Cough: Breathe easy

We often ignore that niggling cough, hoping it will go away on its own. But Sharat Kolke tells us why doing that is not a good idea


“My dear doctor, I am surprised to hear you say that I am coughing very badly,
as I have been practicing all night”
—John Curran

Coughing is a protective response of our body to the invasion of foreign substances or germs in our respiratory tract. These particles irritate the inner lining of the respiratory passage and this irritation initiates a chain of events, which force the air out of the lungs by way of coughing. So a coughing is a sort of signal to you that something is wrong with your respiratory system.

Types and causes of cough

To find out the cause of your cough, it is necessary to answer a few questions:

  • Have you had the cough for 2 weeks or more?
  • Is it a dry cough or is phlegm produced?
  • Do you have any other symptoms like fever, chest pain or breathlessness?

Depending on the answers to these questions, the cause of cough can be determined. It could be due to an infection caused by a virus, bacteria or on rare occasions by a fungus.

Infectious causes of cough

Viral infection is the most common cause and is always associated with fever, watering of the eyes, sore throat and a running nose. Bacterial infections are usually restricted to the upper respiratory tract and cause tonsillitis; they are associated with high fever and throat pain. When the lower respiratory system is affected by bacterial infections it is called pneumonia. Pneumonia is also associated with high fever and chest pain, which worsens when you cough or breathe deeply. There may be yellowish or greenish phlegm.

In case you have blood in your sputum after a bout, you need to see your doctor immediately.

Cough that lasts for more than two weeks and is associated with fever and weight loss can be due to tuberculosis.

Non-infectious causes

A cough can be due bronchitis, or even asthma. Occasionally, it has been associated with conditions that are not directly related to the respiratory system. Certain heart diseases, stomach conditions and sometimes certain medicines, especially those used to control high blood pressure, can cause cough.

Among the non-infectious causes for cough, allergic bronchitis is the most common. This type is associated with breathlessness and production of whitish phlegm. Asthma on the other hand causes more of a dry cough. A whistling sound called a ‘wheeze’ is usually heard in these patients. The environment at home or at work can be an important factor in causing an allergic cough.

A long-standing cough with weight loss and blood in the sputum can be a sign of a serious condition like lung cancer. It is important to remember that a non-infectious cough is often not associated with fever.

Which tests are done?

Apart from routine blood tests, a chest X-ray and lung function test are usually needed. A CT scan of the chest may be ordered by your doctor especially if you have a cough that lasts for more than six to eight weeks.


As mentioned before, the most common causes of cough are viral or allergic. These are treated symptomatically with cough syrups and anti-allergic drugs.


  • Avoid close contact with patients who have viral fever and other infectious diseases.
  • Wash your hands regularly
  • Keep your environment pollution-free and dust-free.

See your doctor if:

  • You have cough for more than two weeks, which is associated with fever and/or weight loss
  • Your sputum is blood-tinged
  • There is chest pain and breathlessness with your cough.

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Sharat Kolke
Sharat Kolke [MD, DNB, MNAMS] is a Consultant General Physician at Kohinoor Hospital.