your CNS, airways, and muscles work together to form a cough through the following process:

  1. Sensory nerves in the tissues lining your trachea (windpipe), larynx (voice box), bronchi, and carina are instantly activated when a foreign invader touches their lining.
  2. Sensory nerves stimulate the vagus nerve, which extends from the brainstem through your neck, all the way to your abdomen.
  3. The vagus nerve signals the medulla—located in the brainstem—to initiate the cough reflex.
  4. The medulla sends signals back through the vagus nerve to your diaphragm and the muscles between your ribs, telling them to contract.
  5. As your diaphragm and rib muscles contract, your lungs fill with air.
  6. The epiglottis, a valve in your larynx that controls airflow, closes. This causes air pressure to build in your lungs.
  7. Your abdominal muscles tighten as the air pressure in your lungs reaches its highest point.
  8. Your glottis reopens, releasing air at an estimated 100 miles per hour.
  9. As the air clears your trachea, the irritant attached to the lining of your airway is cleared with it.

People with weakened respiratory muscles may be unable cough. This can be an effect of several health conditions, including stroke, Parkinson's disease, and multiple sclerosis.

Recap

Your central nervous system and respiratory muscles work together to keep your airways clear. A cough itself isn't a bad thing; it is your body's way of protecting your airways and lungs from damage.

Cough Triggers

There are several things that can activate your coughing reflex. Some can also be reasons for a voluntary cough, when you cough on purpose. (Think of forcing a cough in an effort to break up chest congestion.)

Note, however, that behavioral coughs—i.e., those that occur simply out of habit, much like how some people play with their hair without realizing it—do not share these physical triggers.

Food and Drink Particles

One of the most common causes of coughing is when fluid or a food particle comes in contact with the lining of your airways. Sensory nerves in your airway will trigger you to cough involuntarily to remove it, but if the particles block your airways, you will start to choke.

A person whose airway is partially blocked may still be choking even if they are coughing or making sounds. If coughing does not clear their airway or if they cannot cry, speak, cough, or breathe, then their airways are blocked. They will need the Heimlich maneuver as soon as possible.

A person who is choking and unable to breathe can die in as little as four minutes unless their airways are cleared. Knowing how to perform the Heimlich maneuver on someone who is choking can save their life.

Respiratory Tract Infections

Coughing is a common symptom of upper and lower respiratory tract infections, both of which may be caused by a viral or bacterial infection.

The common cold and the flu are examples of upper respiratory tract infections caused by a virus. Lower respiratory infections, like bronchitis, pneumonia, or sinusitis, may be caused by bacteria or viruses.

As part of your body's immune response to infection, inflammation builds in your airways. Meanwhile, glands in your nose, mouth, and lungs produce mucus, which lines your airways and traps the intruder before it can enter your lungs.

Inflammation and mucus in your airways will cause you to cough. Most respiratory infections clear up within seven to 10 days. But if it doesn't, it can progress to bronchitis, laryngitis, or pneumonia.

Environnmental Allergens

In the United States, around 19 million people have allergic rhinitis. This causes them to experience cold-like symptoms when they breathe in outdoor or indoor allergens, such as pollen from trees and grass, dust mites, or mold spores. This is in response to the immune system reading these allergens as harmful, although they're really not.

An allergic cough is usually caused by postnasal drip, which occurs when glands in your nose and throat produce extra mucus to moisturize the airways. When too much mucus is produced, it cannot drain properly and accumulates in the throat, resulting in irritation, sore throat, and coughing.

Air Pollutants

Ozone pollution and hazardous chemicals that circulate the air can also irritate your lungs and airways when you inhale them. Breathing in air pollution can cause inflammation in your nasal and sinus tissues along with postnasal drip.

Furthermore, long-term exposure to ozone pollution can aggravate other chronic respiratory conditions that cause coughing, like asthma, emphysema, and bronchitis.

As with allergens, avoiding air pollutants is difficult because you can't control what's in the air. However, you can monitor the air quality where you live using the Air Quality Index and consider staying indoors when conditions are poor.

Medical Conditions

Chronic medical conditions that affect your lungs can cause coughing during flare-ups. This includes asthma, a disease that affects around 262 million people worldwide.

With asthma, the airways become narrow and inflamed when exposed to asthma irritants, such as dust, smoke, pollen, weather changes, and animal fur. These irritants trigger coughing, wheezing, and chest tightening. Many people with asthma need to keep an inhaler on them at all times.

Coughing is also a symptom of chronic obstructive pulmonary disease (COPD)—a group of lung diseases that cause inflammation in the airways and block airflow to the lungs. People with COPD also use inhalers to force their airways open during flare-ups.

Although much less common, coughing can be a sign of some medical emergencies, like lung collapse or pulmonary embolism, when an artery that supplies the lungs with blood becomes blocked by a blood clot.

Recap

The cough reflex can be triggered by food particles you accidentally inhale, air pollution, and airborne allergens like pollen. People with COPD and asthma often cough during flare-ups when their airways tighten due to inflammation. Coughing is also a common symptom of respiratory tract infections.

Acute vs. Chronic Cough

There are three types of cough, depending on how long the cough lasts:

  • Acute cough: A cough that lasts less than three weeks usually due to the common cold or another infection like sinusitis or pneumonia
  • Subacute cough: A cough that lasts three to eight weeks and continues to linger after the initial infection has cleared up
  • Chronic cough: A cough that persists beyond eight weeks and can be caused by sinus infections, asthma, allergies, or serious lung conditions like COPD or interstitial lung disease, about 100 lung disorders that cause scarring of the lungs (pulmonary fibrosis)

Sometimes, a cough can become chronic without you realizing it. Any time you develop a cough, it's important to monitor how long the cough lasts and what kind of symptoms, if any, you are having with it. Should you decide to see your doctor, this information will help them make a diagnosis.

When to See a Doctor

Most of the time, coughing is not something to worry about—even if your cough has lasted for more than a week. In fact, one study found that the average length of time an acute cough lasts is 18 days.

Acute coughs usually clear up on their own without medical attention. However, you should contact your doctor if your cough lasts longer than three weeks or is accompanied by one or more of the following symptoms:

  • Fever
  • Headache
  • Drowsiness
  • Whooping or wheezing sounds
  • Any other worrying symptoms, like unexplained weight loss, a change in your voice, or lumps in your neck

Additionally, take note if your cough brings up phlegm, as this could be a sign of pneumonia, bronchitis, or the flu. These illnesses tend to clear up on their own as well, although you may need prescription medicine to manage your symptoms.

If you are coughing up phlegm, try to cough into a napkin and pay attention to the color. You should visit your doctor if your phlegm is yellowish-green.

A cough that does not bring up phlegm is known as a dry cough. Again, this type of cough is not usually something to worry about. But it can signal a life-threatening condition that requires emergency medical attention, especially when accompanied by chest pain or shortness of breath.

Seek emergency care if you:

Recap

When you develop a cough, try to keep track of how long it persists. See your doctor if your cough lasts longer than three weeks. Call 911 if you cough up blood or are in distress.

Treatment

There are a variety of home remedies that help soothe your cough, as well as over-the-counter (OTC) medicines that can help thin mucus and soothe inflammation in your airways.

But keep in mind that coughing is your body's natural defense mechanism, protecting you from things that can make you sick or otherwise cause you harm.

That's why the ultimate aim of cough treatment is not just to ease your cough, but to address the reason it is occurring in the first place.

Natural Remedies

Whether you have a dry cough or your cough is producing mucus, there are a few natural remedies you can try at home:

  • Honey: Alleviate a nagging cough by sipping lemon water with honey throughout the day or swallowing a spoonful of honey before bed. Honey coats the lining of your throat to soothe and protect its tissues from irritation, which may reduce coughing.
  • Hot tea: Drink hot tea to loosen up mucus in your throat so that it can drain better. Herbal teas like rooibos and honeybush are a good choice when you're sick. They're naturally decaffeinated so they won't dehydrate you, and their antioxidant properties help ease inflammation in your throat.
  • Ginger: Infuse fresh ginger into warm water or tea to sooth your throat tissues, loosen up mucus, and give your immune system a boost.
  • Broth: Sip on warm chicken broth plain or as part of a soup. Adding a pinch of turmeric, fresh garlic, and ginger may also help your immune system fight the infection.

Natural remedies aren't a cure-all for the underlying causes of cough. But they are a safe and healthy way to relieve your symptoms and help you stay hydrated.

OTC Medicine

Most respiratory infections that cause coughing will clear up on their own. You can help your immune system fight them by drinking lots of fluids and giving yourself extra time to rest.

You can also take OTC medicine to soothe your throat, but these treatments will not cure the underlying infection.

There are three types of OTC cough medicines:

  • Expectorants: These medicines don't actually stop you from coughing. Instead they thin your mucus so that your coughs are more effective in clearing it out. Mucinex and Robitussin Chest Congestion are both OTC expectorants.
  • Antitussives: Also known as cough suppressants, these medicines work by communicating with your brainstem to block the cough reflex. Robitussin cough and Vicks 44 Cough and Cold are both OTC antitussives.
  • Medicated cough drops: These lozenges may temporarily relieve your cough by lubricating the irritated tissues in your throat.

As for which to choose, consider an expectorant if you are coughing up thick mucus, and an antitussive if you have a dry cough that is interfering with your sleep.

Prescription Drugs

If your cough lasts longer than three weeks or you are also having other worrisome symptoms, OTC medicines and natural remedies may not be enough to resolve your symptoms. Your doctor may prescribe a stronger medication instead.

For example, your doctor may prescribe the antihistamine, promethazine, to treat symptoms of hay fever and suppress your cough. In some cases, antihistamines may also be prescribed for people with asthma.

Inhalers, which are used both for asthma and COPD, also contain prescription drugs—namely corticosteroids or long-acting beta agonists—depending on the type of inhaler.

Your doctor may prescribe antibiotic medicine to help clear up a stubborn respiratory tract infection caused by bacteria. Antibiotics become less effective when they are overused due to antibiotic resistance, so your doctor may avoid prescribing antibiotics unless:

  • Your infection is unlikely to get better without antibiotics
  • You are highly contagious
  • You have a weakened immune system and/or have a high risk for serious infections

Recap

Natural cough remedies can temporarily improve a cough by soothing irritation in your throat and breaking up mucus. Some OTC medications provide cough relief by blocking the cough reflex itself. Prescriptions such as an antibiotic, antihistamine, or inhaled corticosteroid may be used in some cases.

Summary

Sensory nerves in your airways are ultra-sensitive to allergens, food particles, and other irritants that pose a threat to your lungs. When an irritant activates those nerves, they signal your brain to trigger your cough reflex.

Coughing is a symptom of numerous health conditions, ranging from the common cold to asthma and pulmonary embolism. If your cough lasts longer than three weeks, you are having chest pain, or you are coughing up blood, it is critical that you see a doctor right away.

A Word From Verywell

Your cough can send mucus, particles, and droplets zooming more than six feet in front of you. If those droplets contain bacteria or viruses, you could infect other people, including people with weakened immune systems.

Out of consideration for those around you, stay at home and rest when you are sick. Cover your mouth with the inside of your elbow when you cough, instead of using your hand. And if you need to leave the house, consider wearing a face mask.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Rod Brouhard, EMT-P

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.