Coughing may be inevitable this winter, given the prevalence of influenza cases, with the persistence of “Covid-19” infection as well.
Professor Camilla Hawthorne, chair of the Royal College of General Practitioners, said last week that doctors had noticed coughs lingering longer than usual this winter. The suggestion is that this could be due to people contracting one infection after another – possibly due to our reduced resistance to infection after two winters of social isolation.
As Prof Paul Hunter, an infectious disease expert at Norwich Medical School, told Good Health last week, the longer it’s been since a previous exposure, the greater the chance we’ll get reinfected.
So what can you do about that cough?
When you have a respiratory infection, the body increases mucus production to trap the responsible viruses.
Coughing is a reflexive act to clear this mucus from the airways, explains Dr Edward Nash, Consultant Respiratory Medicine at Heartlands Hospital in Birmingham.
Dr Anindu Banerjee, Consultant Respiratory Consultant at University Hospital Southampton NHS Foundation Trust, explains that the mucus that can accompany a cough is due to inflammation, which is part of the body’s immune response, and infection of the small tubes in the lungs. The tubes become so flexible and narrow that when you blow hard — coughing — the speed of the air flowing through them causes changes in the sound. There is no point in trying to suppress a cough because it is because the body knows it needs to get rid of some source of irritation.
But why can a cough continue after the cold or infection that caused it has gone?
“A cough for more than three weeks, even after the virus is gone, means you may have an ongoing inflammatory response,” says Dr. Banerjee.
This is why recovery — in other words, calming yourself down before returning to normal activities and exercise — after a bad cough is important because it’s a sign that the body is still healing.
So taking energy from elsewhere — for example, by resuming a strenuous exercise regimen — can slow your recovery.
What’s more, even low-grade inflammation in the body leads to fatigue because it changes the way cells use energy.
“Continuous inflammation in the muscles and airways can also cause lethargy – fighting viruses can make us fatigued,” says Dr. Banerjee.
And if there’s no point in trying to resist the urge to cough, there are ways to deal with it.
Ashley Woodcock, professor of respiratory medicine at the University of Manchester, says the reason menthol cough lozenges – or throat sprays – help is that they provide a cooling sensation to the throat, which may help counteract “the tickling feeling that makes you want to cough”. Nerve sensitivities in the throat, which can lead to a cough reaction.Menthol is soothing to the throat, so you are less likely to cough.However, the effect of controlling the cough may last from 20 minutes to half an hour only.
Cough syrup helps because swallowing the liquid soothes the throat — which is why Dr. Banerjee suggests mixing over-the-counter cough medicines with water.
“This is how these products were originally meant to be taken,” he says. Whatever product you use, mix the recommended dose with the same amount of warm water and drink it slowly. It’s more calming – and means you drink it for longer, so the effect It will last longer.”
But he says any liquid can soothe and coat the throat – hot drinks and soups will also help ease a cough and the liquid will help thin mucus, making it easier to budge. Keep your home warm – 18 to 21C, suggests GP Dr Andrew Whittamore, clinical lead at Asthma + Lung Hospital UK.
And some research, such as a study published in the Proceedings of the National Academy of Sciences, has found that the immune response — certainly in rodents — decreases in cooler temperatures.
Another tool might be breathing exercises—an idea first proposed in the 1950s when Russian scientist Dr. Konstantin Buteyko noticed that people who breathed through their mouths and kept clearing their throats would experience spasms of a dry, irritable cough.
Emma Tucker, respiratory physiotherapist and coordinator of post-Covid rehabilitation at Oxford Health NHS Foundation Trust, says: “Breathes through the nose help warm, moisten and filter the incoming air.
When our noses are blocked, we don’t, which can lead to throat irritation and more coughing.”
She suggests trying the following exercise that she recommends to patients in her clinic — and that she does herself when she has a persistent cough — to help clear up the mucus that’s causing it: Lie on your back on a soft surface, place your hands on your stomach, and focus on breathing through your nose and moving air down toward your stomach. Feel it gently rise and fall with your breath. Try to focus on your breathing volume – we recommend that a normal, comfortable breath is between 450ml and 500ml (a little more than a can of Coke).
This standard advice to drink plenty of fluids throughout the day is not only because the fluid will soothe the throat to reduce the urge to cough, but it will also loosen mucus, with the same effect.
A potential complication of frequent coughing is its effect on the chest muscles.
Violent contraction of the muscles between the ribs can damage muscle fibers and cause pain, says Dr. Nash. That’s why he suggests “paracetamol or ibuprofen for a few days”.
And if you have more persistent pain — over three to four weeks — it’s important to get it checked out, as it could be a sign of pneumonia, an infection of the lung tissue and airways.
And if you’re sick and less active than usual, Dr. Banerjee reiterates, it’s important to take it easy over the next few days or weeks if needed. “The important thing,” he says, in returning to normal daily life, is to do it slowly — with exercise in particular, not starting at previous levels.
“Pushing yourself before you’re ready can set you back and make you more tired. That’s why it’s so important to listen to your body and how it responds,” says Dr. Gavin Francis, GP and author of Recovery: The Lost Art of Recovering Through Exercise.
Please see the specialist doctor who follows your health condition before applying any advice.