Coughing fits or coughing attacks are terms used to describe episodes of sudden, severe, and uncontrollable coughing. These coughing bouts can occur in anyone, but are most commonly associated with certain respiratory conditions.
What Causes Coughing Attacks?
There are several potential causes of coughing attacks including:
- Asthma – During an asthma flare-up, the airways become inflamed and filled with mucus which triggers coughing.
- Chronic obstructive pulmonary disease (COPD) – COPD causes frequent coughing attacks due to lung damage and airway obstruction.
- Lung infections – Infections like pneumonia, bronchitis, and the flu can cause intense coughing fits.
- Allergies – Allergic reactions can trigger coughing, especially during allergy season.
- Acid reflux – Stomach acid backing up into the esophagus can irritate the throat and provoke coughing.
- Smoking – Chemical irritation from smoking induces coughing.
- ACE inhibitors – These blood pressure medications cause chronic dry cough in some people.
- Cough variants asthma – This is a type of asthma where coughing is the main symptom.
In some cases, the cause of chronic coughing cannot be identified which is known as unexplained chronic cough. Post-viral cough that lingers after a respiratory infection is also common.
What Happens During a Coughing Attack?
When the airways become irritated, it triggers an excessive cough reflex. This leads to forceful expulsion of air from the lungs in an effort to clear the irritants. Several things may occur:
- Difficulty catching your breath during coughing
- Redness or watering of the eyes
- Gagging or choking sensation
- Gasping for air
- Face turning red or blue
- Lightheadedness or dizziness
- Exhaustion after prolonged coughing spell
- Vomiting from intense coughing
- Involuntary urination
Very severe coughing attacks can last for 5-10 minutes or longer before subsiding. The aftermath may leave you tired, sore, or hoarse. In some cases, cough syncope can occur where coughing leads to a temporary loss of consciousness due to depleted oxygen.
When to Seek Emergency Care
While coughing attacks are usually not life-threatening, certain red flags require prompt medical evaluation:
- Cough produces blood-tinged mucus
- Rapid breathing or difficulty catching your breath
- Lightheadedness, chest pain, or fainting
- Face turns blue during coughing episodes
- Fever above 101 F (38.3 C)
- New onset of wheezing or chest tightness
- Immunosuppressed patient with new cough
- Recent choking episode
Go to your nearest emergency department or call 911 if you experience any of these accompanying a bad coughing attack. Severe shortness of breath, fainting, or blue lips indicate a medical emergency requiring prompt treatment.
How Are Coughing Fits Diagnosed?
To determine the cause of your coughing attacks, the doctor will inquire about your symptoms and medical history. Important questions include:
- How long have you had the cough?
- Is it dry or productive? What color is the phlegm?
- Do you have it all the time or just with certain triggers?
- Any accompanying symptoms like trouble breathing, chest pain, fever?
- Existing respiratory condition like asthma or COPD?
- Taking any medications like ACE inhibitors?
- Any recent illness or exposure to allergens/irritants?
The physical exam will focus on your breathing, throat, lungs, and heart. Diagnostic tests may include:
- Chest x-ray
- Pulmonary function tests
- Sputum culture
- Allergy testing
- pH monitoring for reflux
- Blood tests
These tests can detect lung abnormalities, infections, allergies, and other problems that can cause chronic cough.
How Are Coughing Attacks Treated?
Treatment focuses on managing the underlying cause of the cough. Options may include:
- Asthma medications like bronchodilators and inhaled steroids to open the airways
- Antibiotics for bacterial infections
- Allergy medications like antihistamines and nasal steroid sprays
- Gastroesophageal reflux medications to reduce acid reflux
- Cough suppressants like cough syrups to control coughing
- Behavioral remedies – throat lozenges, steam inhalation, hydration
For severe and unexplained chronic cough, speech therapy is sometimes used to retrain the cough reflex. Other remedies target the vagus nerve to calm cough hypersensitivity.
How To Prevent Coughing Fits
You can reduce coughing episodes by:
- Taking medications as prescribed to control your lung condition
- Avoiding your cough triggers like smoke, allergens, or acid reflux
- Treating any sinus drainage or nasal allergies
- Using a humidifier to moisten dry air
- Staying well hydrated
- Sucking on cough drops or hard candy
- Gargling with warm salt water
- Using OTC cough medicine for temporary relief
Preventing respiratory infections through flu shots, handwashing, and masking when appropriate can also reduce cough episodes.
When To See Your Doctor
You should consult your doctor if you experience:
- Cough lasting longer than 3 weeks
- Recurring cough with unknown cause
- Cough interfering with work, school, sleep
- Painful cough
- Cough producing blood or pus
- Wheezing, difficulty breathing, or chest pain with cough
Chronic cough can be a sign of an undiagnosed medical problem requiring treatment. Seeking care can provide relief and prevent complications.
Outlook For Coughing Fits
The prognosis for coughing attacks depends on the underlying cause:
- Allergic coughs improve avoiding triggers.
- Post-viral coughs resolve within 1-3 weeks.
- Cough from asthma or COPD can be controlled with proper treatment.
- Cough from ACE inhibitors ceases with medication change.
- Cough from infections or reflux resolves with appropriate treatment.
Successfully diagnosing and managing the origin of chronic cough is key to stopping recurrent coughing episodes.
Coping With Cough Attacks
Having random, violent coughing spells can be scary and disruptive. Some tips for coping include:
- Keep lozenges or cough drops handy.
- Have water around to sip.
- Use tissues or disposable masks to cover coughs.
- Warn friends/coworkers about your condition.
- Avoid smoke, dust, and other irritants.
- Try pursed lip breathing and coughing posture.
- Notice triggers and discuss strategies with your doctor.
- Practice relaxation techniques.
- Communicate openly with your support system.
Although coughing fits can be very troublesome, identifying prevention methods and coping strategies can help you better manage them.
Conclusion
Coughing attacks or fits involve sudden and severe coughing episodes lasting several minutes. They are most commonly caused by underlying respiratory conditions like asthma, COPD, infections, or acid reflux. Evaluation involves a medical history and tests to pinpoint the origin. Treatment focuses on the underlying cause and may include inhalers, antibiotics, cough medicine, or behavioral remedies. Preventing triggers and prompt medical care for any red flags are important. While coughing fits can be disruptive, understanding your condition and implementing coping strategies can help improve your quality of life.