To treat or not to treat…

Perhaps the second most annoying thing about a winter cold is the cough that it brings.  The most annoying has got to be the runny  nose. 

What should you do about a cough?  Naturally, your first reaction is to suppress it.  But this could be a mistake.  The act of coughing is part of the body’s protective mechanism.  Suppressing it might prolong the discomfort and hence the need for suppression.

The cough is designed to expel foreign and irritating matter from the lungs.  A cough can originate from two areas: high or low. 

The ‘low cough’ is the more worrisome.  It occurs when the lower end of the bronchus (airway) is irritated by mucous produced when the cells in the airway and lungs are infected with viruses.  The danger here is that if one suppresses the cough and allows the mucous to build up, this then predisposes the lung to a more serious bacterial infection or pneumonia.    

So it is often not a good idea to suppress a ‘low cough’.

A ‘high cough’ originates from the back of the throat.  It is that “tickle” that triggers spasms of coughing.  The cause is pretty much the same = irritation. Suppressing a high cough is less of a risk for pneumonia.

So, for the most part, coughing is a needed protective reaction to infection and irritation.  Generally speaking a cough should only be suppressed when it is overly intrusive.  If you’re gonna have to give a speech or run a meeting, temporary suppression of a cough may be called for.  The one disruption that calls for suppression is when the cough is so intrusive that it interrupts sleep.

But how should you suppress that cough?

Most over-the-counter cough remedies contain an expectorant.  This is not actually a cough suppressant.  Rather it helps to liquefy the mucous and make it less irritating and easier to expel (hence the name).  Some formulas do contain a mild suppressant, but for true suppression you need to use either a narcotic-like drug (codeine is the most commonly used) or an anti-histamine.  The most effective of these latter drugs are by prescription only.

The lesson here is that you can self-treat using over-the-counter cough potions for temporary relief but it is not something that you should do each and every time you have a cough.  A cough is good and useful as long as it is tolerable.  If the cough becomes overly intrusive especially if it is disruptive of sleep, then a stronger prescription remedy may be called for.

See your doctor for any cough that persists for more than 7 days, or is there is any blood in the sputum.  Do not attempt to self-treat a cough for more than 3 days at a time.

Allow the cough to serve its purpose, as long as you can tolerate it.