How to get rid of a dry cough?

What is a dry cough?

Coughs are usually a very irritating and common symptom of a respiratory tract infection, which include infections of the nose, throat, and lungs. It is our body’s natural ‘reflex’ in trying to get rid of germs and anything else that doesn’t belong in the respiratory tract.¹

A cough can either be a chesty cough (also known as a ‘wet cough’) or a dry cough. To tell the difference, a chesty cough produces phlegm that can be clear or white, and usually if a bacterial infection is present, the phlegm can be yellow or green. A dry cough on the other hand, does not produce any mucus, and instead, feels irritating and ‘tickly’.²   

Causes

We categorise coughs into three types:³

• Acute: Cough lasts less than 3 weeks
• Sub-acute: Cough lasts between 3 and 8 weeks
• Chronic: Cough lasts more than 8 weeks

Acute Cough

Causes and Details

• Viral upper respiratory tract infection - Examples are the common cold and influenza. They usually heal on their own and are associated with symptoms of a headache, low fever, sore throat and runny nose.⁴
• Acute Bronchitis - An infection of the bronchi in the lungs, leading to inflammation. It is caused mostly by a viral infection and is also associated with fever, aches and pains.
• Pneumonia - Occurs due to an infection which causes the air sacs in the lungs (alveoli) to become inflamed. Dry cough is an early symptom.
• Exacerbations of asthma, COPD, Bronchiectasis - Asthma exacerbations can be brought on by certain triggers such as exercise, cold air and dust. COPD is a chronic and progressive disease where there is limited airflow. Smoking is a large risk factor, but can also be dependent on genes, age and air pollution.
• Pneumothorax - Also known as a collapsed lung means that the lung fails to expand normally.⁵
• Pulmonary Embolism - Occurs when a blood clot travels to the lungs, restricting further blood flow.  A cough is often accompanied by shortness of breath, and chest pain and is classed as a medical emergency.⁶

Sub-acute Cough

Causes and Details

• A post-infectious cough e.g. from Mycoplasma pneumonia or Bordetella Pertussis - Bordetella pertussis is a bacteria that causes whooping cough. It is a highly infectious disease which mostly occurs in young children.⁷

Chronic Cough

Causes and Details

• Smoking - Cigarettes contain toxins and coughing is common, as a way for the body to try and get rid of them. Over time, there is  damage to the airways and the cough tends to produce phlegm.
• Use of ACE inhibitors - A type of medication used to lower blood pressure can commonly cause a dry cough. Alternative medication can be given if this is the case. 
• Upper Airway Cough Syndrome (Post Nasal Drip) - Inflammation of the upper airway, associated with nasal discharge and frequent throat clearing.¹
• Asthma - A condition that causes breathing difficulties, affecting all ages. Symptoms include wheezing, a tight chest and coughing (which mostly occurs at night).
• Gastro-Oesophageal Reflux Disease(GORD) - GORD is when acid from the stomach refluxes back into the oesophagus, causing symptoms of heartburn, belching and bloating. It is often associated with nighttime coughing and coughing after meals.

Symptoms 

A dry cough is not a disease state itself, but a symptom that has an underlying cause (see Causes). If the cause of the cough is viral (e.g. cold or flu), it is not uncommon for the cough to be accompanied by a blocked or runny nose, headache and mild fever. 

In general, a dry cough can be described as having a tickly sensation in the chest. If the coughing persists, it can also lead to a lack of sleep, exhaustion, and rib pain. 

Treatment

It is important to identify the cause of the dry cough, as this will indicate the best course of treatment. For example, if the cough is caused by asthma, this may mean that the asthma is not being managed well enough and medication needs to be changed or the dose increased.

You should also consider avoiding triggers of a dry cough as this can exacerbate the condition. Examples of triggers include:

• Cold weather 
• Smoking
• Poorly ventilated areas
• Mould

In the case of a cough caused by a viral infection, often there is no treatment necessary and the best course of action are steps to help relieve symptoms.

Medicines 

Decongestants

These are often found in cough and cold remedies and help you breathe more easily. An example of a decongestant is Pseudoephedrine. 

Cough suppressants

These preparations can be useful, especially in the initial stages when there is no identifying cause of the cough. An example of a suppressant is pholcodine. As it is a weak opioid medicine, it is associated with side effects such as constipation and drowsiness, and therefore is not recommended for long-term use.

Dextromethorphan is another example of a suppressant that is considered less potent than an opioid preparation such as codeine and pholcodine, however, it also has fewer side effects.⁸

Other cough medicines

Demulcents such as simple Linctus are also an option for those suffering from a dry cough as although there is no ‘active ingredient’, it serves to soothe an irritated throat and is safe for young children.⁸

It is important to understand what kind of cough you have as there are different medicines tailored to different types of coughs. For example, with a chesty (mucus) cough, an ‘expectorant’ medicine such as guaifenesin is often the treatment of choice as it helps the patient expel the mucus. 

 A sedating antihistamine such as diphenhydramine may also be considered in those who suffer from disturbed sleep because of persistent coughing.

Home remedies

Ginger

Ginger is known for its anti-inflammatory properties and is thought to be effective in soothing a cough. It can be boiled in water and drunk several times a day or chewed raw.

Raw honey

Raw honey coats the throat to soothe irritation. Honey also has analgesic effects.

Turmeric

Turmeric is particularly helpful in treating a dry cough. When black pepper is added to turmeric, it increases its potency. It can be mixed with hot water and drunk as tea or can be drunk with milk.

Peppermint

Peppermint: Menthol within Peppermint has a soothing effect on the throat. It can be ingested as a tea or through steam inhalation.

Licorice root

Liquorice root is better suited for chesty coughs as is a natural expectorant. However, it also has a soothing property that may also help with dry coughs.⁹

Marshmallow roots

Marshmallow is a summer flower; its roots contain a thick substance called ‘mucilage’ which helps coat the throat to help with irritation. 

Capsaicin

Capsaicin can be used to treat chest pain and has a warming effect since it is a component that is naturally found in chillies. 

Other home remedies

• Drinking plenty of fluids - This helps to hydrate the lungs and hot drinks especially can have a soothing effect. 

• Steam inhalation - Is more effective in a chesty cough as it helps the mucus to liquefy so the body can get rid of it easier. 

• Bromelain - is an anti-inflammatory component found in pineapples that can help suppress a cough. 

• Probiotics and Multivitamins - These are not an immediate source of treatment; however, they can help strengthen the immune system to help stave away or fight any infections.

• Saltwater gargle - Salt water gargling is great for bacterial infections as it is naturally antibacterial and can help remove mucus in a chesty cough. 

• Environment - A cold environment can irritate the throat and lungs resulting in more coughing, so it is important to keep warm. Irritants and pollutants in the air may also exacerbate coughing. 

• Rest - is important as the body needs its energy to fight off any infections causing the cough. 

Can antibiotics stop a dry cough?

Antibiotics can only treat bacterial infections. A dry cough is a common symptom of upper respiratory tract infections which can either be viral or bacterial. However, it is most common for a cough to be caused by a viral infection, and if this is the case, antibiotics will not work. 

Sometimes a viral infection can progress to a bacterial infection and usually signs of this happening are a worsening and high fever, pus-filled spots of the tonsils and symptoms lasting longer than two weeks.

When to see a doctor

It is common for a cough to be short-lived and can go away by itself over time, usually within 3 weeks. 

However, sometimes a cough can last a lot longer; we call this a chronic cough (or persistent dry cough) and occasionally it can be a sign of something more serious. It is important to see your doctor so that the cause can be found and treated. Usually, it is best to see your doctor when your cough has lasted for longer than 3 weeks. 

In any case, you should also see your doctor if your cough is associated with the following symptoms:¹⁰

• Unexplained weight loss
• Coughing up blood
• Chest pain 
• Fever 
• Breathlessness 

Summary

Dry coughs do not produce any mucus and can feel irritating and tickly. There are many different reasons that you might be coughing, and it’s important to get a persistent cough that causes you any discomfort looked at by a doctor, as it might be a sign of a deeper problem.