Cough without a runny nose: what it can mean

Nasal symptoms are not required for a cough. Smoke, dust, fragrance, dry air or a recent viral illness can irritate the throat and bronchial tubes. Asthma may cause a dry cough, chest tightness or wheezing, sometimes mainly at night or after exercise. Acid reflux can bring stomach contents towards the throat and trigger coughing, especially after meals or when lying down.

Allergy-related cough can follow exposure to pets or house-dust mites, even when a runny nose is absent. A cough with fever, body aches or marked tiredness may occur with influenza or COVID-19. The symptom alone cannot identify one cause.

Drink fluids, avoid tobacco smoke and strong scents, and use a humidified room if dry air is aggravating your throat. Honey may soothe a cough for adults and children older than one year; do not give honey to infants. Note when the cough occurs, what triggers it, and whether mucus, wheeze, fever or breathlessness appears.

A pharmacist or clinician can help choose treatment based on your age, medicines and health conditions. Do not start antibiotics simply because a cough is troublesome; they do not treat every cause.

Seek urgent help for severe breathing difficulty, blue or grey lips, new confusion, fainting, chest pain, or coughing blood. Arrange a medical assessment if the cough is worsening, prevents sleep, returns repeatedly, or continues beyond a short illness. Children, older adults, pregnant people and those with lung or heart disease may need earlier advice.

Could reflux, asthma or an environmental trigger explain this cough? Do I need a chest examination or testing? Which treatments are suitable with my current medicines? What changes should prompt urgent review?