Chesty coughs


Chesty coughs

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke. It's rarely a sign of anything serious.

A “dry cough” means it's tickly and doesn't produce any phlegm (thick mucus). A “chesty cough” means phlegm is produced to help clear your airways.

Most coughs clear up within three weeks and don't require any treatment. For more persistent coughs, it's a good idea to see your GP so they can investigate the cause.

What can cause a cough?

Some of the main causes of short-term (acute) and persistent (chronic) coughs are outlined below.

Short-term coughs

Common causes of a short-term cough include:

In rare cases, a short-term cough may be the first sign of a health condition that causes a persistent cough.

Persistent coughs

A persistent cough may be caused by:

  • a long-term respiratory tract infection, such as chronic bronchitis  
  • asthma – this also usually causes other symptoms, such as wheezing, chest tightness and shortness of breath
  • an allergy
  • smoking – a smoker's cough can also be a symptom of COPD
  • bronchiectasis – where the airways of the lungs become abnormally widened
  • postnasal drip – mucus dripping down the throat from the back of the nose, caused by a condition such as rhinitis or sinusitis
  • gastro-oesophageal reflux disease (GORD) – where the throat becomes irritated by leaking stomach acid
  • a prescribed medicine, such as an angiotensin-converting enzyme inhibitor (ACE inhibitor), which is used to treat high blood pressure and cardiovascular disease

In most cases, a doctor won't worry whether a cough is dry or chesty, but will need to know if you are producing much more or darker phelgm than usual.

Rarely, a persistent cough can be a symptom of a more serious condition, such as lung cancer, heart failure, a pulmonary embolism (blood clot on the lung) or tuberculosis. 

Coughs in children

Coughs in children often have similar causes to those mentioned above. For example, respiratory tract infections, asthma and GORD can all affect children.

Causes of coughs that are more common in children than adults include:

  • bronchiolitis – a mild respiratory tract infection that usually causes cold- symptoms
  • croup – this causes a distinctive barking cough and a harsh sound known as stridor when the child breathes in
  • whooping cough – look out for symptoms such as intense, hacking bouts of coughing, vomiting, and a “whoop” sound with each sharp intake of breath after coughing

Occasionally, a persistent cough in a child can be a sign of a serious long-term condition, such as cystic fibrosis.

When to see your GP

There's usually no need to see your GP if you or your child have a cough for a week or two. However, you should seek medical advice if:

  • you've had a cough for more than three weeks
  • your cough is particularly severe
  • you cough up blood or experience shortness of breath, breathing difficulties or chest pain
  • you have any other worrying symptoms, such as unexplained weight loss, a persistent change in your voice, or lumps or swellings in your neck

If your GP is unsure what's causing your cough, they may refer you to a hospital specialist for an assessment. They may also request some tests, such as a chest X-ray, allergy tests, breathing tests, and an analysis of a sample of your phlegm to check for infection.

Treatment isn't always necessary for short-term coughs because it's ly to be a viral infection that will get better on its own within a few weeks. You can look after yourself at home by resting, drinking plenty of fluids, and taking painkillers such as paracetamol or ibuprofen.

Cough medicines and remedies

Although some people find them helpful, medicines that claim to suppress your cough or stop you bringing up phlegm are not usually recommended. This is because there's little evidence to suggest they're any better than simple home remedies, and they're not suitable for everyone.

The Medicines and Healthcare products Regulatory Agency (MHRA) recommends that over-the-counter cough and cold medicines shouldn't be given to children under the age of six. Children aged 6 to 12 should only use them on the advice of a doctor or pharmacist.

A homemade remedy containing honey and lemon is ly to be just as useful and safer to take. Honey shouldn't be given to babies under the age of one because of the risk of infant botulism.

Treating the underlying cause

If your cough has a specific cause, treating this may help. For example:

  • asthma can be treated with inhaled steroids to reduce inflammation in your airways
  • allergies can be treated by avoiding things you're allergic to and taking antihistamines to dampen down your allergic reactions
  • bacterial infections can be treated with antibiotics
  • GORD can be treated with antacids to neutralise your stomach acid and medication to reduce the amount of acid your stomach produces
  • COPD can be treated with bronchodilators to widen your airways

If you smoke, quitting is also ly to help improve your cough. Read more about stopping smoking.


Chesty coughs

Chesty coughs

When you have a chesty cough (wet, productive or phlegmy) your chest feels heavy and you may cough up mucus or phlegm. A chesty cough may follow a sore throat or a cold and can be worse in the morning.

Coughs and colds are often caused by a virus, so antibiotics are not suitable treatment. Sometimes cough medicines can relieve symptoms, but they should not be given to children under six years old, and given only cautiously to older children between the ages of 6 to 12 years.

A chesty cough can sometimes be a sign of another problem, such as asthma, heart failure, chronic bronchitis or a respiratory infection. The longer a cough lasts, the more ly it is that there may be an underlying, more serious cause.

People who smoke, have low immunity or older people, can be prone to serious complications such as bronchitis and pneumonia.

See Your Pharmacist or Medical Professional

  • if the person with the chesty cough is under two years old
  • if you cough up blood, which may look coffee granules
  • if you cough up mucus of any colour, especially frothy pink or dark green
  • if you have a high temperature (above 39°C)
  • if your cough has changed, such as from a dry cough to a chesty cough
  • if you have other symptoms, such as chest pain, wheezing, difficulty breathing, a fever, weight loss, persistent headache, sore ears or a rash
  • if your cough is mainly at night if you are a smoker
  • if you experience severe and sudden symptoms of the flu (these can include muscle aches and pains, tiredness, headache and fever)
  • if your chesty cough has lasted more than five days, or has worsened
  • if you have high blood pressure, a heart condition, diabetes, thyroid problems, a respiratory illness such as asthma, or if you are taking other medicines
  • if you are pregnant or breastfeeding (some medicines may not be suitable)
  • if you have allergies to any medicines

It is important to speak to a health professional before taking any cough medicine, as many products are for a dry, tickly cough not a chesty cough.

Treatment Tips

  • keep warm, get lots of bed rest and drink plenty of water
  • gargle with plain or salt water for one minute, three times a day; this can ease symptoms of sore throat associated with coughing
  • steam from a hot shower may help break down the mucus, making it easier to cough up and can clear sinuses
  • coughs and colds are spread by contact with others, such as through shaking hands and sharing drink bottles
  • cover your mouth when you sneeze or cough, then wash your hands with soap
  • use tissues not handkerchiefs, as they carry less risk of infection

Treatment Options

  • cough medicines for chesty coughs loosen or break down mucus in your lungs, making it easier to cough up
  • it is important to cough up the mucus; cough medicines that suppress coughs are not recommended as this can lead to further infections
  • guaiphenesin or bromhexine are the first-choice treatments for chesty coughs, but it is important to remember that while they may help with relieving your cough symptoms, they will not cure the underlying condition causing the cough
  • the syrup in cough medicines can also coat the throat to relieve irritation
  • medicines for pain and fever, such as paracetamol or ibuprofen, can relieve throats that are sore from coughing
  • lozenges Strepsils or Difflam, which contain antibacterial, antiinflammatory agents can be used, and Difflam sore throat spray, which has anti-inflammatory, can be used as well
  • stronger lozenges or throat spray containing anaesthetics can be used to relieve severe discomfort
  • some cough medicines and cold remedies contain antihistamines to dry up a runny nose
  • with chesty coughs, antihistamines make it harder to remove mucus from your lungs and should be avoided
  • some ingredients in cough medicines can interact with other medicines, so always check before using
  • cough mixtures often contain multiple ingredients, so match ingredients to your symptoms; sometimes you only need one ingredient
  • combination products can contain ingredients that are not suitable for taking during pregnancy; check with your pharmacist
  • single ingredient products with guaiphenesin or bromhexine are safe in pregnancy

Expectorants, e.g. guaiphenesin

e.g. guaiphenesin (Vicks Cough Syrup for Chesty Coughs)

e.g. guaiphenesin + bromhexine (Dimetapp Chesty Cough Elixir, Duro-Tuss Chesty Cough Liquid Forte, Robitussin Chesty Cough Forte Oral Liquid)

e.g. guaiphenesin + pseudoephedrine* (Robitussin Chesty Cough & Nasal Congestion PS Oral Liquid)

  • expectorants help you to cough up phlegm, and most commonly include guaiphenesin and ammonium chloride
  • they are available as capsules or tablets, lozenges or cough liquids; some are sugar-free
  • pseudoephedrine is a nasal decongestant that unblocks your nose; it may cause a rapid heartbeat, anxiety, restlessness, trouble sleeping and a dry mouth
  • any products with pseudoephedrine will need to be recorded prior to sale in the pharmacy
  • it is important to tell your health professional if you have any medical conditions before taking any cough mixtures
  • check that you are not taking more than the recommended dose if using products with similar ingredients, particularly for paracetamol

Mucolytics, e.g. bromhexine

e.g. bromhexine (Bisolvon Chesty Tablets, Bisolvon Chesty Oral Liquid, Bisolvon Chesty Forte Oral Liquid, Duro-Tuss Chesty Cough Liquid Regular)

e.g. bromhexine + pseudoephedrine* (Durotuss Chesty Cough Liquid plus Nasal Decongestant)

  • bromhexine is a mucolytic (helps break down thick, sticky mucus in your chest, making it easier to cough up)
  • bromhexine can occasionally cause stomach upsets
  • pseudoephedrine is a nasal decongestant that unblocks your nose; it may cause a rapid heartbeat, anxiety, restlessness, trouble sleeping and a dry mouth
  • pseudoephedrine is found in a number of medicines. Check you do not take more than the recommended amount


e.g. Hedera helix (Benadryl Children’s Cough 2 Years, Duro-Tuss Children’s Cough Liquid, Little Coughs, Bronchodual).

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.

*Pseudoephedrine is a Controlled Drug and products containing it may not be available at all pharmacies.

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Last Reviewed: 04/11/2019