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What Causes Coughing Fits & How to Find Relief

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Last updated February 18, 2021

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Uncontrollable coughing fits may signify a serious underlying problem, and causes include chronic respiratory disease and infectious, environmental, and mechanical causes. Read more below about uncontrollable coughing and what it means for you.

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Coughing fits symptoms

Coughing is a reflex triggered when the body senses the presence of an irritating substance in the airways or lungs. Depending on the context, two or three coughs is a normal response, but a coughing fit signifies a more serious underlying problem.

Common accompanying symptoms of coughing fits

Symptoms that can be associated coughing fits include:

Coughing fits causes

Upper respiratory structures

The upper respiratory system is composed of the nose, mouth, and throat. It connects to the lower respiratory system that includes the trachea, lungs, and segments (bronchial tree) that bring oxygen to these areas.

Coughing fits can be caused by any irritant that enters through the upper respiratory tract and aggravates the lungs and bronchial tree.

Chronic respiratory disease

Underlying diseases of the respiratory system can cause permanent structural changes that can contribute to coughing fits, especially in exacerbating situations like weather or underlying illness.

  • Obstructive: Diseases such as asthma and bronchitis result in recurring inflammation of the airways that lead to difficulty in clearing mucus and other irritants from the respiratory tract. The constant buildup of mucus triggers the body into a series of coughing fits.
  • Restrictive: Many diseases can result in stiffness of the lungs that limits the body's ability to fully expand and breathe in oxygen. This restriction in movement can lead to coughing fits because the body is not receiving enough oxygen.

Infectious causes

The respiratory tract is extremely susceptible to infection due to its direct contact with the environment.

  • Viral: Viral infections can produce mucus in the airways that drips down the back of the throat triggering coughing fits. The common cold and flu are examples of a viral infections that can be associated with coughing fits.
  • Bacterial: Bacterial infections can cause more severe upper and lower respiratory issues than viral infections. Bacterial infections are often associated with high fever, chills, difficulty breathing, and coughing up blood. Pertussis is a bacterial infection that leads to persistent coughing fits and sometimes vomiting.

Environmental causes

Just as bacteria can easily enter the upper respiratory tract, other substances from the environment (either intentionally or unintentionally) can enter the body and cause coughing fits.

  • Allergy: Seasonal allergies that cause runny nose and itchy eyes can also result in coughing fits. Allergies can also irritate and exacerbate the respiratory tract triggering the body to cough.
  • Medication: Certain medications called Angiotensin-converting enzyme (ACE) inhibitors used to treat high blood pressure and heart failure can cause coughing fits for some people.

Mechanical causes

Mechanical issues can result in coughing fits.

  • Obstructive: The presence of a structure blocking the airways can cause a coughing fit because your body is attempting to clear out the offending source. Choking on foreign bodies are often the culprit for this type of cause, especially in children.
  • Functional: Diseases that weaken the coordination of the respiratory tract and muscles used for swallowing can make it difficult for your body to clear irritating substances, often leading to painful coughing fits.

10 coughing fits conditions

This list does not constitute medical advice and may not accurately represent what you have.


Acute bronchitis is an inflammatory reaction to an infection in the airways. Most cases of acute bronchitis are caused by a viral infection, although some cases may be due to a bacterial infection.

Symptoms include an acute-onset cough with or without sputum production, low-grade fever, shortness of breat..

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Common cold

The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.

The common cold is, of course, very common..

Benign cough

Benign cough means a cough that is not caused by any harmful condition or serious illness.

Postnasal drip, where mucous from the nose drains into the throat, can trigger a benign cough. So can asthma, exposure to dust or other irritants, acid reflux (heartburn or GERD,) some medications, and breathing very cold air. Postnasal drip itself can be caused by allergy, some medications, and deviated septum.

An occasional cough that brings up a slight amount of clear mucus is normal and helps clear the throat and lungs. The presence of blood or thick mucus is not normal and the person should see a medical provider.

If an unexplained cough persists for more than one month, it is important to identify the cause so that serious illness can be ruled out.

Diagnosis is made through patient history and physical examination, and sometimes through mucus testing, imaging, lung function tests, and bronchoscopy.

Treatment involves addressing any underlying causes, such as allergies. In some cases a cough suppressant may be prescribed.

Rarity: Common

Top Symptoms: cough, cough with dry or watery sputum, severe cough

Symptoms that always occur with benign cough: cough

Symptoms that never occur with benign cough: fever, severe cough, being severely ill, coughing up blood

Urgency: Self-treatment

Acid reflux disease (gerd)

GERD (gastroesophageal reflux disease) in infants refers to the passage of stomach contents into the throat causing troublesome symptoms, such as feeding intolerance, inadequate oral intake of calories and/or poor weight gain. Vomiting or visible regurgitation ..

Smoking-induced cough

The airways are lined with tiny cells called cilia, whose function is to catch toxins in air that is inhaled and push them up towards the mouth. When smoke is inhaled, the cilia are paralyzed for a short while, so toxins are allowed to enter the lungs and create inflammation. During the night, the cilia repair themselves and begin to push up all the accumulated mucus and toxins, causing an increase in cough in the morning.

Rarity: Common

Top Symptoms: cough

Symptoms that always occur with smoking-induced cough: cough

Symptoms that never occur with smoking-induced cough: fever

Urgency: Self-treatment

Chronic obstructive pulmonary disease (copd)

Chronic obstructive pulmonary disease (COPD) is a progressive inflammation of the lungs that makes breathing difficult. It is caused by long-term exposure to irritating gases and/or dust particles, most often cigarette smoke.

Symptoms may take years to develop. They include a chronic cough with mucus (sputum), wheezing, chest tightness, fatigue, constant colds, swollen ankles, and cyanosis (blue tinge to the lips and/or fingernails.) Depression is often a factor due to reduced quality of life.

Treatment is important because there is a greater risk of heart disease and lung cancer in COPD patients. Though the condition cannot be cured, it can be managed to reduce risks and allow good quality of life.

COPD is commonly misdiagnosed and so careful testing is done. Diagnosis is made through patient history; physical examination; lung function tests; blood tests; and chest x-ray or CT scan.

Treatment involves quitting smoking and avoiding exposure to other lung irritants; use of inhalers to ease symptoms; steroids; lung therapies; and getting influenza and pneumonia vaccines as recommended.

Rarity: Common

Top Symptoms: fatigue, cough and dyspnea related to smoking, cough, shortness of breath, trouble sleeping

Symptoms that always occur with chronic obstructive pulmonary disease (copd): cough and dyspnea related to smoking

Symptoms that never occur with chronic obstructive pulmonary disease (copd): rectal bleeding

Urgency: Primary care doctor

Post-infectious cough

Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.

Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.

Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.

A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.

Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.

Rarity: Uncommon

Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice

Symptoms that always occur with post-infectious cough: cough

Symptoms that never occur with post-infectious cough: fever

Urgency: Phone call or in-person visit

Whooping cough

Whooping cough is caused by the bacteria Bordetella pertussis, which affects the respiratory systems of children, adolescents, and adults. Whooping cough has also been called the "100-day cough" because of its extended time course. The symptoms classically associated with whooping cough are a sudden, uncontrollable coughing spell ("paroxysmal cough"), a "whooping" sound on ..

Ace inhibitor induced cough

ACE Inhibitors are drugs used to prevent, treat or improve symptoms in conditions such as high blood pressure, coronary artery disease, heart failure and diabetes. In rare cases, these drugs can cause serious side effects that can be life-threatening. In other cases, it can cause a cough that can affect your quality-of-life.

Rarity: Common

Top Symptoms: cough with dry or watery sputum

Symptoms that always occur with ace inhibitor induced cough: cough with dry or watery sputum

Symptoms that never occur with ace inhibitor induced cough: fever

Urgency: Primary care doctor

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Coughing fits treatments and relief

When it is an emergency

Seek emergency treatment if along with your coughing fits symptoms you experience the following.

When to see a doctor

You should schedule an appointment sooner than later for coughing fits that worsen, persist, or can be characterized by any of the following.

  • Your coughing fits have lasted for more than a week
  • You have had weight loss and/or night sweats
  • You have an existing respiratory condition and your coughing fits have worsened: Your doctor may adjust or add a medication.

Medical treatments

Your doctor may prescribe antibiotics, inhaled medications, or, less commonly, oxygen therapy, depending on the cause, severity, and duration of your coughing fits symptoms.

At-home treatments

Home treatments, such as the following, may help.

  • Drink lots of water: Stay hydrated to keep your mucus thin and easier to clear.
  • Over-the-counter medications: There are medications you can buy that can help clear up mucus (expectorants) and suppress the cough reflex (antitussives). These are particularly helpful for giving relief at night.
  • Honey: A teaspoon of honey can help loosen a cough and alleviate exacerbation but do not give to children younger than a year old.
  • Smoking cessation: Smoking is a major irritant and destroyer of the lower respiratory tract; breathing will improve after smoking cessation.

FAQs about coughing fits

Why do I have uncontrollable coughing at night?

Uncontrollable coughing fits at night are often caused by a backup of fluid from the heart into the lungs, called paroxysmal nocturnal dyspnea. When a heart cannot pump sufficient blood, the fluid accumulates in the lungs and causes difficulty breathing and increased coughing .

Do hot showers help coughs?

Yes, hot showers can help coughs if a cough is due to asthma or cough-variant asthma. The hot steam can help the throat relax and ease breathing. Coughs can also be due to inflammation of the throat and pharynx, and hot steam can help reduce inflammation and moisten mucous membranes and loosen phlegm from within the throat.

Can anxiety cause coughing fits?

Anxiety does not cause coughing fits unless they are psychological in origin. Anxiety can, at times, cause hyperventilation and shortness of breath, but neither of those symptoms can cause coughing fits. Coughing fits are more often due to cough-variant asthma, post-nasal drip, or even gastroesophageal reflux disease (GERD).

Why do my coughing fits lead to vomiting?

Coughing fits, especially if they are extreme or if an individual has a full stomach, can lead to vomiting. Common causes of these types of extreme coughing fits include cough-variant asthma, lung disease such as COPD, acid reflux (GERD), and post-nasal drip.

Why can't I catch my breath after a coughing fit?

A coughing fit may make it more difficult to catch your breath if it occurs along with a narrowing of the airways that allow you to inhale. Asthma and emphysema (COPD) may cause an inability to catch one's breath following a series of coughing fits. Steam or an inhaler may be treatments for a coughing fit.

Questions your doctor may ask about coughing fits

  • Any fever today or during the last week?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Does your cough produce phlegm?
  • Do you currently smoke?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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