While hearing others cough can be quite bothersome, tuning into your own coughs could actually be a lifesaver.

Coughs manifest in a variety of ways, differing in sound, intensity, and persistence. Dr. Naveed Asif emphasizes that understanding these differences can help determine whether you need medical care or merely a soothing lozenge.

Dr. Asif, practicing at The London General Practice, notes that approximately half of his patients report concerns about coughing. Although it often causes alarm, he reassures that coughing is the body’s natural response to an irritant.

In a conversation with the Daily Mail, he explained, “Coughing results from an irritant or infection that causes swelling or discomfort in the airway.”

“The act of coughing is essentially a muscle spasm aimed at expelling whatever is causing the irritation,” he continued.

He warned that failing to clear these irritants can lead to them settling in the lungs or traveling down the airway, potentially resulting in pneumonia.

The NHS says a cough will typically clear up on its own within three to four weeks without you needing to see a GP. 

However, in some cases urgent medical attention is needed—and the warning sign is the sound of the cough. 

Dr Asif says that coughs can roughly fit into six different categories. Read on to find out more about each one, and the ones which are always cause for concern.

Dry cough

Dr Asif describes a dry cough as having a hacking sound that produces no phlegm – a sticky mucus produced by the lungs to trap irritants like dust, germs and viruses to protect the airways.

If caused by an allergy, for instance to pollen, they are commonly experienced in spring, but if triggered by a viral infection, more common in winter. 

He said: ‘The majority of these coughs get better over days or weeks by themselves and are usually mild.

‘However, we worry about a cough that doesn’t improve after three weeks as it may suggest cancer.’ 

A dry cough can be a warning sign of lung, oral, throat or other upper airway cancer.  

He added: ‘Equally, you can get metastasis, which is when any cancer spreads to the lungs, and often one of the worrying signs is a cough.’

If it is an early sign of cancer, it is often also accompanied by weight loss, reduced appetite and abdominal tenderness.

It’s estimated there are nearly 50,000 new cases of lung cancer in the UK every year, which is more than 130 a day.

Tragically, it kills over 33,000 Britons annually, making it the most common cause of cancer death in the nation.

The cancer is more common in older people, with almost half of all cases being diagnosed in people aged 75 and over.

However, another cause of dry coughs is acid reflux, a problem that affects around a fifth of adults.

It occurs when the stomach acid that breaks down food, flows backward into the  oesophagus and causes a burning feeling in the chest, commonly known as heartburn.

Other symptoms include a cough or hiccups that keep coming back, a hoarse voice, bad breath, bloating and feeling sick. 

Wet cough

A wet cough, Dr Asif explained, produces mucus and has a gurgling, rattling sound. 

As phlegm helps protect the airways from bacteria and viruses, the body makes more of it when it is trying to fight off an infection. The presence in the lungs can make it harder to breathe, and the body will cough to expel it along with the nasties it has picked up.

The process of coughing up the mucus can put strain on chest muscles, causing pain in the chest, back and ribs. 

Like most coughs, a wet one will typically clear up on its own within three to four weeks without needing treatment. 

It is often accompanied with a stuffy or runny nose, which can be uncomfortable, because the excess mucus is also expelled out through the nostrils. 

Children will often end up swallowing the mucus, which Dr Asif says is nothing to worry about. 

In mild cases, Dr Asif says that a wet cough can be resolved with rest, fluids and by eating soft foods. 

If it gets worse at night, try sleeping propped up on pillows because ‘it will help you get rid of the wet secretions better’.

He also urged ‘parents to keep an eye out for respiratory distress, particularly in ‘non-verbal or young children’ which is ‘when their breathing becomes harder or faster’.

However, if they have a fever, blood in thick mucus, or are generally getting worse, make an appointment to see your GP, because it could signal bronchitis which can lead to life-threatening pneumonia.

Bronchitis is inflammation in the airways, which in severe cases can cause respiratory failure. It happens when the ‘bronchus’, the tube going in the lungs, becomes infected.

He said: ‘It’s often characteristically harsher sounding and it will be wet and productive but hasn’t reached the lungs.’

Meanwhile, pneumonia is a potentially life-threatening infection in the lungs in which the tiny sacs in the lungs become filled with fluid, making it difficult to breathe.

Signs of pneumonia include a fever that isn’t coming down with paracetamol, discolouration, dehydration and fatigue, difficulty swallowing and vomiting.

Barking cough

A barking cough needs urgent medical attention as it often needs treatment—particularly in children. 

While rarer in adults, they can also suffer from it and similarly might need to receive treatments like steroids. 

Dr Asif explained: ‘It has a harsh and loud sound. Textbooks often describe it as “seal-like barking”.’ 

It’s classically associated with croup, a viral infection that affects the upper airway. 

‘It’s associated with some viral symptoms as well. They might have a fever or a runny nose,’ he said.

‘The main worry is what we call stridor, which is where there is inflammation in the upper airway. When they’re breathing in, it can almost be like a gasping type of noise.

‘It can be quite scary when you see it and the worry about it is if it causes respiratory distress which is when they’re breathing harder and faster or having difficulty breathing.

‘That can cause obstruction to the airways, partial blockage of the airway where we need to give them oxygen or nebulizers which they have to inhale in.’

The trouble is, he said: ‘Children compensate very well, so they’re fine, fine, fine until they’re not and that’s why they often won’t complain of anything.’

This cough, he explained is ‘typically always at night’ so it will typically need treatment by out-of-hour services or at A&E.

‘We usually encourage early review, because one of the main treatments is steroids,’ he said.

‘If parents find their child has got a barking cough, get them seen, because actually we have a low threshold to give steroids in that situation.’

Wheezing cough

Dr Asif warned a ‘wheezing cough’ should always be taken seriously. It can be determined by a distinct whistling or squeaking sound, which is apparent during coughing and also during normal breathing. 

This type of cough which can be painful because it is caused by swollen airways can be a symptom of a chest infection says the NHS, which can also cause mucus. 

This sort of cough is primarily associated with asthma and chronic obstructive pulmonary disease (COPD), a group of lung diseases which make it difficult to breath.

Viral infections pose a greater risk to those with COPD and asthma, a chronic lung condition where airways become inflamed, swollen and narrowed making breathing difficult.

He said: ‘Though this can be an ongoing cough associated with a chronic condition, we always advise to sought review if it is getting more frequent or breathlessness is worsening.’

The treatment depends on what is causing it, as for example, if it is a sign of an asthma attack, it will need urgent treatment, as they can be life-threatening.

If you’re having an asthma attack, the NHS says to sit up straight to try and help your breathing, stay calm and use an inhaler if you have one.

Those with a blue one should take one puff every 30 to 60 seconds until you feel better, for up to a maximum of 10 puffs, shaking the inhaler between each puff and use a spacer with the inhaler if you have one. 

Meanwhile, those with one for both prevention and treatment, known as an AIR or MART inhaler, should take one puff every one to three minutes until you feel better, for up to six puffs.

And, if you have a wheezing cough, have seeked medical advice and a doctor diagnoses you with pneumonia, you may need to be prescribed antibiotics. 

Whooping cough

A whooping cough can leave you feeling like you’re on the verge of choking because of how it affects your ability to breathe. 

‘Once you’ve heard it, you’ll never forget it,’ Dr Asif said.

It is associated with a highly contagious bacterium known as Bordetella pertussis, and can rapidly spread among family units. 

While it’s more common in children, adults can still catch it, but they may not necessarily make the same ‘whoop’ sound.

Babies younger than six months old may also not have a classic whooping cough, or it may be difficult to hear.

According to the NHS, whooping coughing bouts can last for a few minutes, are worse at night and may leave people struggling to breathe. 

Because of the reduced oxygen being taken into the lungs and pushed out into the bloodstream, their skin may even take on a blue or grey tinge.

Whooping cough may also bring up thick mucus which can make sufferers vomit and may leave you very red in the face. 

It’s particularly dangerous for babies under 12 months, who have an increased risk of dehydration, breathing issues, pneumonia and seizures.

Meanwhile, in older children and adults it says it can also cause sore ribs, a hernia, middle ear infections, and urinary incontinence when you cough.

Dr Asif said: ‘These coughs, particularly in children, need treatment promptly with antibiotics and confirmed infections must be notified to public health authorities.

‘Again, if it’s associated with any respiratory symptoms of distress, you shouldn’t stay at home, seek urgent review.’

The treatment depends on an individual’s age and how long they have had the cough before being diagnosed.

According to the NHS, hospital treatment is usually needed if they have severe whooping cough, or the baby is under six months old and has whooping cough.

If whooping cough is diagnosed within two weeks of your cough starting, they’ll be given antibiotics to help stop it spreading to others.

Some healthcare and nursery workers may be given antibiotics within three weeks of the cough starting.

Chronic cough

The final cough on Dr Asif’s list is described as a chronic cough, which the GP says ‘is the trickiest and most variable’ as it can be a sign of underlying illnesses.

These can include asthma, chronic bronchitis and gastro-oesophageal reflux disease (GERD) which is ongoing acid reflux, or something gravely serious, like lung cancer.

It doesn’t necessarily have a distinct sound in itself, like the other types of coughs which he discussed. 

Depending on what is causing it could make a range of sounds such as a whistling cough, and it can also be painful and accompanied with mucus or not.

He said: ‘If ongoing for more than eight weeks, a doctor review is required to avoid progression of the disease.

‘As part of NHS, I understand, any cough that is lasting more than three weeks, we’d advise you to review.

‘The biggest thing is that lung cancer often presents late, and early diagnosis means that you could go down the curative option.’