An unhealthy cough

Everyone knows that cough. If not with themselves, then with others. Frequent coughing even though one does not have a cold, sometimes with a strong cough or cough. It is the infamous smoker’s cough with the complication of chronic bronchitis that is accompanied by shortness of breath and coughing up yellow-green mucus (sputum). Many respiratory diseases start with a dry cough or tickly cough at the back of the throat. The wet cough or phlegm cough develops over time. It must be said that an occasional cough is completely normal. Thanks to cilia movements, the excess mucus in the airways is regularly expelled from the bronchi to the mouth and throat. By the way, many people cough due to nervousness. The question is when one can call a cough ‘unhealthy’. In any case, a lot can be read from the sputum (mucus).


  • About coughing, coughing and the cough reflex
  • A dry cough is usually suspicious
  • Causes
  • Smoker’s cough
  • Phlegm cough (wet cough)
  • Causes
  • Sputum (coughed up mucus)
  • The aspect of sputum
  • When to go to the doctor?


About coughing, coughing and the cough reflex

An occasional cough or cough is normal. The ciliated epithelium in the airways keeps the lungs clean twenty-four hours a day. In addition, dust particles and excess mucus are already captured in the nose and throat before they can penetrate deeper into the airways. In fact, even the Eustachian tube is lined with mucous membrane, provided with ciliated epithelium, to transport the mucus in the middle ear to the throat.

Heart and lungs / Source: Patrick J. Lynch, Wikimedia Commons (CC BY-2.5)

Cough reflex
The cough reflex occurs as soon as the mucous membranes in the larynx or throat are stimulated, regardless of the cause. It starts with a deep inhalation and ends with an abrupt exhalation. The originally closed epiglottis opens suddenly, causing mucus or a piece of peanut or a crumb of bread or biscuit to be coughed up forcefully into the oral cavity. In fact, coughing is a very forceful exhalation.

A dry cough is usually suspicious

Everything outside the stated ‘normal cough’ is basically food for thought. Coughing is a symptom in that respect . It is caused by virtually all diseases of the lungs and respiratory tract. A dry cough is common in the early stages of both chronic bronchitis and bronchial asthma. A dry cough or cough is not always harmless, unless it is a nervous cough. A tickly cough can also be a precursor to bronchial carcinoma.


coughing stimuli occur because the mucous membrane/ciliated epithelium has become damaged or irritated. In most cases, a dry cough (irritating cough) is due to, among other things:

  • Virus infections (including colds).
  • Corpus alienum , dust particles or other very small, foreign particles that adhere to the trachea. A larger object, such as a piece of peanut, causes acute symptoms because the body will forcibly and reflexively remove the foreign body from the trachea (coughing fits, even a risk of choking).
  • Stress.
  • Allergy.
  • Smoke.
  • Medicines.
  • Whooping cough.
  • Dry pleurisy.
  • Chronic bronchitis and cardiac asthma (first stage).
  • Harbinger of bronchial carcinoma.


Smoker’s cough

Smoker’s cough can manifest itself in many ways. As a persistent dry cough or tickly cough that does not go away due to damaged ciliated epithelium due to the toxic substances in tobacco smoke. They irritate the lungs constantly. After years of smoking, a wet cough or coughing cough develops insidiously. Smokers will also develop wheezing. The complaints are worsened by temperature changes, such as suddenly stepping out of a warm room into the cold outside air and vice versa.
Shortness of breath
In a later stage, smoker’s cough is also accompanied by wheezing, shortness of breath and other lung complaints. The consequences of long-term smoking are known and infamous. They range from chronic bronchitis to pulmonary emphysema (COPD), throat and lung carcinoma.

Source: FotoshopTofs, Pixabay

Phlegm cough (wet cough)

In this type of cough, mucus is expelled from the airways into the throat and oral cavity. With a cold, bronchitis and pneumonia, dry and wet coughs usually go hand in hand, even if there is tumor formation in the upper or lower airways. This type of cough often occurs after viral and bacterial infections of the respiratory tract, in the aforementioned long-term smokers (COPD) and the more rare bronchiectasis. Frequent coughing at night is usually symptomatic of upper respiratory tract diseases, such as sinusitis, allergic bronchitis, but it is also a symptom of congestive heart failure.


A wet cough (mucus cough) is due to, among other things:

  • Cold (bronchitis).
  • Pneumonia (pneumonia).
  • Whooping cough.
  • Allergies.
  • COPD (including pulmonary emphysema).
  • Heart disease (cardiac asthma).
  • Tuberculosis.
  • Cystic fibrosis.
  • Tumors in the airways and lungs.


Sputum (coughed up mucus)

A lot can be read from sputum (coughed up mucus). It is often used for cytological research , such as the detection of malignant cells, and for determining the presence of pathogenic microorganisms. Preferably, sterile collected morning sputum (washed sputum) is used. In other words, coughed up mucus provides very important clues as to the nature of the condition and, depending on the nature of the condition, contains, among other things:

  • Living and dead bacteria.
  • Airway epithelial cells.
  • Malignant cells.
  • Leukocytes.
  • Blood.


The aspect of sputum

As a result of the above components of the coughed up mucus, sputum often acquires a typical color and a different consistency than normal coughed up mucus. Yellow-green mucus is called purulent sputum, which is usually the result of an inflammation, such as (chronic) bronchitis. In bronchial asthma the sputum is tough and stringy, and in pneumonia the coughed up mucus often has a brownish color. Pulmonary edema is usually accompanied by frothy, pink mucus.

Source: Jarmoluk, Pixabay

Blood in sputum
The causes of sanguinolent sputum, or blood admixture, are usually serious and are the result of:

  • Severe respiratory infection.
  • Tumor formation in the upper airways or lungs.
  • Tuberculosis.
  • Bronchiectasis.


When to go to the doctor?

In most cases, coughing is harmless. In case of a persistent tickly cough or a wet cough that does not go away, it is better to go to the doctor. Always seek medical advice if the following occur:

  • The cough got worse after a week (also with bronchitis).
  • Fever.
  • The sputum (coughed up mucus) is mixed with blood.
  • Shortness of breath or sharp pain in the chest.
  • Cyanosis (cyanosis).
  • Tachycardia (very fast pulse).

Heart disease
These symptoms may indicate that the cough and accompanying symptoms are part of serious and in some cases acute disease processes , including pleurisy, pneumonia or heart problems. They require immediate medical attention.

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