Most people are unable to differentiate between the different kinds of cough and hence end up taking the wrong OTC drugs, which in turn may not give them any relief. We interviewed Dr Mehul Thakkar, well-known pulmonologist practicing in Mumbai, and asked him about the different types of cough, how you can differentiate between them, and what treatment options you might have.
Could you tell us about the different types of coughs?
Dr Mehul Thakkar: Coughs are basically divided into two types – dry cough and wet cough. Dry cough is one where there is no phlegm or no sputum production. It can be of two or three types. Most commonly you see a dry hacking cough which is seen in viral infections of the nose and throat. In which you get a continuous cough with a feeling of something being stuck in the throat. (Read: Coughs are different, so are their syrups)
The other type of cough is what is called a barking cough or croup, which is mainly seen in laryngitis. (Swelling or infection of the larynx). When the patient coughs, there is pain in the throat and difficulty in breathing.
The third type of dry cough would be a whooping cough, caused by bacteria. This is a very uncommon occurrence nowadays because of the presence of a vaccine programmes run by the government of India. This condition is usually seen only in children. It is a cough where the patient coughs continuously, after which there is a characteristic whoop sound and strong intake of a breath.
In wet cough, the person expels a lot of phlegm (or sputum), because of problems arising from the lungs like bronchitis, pneumonia,asthma or some rare uncommon disorders like lung cancer or GERD as well.
What are the different modalities to treat a cough?
Dr Mehul Thakkar: For treating a cough, it is very important to identify the type of cough. For a dry hacking cough the treatment usually is aimed at moistening the upper airways and getting rid of the root of the cough – which in most cases is due to an infection. Therefore most dry coughs can be treated using home remedies like steam inhalation. It moistens the airways and helps relieve a sore and irritated throat. Other remedies include using lozenges to sooth the throat and OTC cough syrups specifically formulated to treat a dry cough. In cases where the cough is due to an allergy or infection, one may be prescribed antibiotics or anti-histamines to relieve the associated symptoms. If the patient’s condition worsens it may be necessary to use a nebulizer, which is a method to help the patient breath easily.
Treatments for wet cough are mainly aimed at relieving the congestion in the chest. This can be treated by using OTC expectorant. This is something that will bring out the congestion. Along with this, the cause of the cough should also be treated. If it is bronchitis, there are prescription medicines that contain bronchodialators, or inhalers that contain steroids. There are also tablets available which contain these bronchodialators and steroids. If the situation is severe, there are injectables available. The third approach is to prescribe antibiotics. (Read: What’s in a cough syrup?)
What are the complications of untreated cough?
Dr Mehul Thakkar: A cough if left untreated can cause a lot of problems and it is important that we know when to visit a doctor or when it is dangerous. Usually when a cough lasts for longer than a week and over the counter medication is not helping you, it means there is something wrong. These are the times when complications arise. This is basically because the cause of the cough is untreated.
Another complication is the physical nature of the cough itself. Sometimes the nature of the cough is so severe that it can cause vomiting,fractures specifically of the ribs, muscle pain around the back, urinary or stool incontinence. Other uncommon problems include fainting or syncope, heart palpitations.
What can we do to prevent the transmission of cough?
Dr Mehul Thakkar: The best way to avoid a cough is to stay away from a patient who has a cough. If you have cough, the best way is to cover your nose and mouth while coughing, with either a hanky or tissue, and throw away the tissue after each use. Wash your hands often and keep your environment clean. Make sure you keep the environment in your house and/or office free of dust and fungus. If someone has been suffering from a cough for a long time, get them treated immediately.