Coughing is a natural reflex that clears the throat and breathing passage of foreign particles, microbes, irritants, fluids, and mucus. A dry cough, or sometimes a tickly cough, is a cough that does not bring up any phlegm or mucus. A wet, or productive, cough brings up phlegm that helps clear the airways of irritants.
Dry coughs may cause a tickling sensation and are often due to irritation in the throat. While an occasional dry cough is rarely a cause for concern, persistent coughing can indicate an underlying medical condition that may be more serious.
What Can Cause a Dry Cough?
Many things — from allergies to acid reflux — can cause a dry cough. In some cases, there’s no obvious cause. Regardless of the cause, an ongoing dry cough can seriously impact your day-to-day life, especially if it’s worse at night.
Cough-Variant Asthma
One of the most common symptoms of asthma is coughing, which is often worse at night or early in the morning when a person first wakes up. Cough-variant asthma is a type of asthma in which the main symptom is a dry, non-productive cough. People with cough-variant asthma often have no other "classic" asthma symptoms, such as wheezing or shortness of breath.
Cough-variant asthma is sometimes called chronic cough to describe a cough that has lasted longer than six to eight weeks. The coughing with asthma can occur during the day or at night. It can interrupt sleep. Coughing increases with exercise. Coughing may increase upon exposure to asthma triggers or allergy-causing substances like dust, strong fragrances, cold air, animal dander, intense emotions like stress, some drugs like aspirin, smoke and other air pollutants or respiratory infections like the common cold. Cough-variant asthma can turn into classic asthma if not treated.
Idiopathic Pulmonary Fibrosis
Idiopathic pulmonary fibrosis (IPF) is a condition in which scar tissue develops inside a person's lungs. As the scar tissue thickens, it makes breathing in air increasingly difficult. It is a chronic progressive lung disease. The term idiopathic means that doctors do not know exactly what causes the condition.
One of the most common symptoms of IPF is a persistent, dry cough. Other symptoms can include: shortness of breath, loss of appetite and gradual weight loss, fatigue, clubbing, or widening and rounding of the tips of the fingers or toes, also affecting the shape of the nails.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a condition where acid leaks from the stomach back up into the esophagus, or food pipe. GERD causes a chronic, dry cough in up to 40 percent of people with the condition. Chronic cough is often a symptom of GERD. A hacking dry cough at night is the usually the most common complaint for patients.
Heartburn usually is described as a burning pain in the middle of the chest. It may start high in the abdomen or may extend up the neck or back. Sometimes the pain may be sharp or pressure-like, rather than burning. Such pain can mimic heart pain (angina). Typically, heartburn related to GERD is seen more commonly after a meal.
Other symptoms of GERD include: hoarseness; if acid reflux gets past the upper esophageal sphincter, it can enter the throat and even the larynx, causing hoarseness or sore throat, feeling as if there is a lump in the throat, pain or difficulty when swallowing, nausea, vomiting, sudden increase of saliva and bad breath.
Postnasal Drip
Normally, you don't notice the mucus from the nose because it mixes with saliva, drips harmlessly down the back of your throat, and you swallow it. When your body produces more mucus than usual or it’s thicker than normal, it becomes more noticeable. The excess can come out of the nostrils -- that’s a runny nose.
When the mucus runs down the back of your nose to your throat, it's called postnasal drip. When the mucus drips into the throat, it can trigger a cough. Although this cough is often productive, it can sometimes also be dry.
There are several conditions that can cause post-nasal drip. Post-nasal drip also can be caused by changes in temperature and humidity.
Postnasal drip often occurs with a sinus infection or due to a nasal allergy. Rhinitis is one of the most common causes of post-nasal drip. Rhinitis is often due to allergies but can be caused by other things such as the hormonal changes and certain medicines.
Acute sinusitis is inflammation of the sinuses usually due to a viral or bacterial infection. Chronic rhinosinusitis is when there is ongoing inflammation of the lining of the nose and sinuses, with symptoms lasting longer than 12 weeks.
People with upper airway cough syndrome have post-nasal drip, abnormal sensations in the throat plus a chronic cough. Extra-sensitive nerves in the back of the throat may cause a feeling of increased mucus in the throat when there is, in fact, no increase in mucus. Allergies and inhaled irritants can trigger upper airway cough syndrome.
Smoker’s Cough
Smokers cough is the cough that develops in smokers and lasts for more than two or three weeks. This cough can develop while smoking or after quitting smoking.
This cough is caused by the body clearing out the chemicals that enter the airways and lungs through tobacco use. While the cough may begin as a dry cough, it can eventually produce phlegm. Other symptoms include a sore throat, chest pain, frequent cough, shortness of breath, coughing up phlegm or mucus and wheezing.
The cilia in the lungs – little hair-like structures that help keep the lungs clean – are often damaged or completely paralysed by certain chemicals in cigarette smoke. This means that any toxins usually cleaned up by the cilia instead just settle in the lungs. After a while, this can lead to a build-up of mucus.
The lungs become irritated and inflamed when they’re regularly exposed to smoke. Each time you smoke, you inhale irritating particles. In response, the cells that make mucus grow larger and increase in number. They make more mucus, and it’s thicker than usual. This thicker mucus is harder to cough up so it gets stored. Mucus clogs up your airways, which contributes to smokers cough.
Smokers don’t just cough more than other people, they also get sick more often. They’re more likely to get colds and respiratory infections, like bronchitis and flu.
Coughing After Quitting Smoking
Although quitting smoking will improve your breathing, you may cough after you stop. Why? The cilia begin to recover when you stop smoking. Recovery usually starts within 4 to 6 days of quitting, and it can continue for months. Eventually, most people regain normal cilia function. As the cilia become more active, they can clear more mucus from your lungs.
As a result, you may find that you cough more often. In fact, you may cough more than you did when you were smoking. This isn’t something to worry about. It’s actually a sign of recovery. The quit smoking cough can continue for a few months after you stop smoking.
In the beginning, the cough can be dry. Later on, you may start coughing up phlegm. For most people, the coughing lasts only a month or two after quitting smoking. Some smokers don’t cough more after they quit. This isn’t something to worry about.
If you don’t cough more after you quit smoking, it means that the repair process is occurring more gradually. Or that the phlegm is coming up steadily, but in small amounts, so you don’t notice it. Coughing after quitting smoking helps to remove the irritants from your lungs, so it’s not a good idea to try to suppress it with cough medicines.
Other causes
Upper respiratory infections such as common colds and the flu can cause acute coughing. The cough often starts out productive but may become dry as a person recovers from the infections. Whooping cough is a contagious respiratory infection that causes a characteristic dry cough with a “whoop” sound as you gasp for air.
Other causes of a dry cough can include: some medications, such as ACE-inhibitor drugs for high blood pressure, prolonged exposure to pollution, dust, irritating chemicals and allergies.
A chronic, dry cough can sometimes be a symptom of lung cancer. However, other causes of dry cough are far more common.
Prevention Tips
It is not always possible to prevent a dry cough. However, tips that can help include: avoiding tobacco smoke, using a humidifier to moisten the air, get more exercise, deep breathing and allergy-proofing the bedroom to reduce irritants.
Drinking lots of fluids so you stay hydrated. Water is the best choice. Hot beverages that may be comforting include: clear broths, herbal teas, warm water or warm fruit juices. Thyme has both culinary and medicinal uses and is a common remedy for a cough, a sore throat, bronchitis, and digestive issues. Ginger may ease a dry or asthmatic cough, as it has anti-inflammatory properties.
Try taking a spoonful of honey once or twice a day. Honey will coat the lining of your throat and soothe it. It’s best to limit other sweets, though. Candy, cake, cookies and other foods that contain a lot of sugar can prompt your body to make more mucus.
Avoiding foods that can trigger acid reflux is one of the best ways to manage this condition and reduce the cough that accompanies it. The foods and beverages that most commonly trigger acid reflux include: alcohol, caffeine, chocolate, citrus foods, fried and fatty foods, garlic and onions, mint, spices and spicy foods, tomatoes and tomato-based products.
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