Coughing: what might it be a sign of?

Written by: Dr Farid Bazari
Published:
Edited by: Robert Smith

In 2021, we are more aware of our own health, and in-particular symptoms of an underlying lung disorder.

coughing

We got in contact with the experienced and recommended specialist Pulmonologist , Dr Farid Bazari , who is based in London, to find out about the different types of cough and what their causes are. We also discussed the warning signs that indicate you should see a doctor about a cough.


Why do we cough in general?


Cough is a reflex to airways irritation in the lungs. The cough is to aid for clearance of lungs, as a natural clearance method. A cough can also be a controlled reaction, it can be initiated at will. It’s a natural reflex if you irritate the airways for example. It can be a natural response to irritants, habit or other factors to clear lungs, or may be the first common symptom of a range of lung diseases.

 

What are the different possible characteristics of a cough?

Assessing a patient with a cough requires a full history and examination, to be followed by specialist investigations to try and identify a cause.

In terms of history, the chronicity, characteristics at onset, other associated symptoms, whether it is a dry or productive cough gives information. If it’s productive it means there is mucus that needs to be cleared.

We look at characteristics, the time of day coughing occurs, external factors, (for example, cold air) and whether it occurs during exercise. We also look at certain characteristics, if the cough has a barking nature, or a whooping cough. These all are clues to the cough that will guide the investigation. Whooping may be a sign of bronchitis for example.
 

Associations with other red flag symptoms, such as losing weight, breathless, fevers or sweats or if there is blood produced, are all red flags.
 

What are the possible conditions that it might be a symptom of?

Cough is one of the most common symptoms presenting to medical practitioners, it can be due to a whole range of respiratory symptoms, and most cough of less than 3 weeks is self resolving.
 

However, if the patient has an underlying respiratory disease, or there are other associated symptoms, a history of significant smoking, or a cough lasting more than 3 weeks, we would investigate as to the underlying cause.
 

Serious conditions can include:
 

  • COVID-19 or other viral bronchitis
  • Lung fibrosis
  • Lung cancer
  • Asthma or other obstructive airways disease such as COPD
  • Allergies
  • Acid reflux
  • Post nasal drip
  • Bronchiectasis
  • Chronic lung infections or TB
  • Idiopathic cough
     

The commonest causes can often be identified through a chest x ray or lung function tests. A CT scan of the chest is often helpful if there are other symptoms accompanying the cough, or to exclude more serious conditions. There are blood tests and other tests such as those of airways inflammation through breath assessment that can help in making a definite diagnosis and treatment plan.
 

What about a cough in relation to COVID-19?

A common symptom of COVID-19 is a persistent cough. During the pandemic, if you are suffering from a persistent cough, you will need to isolate and get a PCR test. Lots of other causes may be identified, if its chronic and persistent, other symptoms may include coughing up blood and weight loss. You should seek medical advice from a specialist if this is the case.
 

Most cough caused by COVID-19 will resolve, but a small proportion may become chronic that may require specific treatment. If the initial infectious period has passed, or there is breathlessness, a chest x ray or CT scan to makes sure there’s no COVID-19 inflammation in the lungs will be necessary.
 

When should someone see a doctor about their cough?


If a person develops a new cough with other associated symptoms such as breathlessness, fevers, sweats, weight loss, chest pain, coughing blood or coloured sputum, they should seek early medical advice. Of course, during the pandemic, any person with a new persistent cough should seek advice and request a PCR test to exclude COVID-19. If the cough has associated symptoms, a chest Xray and further investigations are necessary. We would always investigate a cough that has lasted more than 3 weeks, in-particular if there are underlying lung disorders or a history of significant smoking.

 

If you will need to see a medical specialist regarding a cough, we recommend booking an appointment with the highly experienced pulmonologist, Dr Farid Bazari. Click here to visit his Top Doctors profile today for more information on appointment availability.

 

By Dr Farid Bazari
Pulmonology & respiratory medicine

Dr Farid Bazari is a leading consultant respiratory and internal physician with a wide practice covering all respiratory and internal medical problems. He offers consultations for patients with sleep apnoea and related disorders, persistent cough, unexplained shortness of breath, asthma, lung infections, lung cancer and all general medical and respiratory disorders.

Dr Bazari’s early career included undergraduate medical training at Guy's and St Thomas’ Hospitals. He had specialist respiratory training on the London rotation, including the Royal Brompton Hospital, a world-renowned centre for respiratory disease.

Dr Bazari has been a full-time NHS consultant at Kingston Hospital NHS Foundation Trust for over 10 years, where he holds a number of leadership roles aimed at improving patient care and developing clinical services. In addition to his clinical practice, Dr Bazari is involved in several projects in improving patient experience and developing clinical services. He is the clinical lead for the department of respiratory medicine and the chair of the lung cancer service.

Dr Bazari provides a patient-centred service allowing rapid diagnosis and treatment of respiratory conditions using the latest evidence-based medicine and close working with a team of experts where further investigations are required. 

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