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Dry cough

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 6 minutes read
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A cough is the body’s natural way of responding to irritation in your respiratory tract. When specialised sensors in your airways detect an irritant such as smoke, dust or pollution, it triggers a cough reflex that causes the muscles in your airways to contract and pushes a burst of air out through your airways in an attempt to remove the cause of the irritation – this is a cough.

A dry cough is when you cough without bringing up any mucous or phlegm and can be irritating for your throat. It is a very common type of cough that can be caused by an infection, asthma, environmental irritant or irritation caused by acid reflux. It may also be a side effect of certain medications such as ACE inhibitors, used to treat high blood pressure. A constant dry cough is the result of your cough reflex becoming more sensitive than usual.

Doctor’s advice

Causes of a dry cough

It can be caused by various factors, ranging from environmental irritants to underlying medical conditions. Here's a detailed overview of the potential causes of a dry cough:

Viral infections

Viral infections, such as the common cold, flu (influenza), or respiratory syncytial virus (RSV), are among the most common causes of acute dry cough. These infections typically affect the upper respiratory tract and can irritate the throat, leading to coughing.

Allergies

Allergic reactions to airborne particles, such as pollen, dust mites, pet dander, or certain foods, can trigger inflammation in the airways, resulting in a dry cough. This type of cough is often accompanied by other allergy symptoms, such as sneezing, nasal congestion, and watery eyes.

Environmental irritants

Exposure to smoke, air pollution, strong odours, or chemical fumes can irritate the throat and airways, leading to a persistent dry cough. Smokers or those regularly exposed to secondhand smoke are particularly prone to developing a chronic dry cough.

Asthma

Asthma is a chronic respiratory condition characterised by inflammation and narrowing of the airways, which can cause coughing, wheezing, and shortness of breath. While some people with asthma may experience a productive cough with mucus production, others may have a dry, non-productive cough as a predominant symptom.

Postnasal drip

Postnasal drip occurs when excess mucus from the nose and sinuses drips down the back of the throat, leading to irritation and coughing. This can be caused by allergies, sinus infections, or other conditions that increase mucus production.

Gastro-oesophageal reflux disease (GORD)

GORD is a digestive disorder characterised by the backward flow of stomach acid into the oesophagus, leading to heartburn, regurgitation, and coughing. A persistent dry cough, especially when lying down or after eating, can be a symptom of GORD.

Medications

Certain medications, such as angiotensin-converting enzyme (ACE) inhibitors used to treat high blood pressure, can cause a dry cough as a side effect. This type of cough usually resolves once the medication is discontinued or replaced with an alternative.

Chronic bronchitis

Chronic bronchitis is a condition, which can be caused by chronic obstructive pulmonary disease (COPD) characterised by inflammation of the bronchial tubes, which can lead to a persistent dry cough, often accompanied by mucus production.

Interstitial lung diseases

Interstitial lung diseases, such as idiopathic pulmonary fibrosis or sarcoidosis, can cause scarring and inflammation of the lung tissue, leading to coughing and breathlessness. A dry cough may be an early symptom of these conditions.

Respiratory tract infections

In addition to viral infections, bacterial infections such as pertussis (whooping cough) or pneumonia can cause a persistent dry cough, often accompanied by other symptoms such as fever, fatigue, and difficulty breathing.

What to do with a dry cough?

Start small by taking it easy, getting good amounts of sleep, and ensuring that you’re eating and drinking well as this will all help. Going out in cold weather can cause you to cough more, so wrap up warm. You can try some simple over-the-counter treatments to help with your symptoms.

Healthwords pharmacists have put together some of our favourite medications that can be purchased to help with a dry cough. (Over-the-counter cough and cold medicines shouldn't be given to children under the age of six, and children aged 6 to 12 should only use them on the advice of a pharmacist or doctor.)

A homemade remedy containing honey and lemon is likely to be just as useful and safer to take but remember that honey shouldn't be given to babies under the age of one because of the risk of infant botulism.

Healthwords pharmacists' top tips

These treatments will not stop your cough but may help to relieve your symptoms. Paracetamol or ibuprofen can be used to relieve coughing pain in your throat or respiratory muscles. Simple Linctus or a hot honey and lemon drink can soothe your throat, and Bronchostop, cough sweets or lozenges work in the same way, if you're out and about.

Dextromethorphan can help suppress the urge to cough, which might help if you’ve got a phone call to make or a meeting to attend.

How can I stop my cough interrupting sleep?

It is relatively common to find that your dry cough is worse at night and is affecting your sleep. This is likely due to the reduction in saliva you produce which leads to your throat becoming drier and more sensitive to triggering your cough reflex.

If this is the case, you can try the previous simple remedies, and add a sleep aid such as the antihistamine diphenhydramine. The cough suppressant dextromethorphan can often be found in combination with diphenhydramine to aid with relieving night time coughing.

When should I see my doctor?

Most dry coughs get better by themselves within two weeks with rest, plenty of fluids, and throat-soothing treatments as necessary. In some cases, symptoms can last for up to three weeks. You should book a routine appointment to discuss with your doctor if your cough is not improving after two weeks, you have asthma or you are concerned about your symptoms.

If your symptoms are severe and not responding to pharmacy medications, you are finding it hard to catch your breath, difficult to maintain fluids or to bring your fever down with medication, you are coughing up blood, or you are a smoker and are suddenly losing weight, speak to your doctor urgently or call 111 outside of working hours.

If you are immunocompromised because of medication or a condition, or you have long-term medical conditions such as diabetes, heart, lung, kidney, or neurological illnesses, speak to your doctor.

Your doctor will listen to your concerns and symptoms, and take note of other medical conditions, medications and any family history. They will take your vital signs, including breathing rate, heart rate, oxygen content in your tissues and blood pressure. They will listen to your heart and chest and may look at your throat. They may send you for further investigations, such as a chest X-ray, blood tests, take any mucus sample or throat swab, and they will refer you to a hospital team if necessary.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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