Hem Hem! A Guide to Coughs

December 2012 Prof. Scarlet Leslie

Oh no! You have an itch in your throat. Should you cough it out or try to suppress it? Is it the beginning of a cold or simply an irritant in the air? Coughing is a natural defensive reflex of the body. Sometimes, though, a coughing fit may seem never-ending. Different types of coughs can last different lengths of time. Let's "clear up" some of the confusion, eh?

Dust and Dander

The air is full of substances that can irritate the lung. The nose actually does a great job of filtering out most of the irritants. However, environmental irritants like dust and dander may make it through via the mouth. The body coughs a reflex cough to clear the airway. Reflex coughs only last a few seconds.

An Excess of Phlegm

Secretions are seen with productive coughs. The coughs are classified as effective if the secretions leave the body easily. They are called ineffective if the phlegm gets stuck and cannot be expelled so readily. The secretions sometimes give a clue as to the cause of the cough, but not always. Bronchitis is associated with clear secretions while bacterial infections lead to secretions of yellow/green mucus.

Was that a Bark or a Cough?

Dry coughs are associated with viral or bacterial infections. The "barking" cough is also known as croup. It is common in children under five years old. Caused by a virus, croup typically lasts five or six days. Unfortunately, there is not much to do in the treatment of dry coughs. The cough will usually go away once the infection is cleared. A humidifier may help relieve some of the dryness. Dry coughs also occur with certain disease states, like chronic acid reflux, or medications. The ACE cough is a well-known side effect of angiotensin-converting enzyme (ACE) inhibitors used in the treatment of high blood pressure.

Did I Hear a Whoop?

When a "whooping" sound is heard when someone is trying to catch their breath after a cough, that person must have gotten a bacterial infection known as pertussis. Whooping cough is much more common in the very young children because they have not received all of their vaccinations against pertussis yet. A total of five shots are needed by the age of six years old for full protection. The vaccination wears off, so booster shots are needed every five to ten years. Whooping cough is highly contagious, so anyone who is infected should stay away from infants and children.

Hem Hem

The habit cough may occur after someone has just recovered from a cold. It is more common in younger children. Habit coughs can also be a nervous habit of certain individuals. In the case of Dolores Umbridge, her "hem hem" was used to get the attention of others. Clearly the "hem hem" cough worked well, except for one Minerva McGonagall.

Cough Remedies

Never, ever, ever get a product that combines an expectorant and a cough suppressant! They have opposite effects. Drug manufacturers try to trick you into thinking two is better than one, but it really is not. Personally, I believe those products shouldn't even be sold. Use an expectorant, such as guaifenesin, when you have an ineffective productive cough. It helps break up the phlegm, so it is easier for the body to cough it out. An antitussive or cough suppressant should only be used if coughing is disturbing your sleep at night. One common antitussive in multiple preparations is dextromethorphan. Codeine is also available as a cough suppressant, but it is more heavily regulated. You may have to ask for it since it cannot be out on the shelves with other products. Diphenhydramine, a first generation antihistamine, also has antitussive properties. But if you have taken Benadryl for allergies, you'll know how diphenhydramine tends to knock people out! Cough drops with menthol or camphor are good for soothing the throat. Ahem, remember to drink plenty of water if you have a... *cough*!