A dry cough is a very common reason for medical consultation. It is not a disease, but a symptom, which is trivial in itself but can have multiple causes.

The cough is a sudden and forced exhalation of air reflex, which should make it possible to “clean” the respiratory tract. Unlike the so-called fatty cough, a dry cough does not produce sputum (it is non-productive). It is most often an irritating cough.

The cough may be isolated or accompanied by other symptoms, such as fever, runny nose, chest pain, etc. In addition, it happens that the dry cough then becomes oily, after a few days, as in the case of bronchitis for example.

A cough is never normal: it is not necessarily serious, of course, but it should be the subject of a medical consultation, especially if it becomes chronic, that is to say if it persists for more than Three weeks. In this case, an x-ray of the lungs and a medical examination are necessary.

Dry cough can be caused by many conditions.

Most often, it occurs against a background of a “cold” or respiratory infection and resolves spontaneously within a few days. It is most often a virus that is involved, causing a cough associated with nasopharyngitis, laryngitis, tracheitis, bronchitis or sinusitis, etc.

Chronic cough (more than 3 weeks) is of greater concern. The doctor will be interested in his seniority and the circumstances of occurrence to try to understand the cause:

• is the cough mostly nocturnal?
• does it occur after exercise?
• is the patient a smoker?
• is the cough triggered by exposure to an allergen (cat, pollen, etc.)?
• Is there an impact on the general condition (insomnia, fatigue, etc.)?

Most often, a chest x-ray will need to be done.

Chronic cough can have many causes. Among the most frequent:

• posterior nasal discharge or posterior pharyngeal discharge: the cough is mainly in the morning, and is accompanied by discomfort in the throat and a runny nose. The causes can be chronic sinusitis, allergic rhinitis, viral irritation cough, etc.
• a ‘dragging’ cough after a seasonal respiratory infection
• asthma: coughing is often triggered by exertion, breathing may be wheezing
• gastroesophageal reflux disease or GERD (responsible for 20% of chronic coughs): chronic cough may be the only symptom
• irritation (presence of a foreign body, exposure to pollution or irritants, etc.)
• lung cancer
• Heart failure
• Whooping cough (characteristic coughing fits)

Many medicines can also cause a cough, which is often dry, called an iatrogenic cough or medicated cough. Among the drugs most often incriminated:

• ACE inhibitors
• beta-blockers
• nonsteroidal anti-inflammatory drugs / aspirin
• contraceptives in women smokers over 35

Coughing can dramatically alter the quality of life, especially when it is nocturnal, causing insomnia. In addition, coughing irritates the respiratory tract, which can make the cough worse. This vicious cycle is often responsible for persistent coughs, especially after a cold or a seasonal respiratory infection.

It is therefore important not to let a cough “drag out”, even if it seems trivial.

In addition, certain signs of seriousness can accompany a dry cough and should prompt you to consult a doctor as soon as possible:

• deterioration of general condition
• difficulty breathing, feeling of tightness
• presence of blood in sputum
• new or changed cough in a smoker

Cough is not a disease, but a symptom. Although some medications can suppress or lessen a dry cough (cough suppressants), it is important to know the cause because these medications are not treatments.

In general, the use of over-the-counter cough suppressants is therefore not recommended, and should be avoided if it is a persistent cough, unless otherwise advised by a doctor.

When the dry cough is very painful and disturbs sleep, and / or no cause is identified (irritative cough), the doctor may decide to prescribe a cough suppressant (there are several types: opiate or not, antihistamine or not , etc.).

In other cases, treatment varies depending on the cause. Asthma, for example, can be controlled with DMARDs, with treatments to be taken as needed in an attack.

GERD also benefits from a variety of effective medications, from simple “gastric bandages” to prescription drugs like proton pump inhibitors (PPIs).

In case of allergies, desensitization treatments can sometimes be considered.