The Independent Pharmacy

Chesty Cough

When you have a chesty cough, it means your body is trying to clear mucus and phlegm from your airways. Most coughs are caused by the cold or flu virus, so antibiotics won’t help. And while the constant coughing can be wearing, even keeping you up at night, it’ll usually clear up on its own within three to four weeks. There are many treatments you can buy over the counter to help ease your symptoms but if your cough lasts longer then it’s wise to see your GP in case it’s a sign of something more serious. Let’s find the right approach to ease your chesty cough and get you back to feeling your best.

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Advice for Chesty Cough

What is a chesty cough & what causes it?

While irritating and unpleasant, conventional coughing is very rarely a cause for concern. The everyday variety is simply a reflex action stemming from the presence of irritants such as dust or smoke in the body’s airways, and will soon clear up.

A chesty cough is typically characterised by its heavy, ‘hacking’ feel, and the production of mucus or phlegm. These viscous fluids accumulate in the lungs and lower airways, making the cough difficult to clear. This is distinctly different from a dry cough, which is classed as non-productive and usually caused by irritation at the back of the throat.

As for the cause, a chesty cough is most likely to stem from a cold or flu virus, but it can also result from exposure to an atmospheric irritant such as pollution, cigarette smoke, or an allergen. Potential causes of chesty coughs are as follows:

  • Secondary infections. Bacterial infections can affect the upper or lower respiratory tract and give rise to conditions such as bronchitis, pneumonia, or chest infections. Coughing up yellow phlegm is a strong sign that your body is fighting off an infection — the colour comes from white blood cells.
  • Smoking. Long-term smokers will be familiar with the chesty ‘smoker’s cough’. The harsh chemicals and additives present in tobacco, as well as the physical properties of the smoke itself, serve to irritate the lungs, leading to persistent symptoms. Smoking damages the lining of the lungs and prevents the delicate alveoli from removing excess mucous or debris. Since the smoke itself leaves further debris and chemical waste in the lungs, this can easily lead to the lungs becoming clogged.
  • Other medical conditions. COPD (chronic obstructive pulmonary disease), cystic fibrosis, and asthma are all conditions that can give rise to chesty coughs, though they’re usually diagnosed very early in life.

Very rarely, a chesty cough can be an indication of heart failure. When heart failure occurs, fluid may build up in the lungs, causing a persistent productive cough: this is known as a ‘pulmonary edema’. In the typical case, a chesty cough isn’t a major cause for concern and should resolve itself gradually over time. If you have a chesty cough for more than three weeks with no sign of improvement, though, you should visit your GP for advice.

What are the symptoms of a chesty cough?

A chesty cough will usually feel ‘weighty’ and involve coughing fits that bring up phlegm or mucus. Other symptoms include the following:

  • An aching throat. During coughing, mucus can irritate the lining of your throat, causing inflammation
  • A rattling sound while inhaling. Dislodged mucus and phlegm can cause this sound farther down in the chest
  • A sensation of breathlessness. Excess phlegm and mucus can cause airway obstruction
  • Pain in the abdomen or chest. Prolonged coughing fits can strain the muscles and cause aches and pains that persist even after coughing stops

Chesty coughs are usually the results of viral infections. The typical symptoms of a viral illness include the following:

  • Congestion
  • A sore throat
  • Fatigue
  • Headaches
  • General aches and pains

How is a chesty cough diagnosed?

In most cases, there isn’t usually a need to visit a GP for a cough. However, it is advised to seek medical advice should any of the following apply:

  • The cough has lasted for longer than three weeks
  • The cough is particularly severe or seems to be getting worse
  • The cough is causing breathing difficulties
  • You are experiencing chest pain
  • You are coughing up blood
  • If there are any additional unexplained symptoms, such as weight loss, lumps or swellings, or a persistent change in voice

If your GP is unsure as to what’s causing the cough, they may need to refer the case to a specialist for further assessment. This could include having a chest X-ray, breathing and allergy tests, or analysing a sample of phlegm to check for the cause of infection.

How do I treat a chesty cough?

Chesty coughs usually won’t require any treatment as the symptoms should pass within three or four weeks. If you have a cough caused by an underlying condition, though, you should focus on treating that root condition. If COPD is the cause, for example, controlling the disease itself through the use of an inhaler and specialised medication is the best way to get relief from the cough.

If your chesty cough was brought on by a cold or flu virus, you should focus on getting rest, keeping warm, and drinking plenty of fluids to stay hydrated. A class of medications known as expectorants can also help to ease the symptoms. Expectorants work by thinning the secretions produced by the lungs, enabling phlegm and mucus to be coughed up more easily. An expectorant will usually have guaifenesin or ipecacuanha as its active ingredient.

Some chesty cough treatments may contain combinations of active ingredients. For example, an expectorant may also contain a decongestant such as pseudoephedrine. Other preparations might instead contain painkillers such as paracetamol or ibuprofen.

Antitussive or ‘cough suppressant’ medication can also prove effective at controlling a chesty cough. These medications work by decreasing activity in the part of the brain that triggers the reflexive impulse to cough. However, antitussives alone won’t treat the root cause of a cough, and thus can only have limited efficacy.

While each of the chesty cough treatments listed above can be easily acquired without a prescription, a homemade remedy of hot water, lemon juice and honey can work well without requiring you to order anything. Just be aware that honey shouldn’t be given to babies under the age of one, as it carries the risk of infant botulism.

How can I prevent a chesty cough?

While chesty coughs are often caused by infections that are difficult to prevent, the best advice here is to take good care of your general health.

Boosting your immune system with simple steps like eating well and exercising regularly will give you a greater chance of fighting off infections.

Other steps you can take to ensure your immune system remains in good working order include the following:

  • Getting plenty of high-quality sleep
  • Avoiding stress and anxiety
  • Staying hydrated (pure water is ideal)
  • Avoiding excessive alcohol consumption
  • Quitting (or at least minimising) smoking
  • Keeping asthma under control

If you experience a persistent or recurring cough that worries you, visit your GP. They can determine if there is an underlying cause and provide treatment if necessary.

Chesty Cough FAQs

  • Most coughs are a response to a cold, flu or allergies. This is normal; everyone will cough occasionally. If your cough is bringing up blood and/or mucus, this is abnormal and you should consult your doctor. Likewise, you should talk to your GP if your cough is causing you severe pain or making you feel fatigued or light-headed.

  • Coughing itself is not a disease – it is an indication that something else is wrong with your body. For this reason, cough medicine will not address the cause of the cough.

  • There are two different categories of cough medication: expectorants and suppressants.

    Expectorants are used to treat a wet cough, which may be due to a condition like bronchitis or pneumonia. The medication helps the cough to remove the excess mucus from the bronchial tree and lungs.

    Suppressants are used to ease a dry non-infectious cough. If there is a chance that your cough is due to another serious condition, you should be wary of using suppressants. This is because coughing is the body’s way of removing substances from the respiratory pathway.

  • Some medications for high blood pressure (ACE inhibitors such as enalapril, lisinopril and perindopril) may cause a chronic cough.

  • You should talk to your GP if you notice that your cough is causing you to expel blood or mucus, to have a fever, or to have difficulty breathing. These symptoms might indicate that you have a more serious problem than a cold or flu. One such condition is a chest infection, which may also cause a rapid heartbeat, wheezing, or disorientation.

    You should also see your GP if your cough lasts for more than three weeks, or does not improve after seven days of medication.

  • When the respiratory system is working normally, the tissue of the lungs is lined with a layer of mucus (or phlegm), which prevents irritants from entering the lungs. These irritants include bacteria, viruses and dust. Coughing is the body’s mechanism of removing the mucus which has trapped irritants. This is why you have an excess of mucus and a chesty cough when you are fighting a cold.

  • It is important to look after yourself. Staying rested will help your immune system to recover, and frequently washing your hands will stop the spread of germs. Another way to help your immune system is to ensure that you are fully hydrated. Water can also help to loosen mucus, and replenish fluids you have lost through your nose and mouth.

    If you are struggling to sleep, try sleeping on a slight incline. This will prevent mucus from reaching your throat, and help with congestion.

    Consider avoiding cigarettes and other forms of smoke. Smoke commonly causes irritation of the lungs.

  • Tickly dry coughs occur due to an irritation of the throat rather than the lungs, which is why no mucus is involved. The irritation may be due to cold or flu infections, or common irritants including dust and smoke. Several allergens can cause a dry cough; if you think you are coughing due to an allergy, try taking antihistamines.

    Other conditions can cause a dry cough as well. One is asthma, which will also cause wheezing. Another is gastric reflux, in which case you will likely also be suffering from heartburn. In either case, you may want to talk to your GP.

    The mechanism of a dry cough can further irritate the airways, and cause a sore throat. So, you should try to soothe your throat as quickly as possible.

  • Along with suppressant cough medicines, consider using lozenges, hard sweets or even ice cubes to ease the irritation in the throat.

    Steam from a hot shower can moisturise the nose and throat. If, however, you suffer from asthma, steam may worsen your cough.

    If the air in your bedroom is dry, use a humidifier.

    Remove dust from your house and bedding. Dust is a common irritant, and dust mites can trigger allergies.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.