Chronic obstructive pulmonary disease (COPD) usually presents with one (or more) of the following four symptoms:
- shortness of breath, especially with activity
- wheezing or producing a gasping, whistling sound when you try to breathe
- feeling tight or constricted in your chest area
- coughing that produces moderate to large amounts of mucus or sputum
People tend to find coughing the most embarrassing and disruptive of these symptoms. Coughing can interfere with social events, like going to the movies, and it can prevent you from falling asleep at night. Many people go to their doctor or an urgent care center seeking relief from the chronic coughing associated with COPD.
As annoying as this coughing may be, it actually serves a useful function. Deep coughing clears the mucus that clogs your airways, allowing you to breathe more easily. Some doctors teach their patients how to cough and encourage them to do so often. Some experts even go a step further and advise against doing anything to stop the coughing, as a clear airway means easier breathing in the long run.
You probably know how much you usually cough if you’ve had COPD for a while. If you find yourself coughing more than usual, or coughing up sputum that looks different than it normally does, it may be time to go to the doctor to make sure you’re not having a flare-up or an exacerbation.
An increase in coughing can have several causes. Your body may be experiencing an increase in the amount of sputum or mucus it produces. Exposure to irritants, especially cigarette smoke or harsh fumes, can also increase coughing. You may also be coughing more because you’ve developed a comorbidity, which means another illness that exists alongside your COPD. Examples of comorbidities include infections like pneumonia or influenza, or issues like gastro-esophageal reflux disease (GERD). When you lie down, GERD can push stomach acid into your throat and mouth and cause you to cough.
If your increased coughing is due to a comorbidity, you can use antibiotics or medications to return to your normal amount of coughing. Don’t make any assumptions, though — speak to your doctor, who will make a diagnosis and prescribe you the right medication.
Long-acting inhaled beta-agonists such as salmeterol sometimes decrease coughing. Beta-agonists are another type of bronchodilator. They help open your airways and get more oxygen into your lungs.
Some researchers have studied the effectiveness of cough syrup with codeine. Although a few small studies showed a significant reduction in coughing, other studies were unable to reproduce that result. Using cough syrup and codeine to control coughing is a decision for you and your doctor to make together.
Finally, stop smoking to put an end to “smoker’s cough,” the dry, hacking cough common among people who smoke tobacco. A deep, productive cough that clears the airways of mucus may replace this dry cough.
There are a few medications that aren’t effective against COPD-related coughing. These include:
- corticosteroids such as prednisone
- long-acting anticholinergics such as Spiriva (these can actually make the cough reflex more sensitive)
Usually, COPD results in coughing and excess mucus production, but not in the case of emphysema. Emphysema is one of the diseases classified as COPD. It’s a progressive disease in which the air sacs (alveoli) in your lungs begin to collapse.
Emphysema may have no symptoms other than shortness of breath. Many of those who develop emphysema may have no cough or excess mucus production. Some people have both emphysema and chronic bronchitis.
Emphysema is a serious disease with the potential for severe complications. If you have shortness of breath during even simple activity, see your doctor for an evaluation. You may have a form of COPD, even without an annoying cough.
Although coughing is a primary symptom of COPD, surprisingly little research has been done on controlling it or even on whether or not it should be controlled. If coughing interferes with your quality of life, talk to your doctor to find treatment options.