Case of the chronic cough

You know the colder months have arrived when that dreaded runny nose begins and that nagging cough seems to last for weeks.

When you have a cough, you’ll find no shortage of remedies at the pharmacy. But how much relief do these medicines really provide and is anything else worth trying?

Coughing is an important reflex that keeps our throat and airways clear from irritants and mucus.

A cough often accompanies viral infections of our upper airways, such as colds or the flu.

Most adults have up to two upper airway infections a year, but some of us experience more depending on how frequently we come into contact with children, who can have up to 10 infections a year.

A cough is caused by a number of mechanisms in the throat, chest and nose.

Nerve endings in our throat can fire off easily in response to triggers such as a tickle from a dry crumb or a sudden change in air temperature, prompting a cough.

However, when we catch one of the viruses that can cause an upper airway infection, the virus inflames our throat, making the nerve endings more sensitive and more prone to firing.

What is in cough syrup?

Respiratory physician at Sydney’s Concord Hospital, Professor Christine Jenkins, says while the pharmacy is “stacked” with cough remedies, most over-the-counter medications do not make a big difference to the coughs we get when we have an upper airway infection.

There are generally two types of medications in cough syrups. The first type is an expectorant such as guaifenesin, which aims to loosen mucus making it easier to cough up.

The other type is a suppressant such as codeine or dextromethorphan which works to suppress our urge to cough.

While there is some evidence that cough syrups containing expectorants or suppressants may reduce the intensity or frequency of a cough, they have no effect in reducing its duration.

Professor Jenkins says the idea that cough suppressants are harmful because they leave mucus in the body is nothing but “folklore”.

Simple and cheap remedies:

• A spoonful of honey is said to bring some relief to chronic coughing.

Professor Peter Gibson, staff specialist at John Hunter Hospital in Newcastle, NSW, says a study has shown swallowing honey can help to suppress a cough.

“[It’s] a combination of lining the sensitive mucus membranes and the swallowing, because whenever you swallow you suppress a cough,” he explains.

• Try a mentholated lozenge. These lozenges keep the throat lubricated and reduce the urge to cough.

“In animal studies [menthol] has been shown to reduce the irritability of these sensory receptors in the airway that often contribute to a cough,” Professor Jenkins says.

Time to see a doctor?

Coughs linked to upper airway infections will usually resolve themselves after two weeks, but there are some “red flags” that should be the signal to seek advice from your doctor.

If you notice difficulty breathing, persistent high fever, severe chest pain and coughing blood, you could have an underlying condition, such as pneumonia or infective bronchitis.

Share your secret remedies to treating coughs by commenting in the box below.