Whether caused by an allergy, bronchitis, or gastroesophageal reflux, coughing is not very pleasant to live with daily. It is, however, a “lung protection reflex,” explains Dr. Gérald Kierzek, an emergency physician and medical director of Doctissimo, to expel irritants, mucus, or germs from the respiratory tract.
But not all coughs are the same. Depending on their duration, dry or productive nature, and associated symptoms, they can reveal very different causes.
Dry or productive cough: how to differentiate between them?
A cough can be dry or productive, depending on the presence or absence of expectorations (phlegm).
“Dry cough can be caused by irritation of the throat (smoke, pollution, allergens)” explains our expert. “It is often associated with a cold, flu, allergies, but also gastroesophageal reflux (GERD) or certain medications (e.g., ACE inhibitors).”
On the other hand, a productive cough will be accompanied by mucus, a sign that the body is fighting an infection. “It can be caused by a cold, flu, or bronchitis,” indicates Dr. Kierzek. “But also by certain chronic diseases such as asthma or chronic obstructive pulmonary disease, or COPD.”
The medical director of Doctissimo warns: “If the expectorations become yellow, green, or bloody, it may indicate a bacterial infection requiring treatment.”
When a cough becomes a warning signal
Some coughs can reveal more serious pathologies. Dr. Gérald Kierzek lists them:
- Spasmodic cough. “It takes the form of violent and uncontrollable coughing fits and can be present in cases of whooping cough, severe asthma, or tuberculosis;”
- Asthma cough. “It is rather dry, with wheezing on expiration. Intensifies at night or during physical exertion“;
- Reflux cough. “Severe and spasmodic, it is linked to gastroesophageal reflux. It intensifies after meals or in a lying position“;
- COPD cough. “It is chronic, with a lot of mucus, especially in the morning. And remains primarily caused by smoking or exposure to pollutants“;
- Cardiac cough. “Persistent and dry, it can worsen when lying down. It can also be accompanied by shortness of breath, fatigue, and edema. And is caused by fluid accumulation in the lungs due to heart failure” specifies Dr. Kierzek.
How long have you been coughing?
In addition to the appearance of the cough, its duration also matters in medicine. “The timing of the cough is essential to make a diagnosis,” insists Dr. Kierzek. There are three distinct types:
- Acute cough, lasting less than 3 weeks. It is caused by a cold, flu, or respiratory tract infection;
- Subacute cough, persisting between 3 and 8 weeks. It can be due to a post-viral infection or exacerbation of a chronic disease;
- Chronic cough that persists for more than 8 weeks. It can reveal COPD, asthma, GERD, or a more serious illness such as lung cancer.
When should you see a doctor?
If your cough is accompanied by persistent fever, night sweats, unusual shortness of breath, chest pain, unexplained weight loss, or bloody expectorations, promptly consult a healthcare professional.
“Do not treat a cough without investigating the underlying cause” cautions Dr. Kierzek.
