Cough

Cough is one of the most common reasons for visits to health care providers. Normal coughing is important to keep your throat and airways clear. However excessive coughing may mean you have an underlying disease or disorder. Coughs generally fall into one of the two following categories.

Acute coughs (typically lasting no longer than three weeks) usually begin suddenly because of a cold flu or sinus infection.

Chronic coughs (lasting longer than three weeks) are most commonly caused by cigarette smoke airborne pollutants postnasal drip asthma and bronchitis.

Signs and Symptoms

Depending on the condition causing it a cough may be accompanied by the following.

• Upper respiratory tract infection (URI)
• Postnasal drip
• Wheezing (possible asthma)
• Heartburn
• Vomiting
• Fever chills night sweats
• Edema or fluid retention

What Causes It?

• Upper respiratory tract infection
• Irritants inhaled into the airway passages
• Postnasal drip
• Certain heart disease or blood pressure medications
• Aspiration (foreign matter drawn into the lungs)
• Congestive heart failure

What to Expect at Your Provider's Office

Your health care provider will conduct a physical examination including a careful detailed history of your symptoms. He or she will examine your nasal passages throat and lungs.

Treatment Options

Treatment Plan

The first treatment goal is to identify and try to eliminate any underlying cause or disease such as cigarette smoking or asthma. The second goal is to relieve the symptoms of your cough. Quit smoking and avoid passive cigarette smoke and airborne irritants. If possible stop taking medications that trigger your cough. Depending on the type of cough that you have your provider will prescribe medications to relieve the symptoms.

Drug Therapies

Prescription

• Antitussives—are drugs that prevent or relieve cough; they may be taken by mouth or inhaled
• Expectorants and bronchodilators—help to bring up mucus thus also relieving the cough
• Antibiotics—to treat any underlying bacterial infection that is causing the cough
• Antihistamines and decongestants—for postnasal drip

Over the Counter

• Antitussives antihistamines and decongestants—also available in nonprescription strength

Complementary and Alternative Therapies

While coughs due to severe underlying causes require medical treatment alternative therapies can be useful in treating coughs secondary to viral URI allergens irritants and asthma. In addition alternative therapies can be used at the same time as conventional medications to optimize your recovery.

Nutrition

• Avoid foods that you are allergic to. Food allergy testing can help determine your food allergies.
• Eat less mucus-producing foods such as dairy citrus wheat and bananas. Eat more fresh vegetables fruits and whole grains.
• Take Vitamin C (1 000 mg three or four times a day) zinc (30 mg per day) and beta-carotene (100 000 IU per day) to support your immune system.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

• Strong expectorants: horehound (Marrubium vulgare) thyme (Thymus vulgaris) and mullein (Verbascum densiflorum)
• Gentle expectorants: fennel (Foeniculum vulgare) sweet violet (Viola odorata) ginger (Zingiber officianalis) and balm of Gilead (Populus candicans)
• Cough suppressants: wild cherry bark (Prunus serotina) coltsfoot (Tussilago farfara) and linden flowers (Tilea europea)
• Immune support: purple coneflower (Echinacea purpura) licorice root (Glycyrrhiza glabra) garlic (Allium sativum) and onion (Allium cepa). Avoid licorice root (Glycyrrhiza glabra) if you have high blood pressure.
• Toning: Indian tobacco (Lobelia inflata)--especially useful for smokers elderberry (Sambucus nigra) elecampane (Inula helenium) plantain (Plantago lancelota) and gumweed (Grindelia camporum)

Thyme (Thymus vulgaris) eucalyptus and pine oils can be applied to the skin to help with a cough. Make a chest rub with 2 to 4 drops of essential oil in 1 tbsp. of food-grade oil (olive flax sesame almond and the like). Or make a castor oil pack with 4 to 6 drops of essential oil. Note that exposure to essential oils may keep homeopathic remedies from working.

Homeopathy

Some of the most common remedies used for cough are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Aconite for sudden onset of cough or croup (difficult noisy breathing with a hoarse cough)
• Spongia toasta for harsh barking cough
• Drosera for dry spasmodic cough
• Rumex crispus for dry shallow tickling cough
• Ipecac for deep wet cough with gagging from the cough
• Phosphorous for tight chest with cough
• Causticum for cough with raw painful feeling in chest
• Antimonium tart for rattling cough with dizziness

Following Up

Use the remedies that work best for you and follow the instructions of your health care provider. Be sure to get rest and drink plenty of water.

Special Considerations

Severe coughing can cause rib fractures in which case your provider will investigate the possibility of bone disorders such as osteoporosis.

Supporting Research

American Academy of Family Physicians. Available at: http://www.aafp.org/.

Duke JA. The Green Pharmacy. Emmaus Pa: Rodale Press; 1997.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992.

Newall A Anderson LA Phillipson JD. Herbal Medicines. London England: The Pharmaceutical Press; 1996.

Schulz V Hänsel R Tyler VE. Rational Phytotherapy. 3rd ed. Berlin Germany: Springer-Verlag 1998

Tierney Jr. LM McPhee SJ Papadakis MA eds. Current Medical Diagnosis & Treatment 1999. Stamford Conn: Appleton & Lange; 1999.

Tyler VE. Herbs of Choice. Binghamton NY: Pharmaceutical Products Press; 1994.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.