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October 13, 2016

When Should You Get a Cough Checked Out?

by Amanda MacMillan

A lot of people are doing a lot of coughing these days. It’s the time of year for it: Seasonal allergies are still prevalent while colds are starting to circulate, and both can produce coughs that last for a surprisingly long time. In fact, a run-of-the-mill cold can cause a cough that lasts a full two weeks, and a cough after flu can stick around even longer. (The most common culprit behind a persistent cough? Simple post-nasal drip, often caused by inflammation of the nasal membranes due to allergies.) But when a cough is exhausting, or when it disrupts your work, leisure time and sleep, it can be hard to know whether you should get it checked out by a doctor.

“Coughing is a protective reflex that helps keep your lungs clear,” says Effie Singas, MD, pulmonary critical care specialist and associate professor of medicine at Hofstra Northwell School of Medicine at Hofstra University. Generally, she says, it’s okay to let a cough run its course, as long as you feel well otherwise, and to treat it with home remedies like hot tea and throat lozenges. Sometimes, though, a cough really can be a sign of something more serious -- something that requires additional testing or medication from your doctor.

How do you know the difference? Here are six signs you should get your cough checked out by a doctor:

1. You’re wheezing or have shortness of breath. “It can indicate asthma or a more serious pulmonary condition,” says Singas. (If you’re having severe wheezing or a hard time catching your breath, you should seek medical care right away.)

2. You’re coughing up blood. “Usually, blood-tinged sputum is from bronchial inflammation, but it could be something more serious -- especially if you’re a smoker,” she says. “It should always be evaluated by your doctor.”

3. You’re running a fever. Cough plus a fever over 100.4°F could mean pneumonia that requires antibiotics.

4. You’re coughing up dark yellow or green phlegm. “If you have allergies or a simple cold, you’ll probably be coughing up clear mucous,” she says. “Dark yellow or green mucous suggests a bacterial infection in your lungs or your sinuses.”

5. Your cough kicks in after you eat or when you lie down. If your cough usually happens at these times, it might actually be caused by heartburn – even if you don’t feel the classic burning pain behind your breastbone. Chronic heartburn should be checked by a physician, because it could mean that stomach acid is regularly getting into your esophagus, where it doesn’t belong. Over the long haul, that can cause damage. Over-the-counter medicines might help, but you may need a prescription-strength treatment or lifestyle changes to resolve the problem.

6. Your cough doesn’t go away after two to three weeks. Even if you don’t have any of these other symptoms, Singas recommends seeing a doctor if there’s no change in your cough. “You may need additional tests, like an X-ray or allergy tests,” she says. “It can help you get to the bottom of what’s causing your cough, so you can get the treatment you need.”