Is there anything that really works for a stubborn cough?

If you're looking for an effective cough remedy, you might be out of luck.

Nothing has been proven to work that well, according to a new report from the American College of Chest Physicians (ACCP).

OTC cough medicine not recommended

After reviewing clinical trials testing everything from cough syrups to zinc, an ACCP panel came to some less-than-positive conclusions: Over-the-counter medicines – including cold and cough products and anti-inflammatory painkillers – cannot be recommended.

Nor is there evidence supporting most home remedies – though, the group says, honey is worth a shot for kids.

However, not everyone agrees, and a previous Health24 article has the following advice for treating coughs:

  • Half a teaspoon of honey before sleep has been shown to provide soothing relief from coughs related to upper airway infection.
  • Sucking lozenges or sipping water may temporarily supress a cough and temporarily relieve the sensations of throat irritation.
  • For productive (wet) cough, mucolytic medications like N-Acetylcysteine (NAC) are important, designed specifically to break down the mucus which is causing the cough. 
  • Mucolytics have been shown to assist in reducing cough in adults and children.

People want relief

Every season, most people probably battle at least one cold-induced cough, said report author Dr Mark Malesker.

The recommendations were published in the journal Chest.

And they apparently want relief. In 2015, Americans spent more than $9.5 billion (±R135 billion) on over-the-counter cold/cough/allergy remedies, according to the report.

In South Africa the situation is similar, and in 2016, South Africans spent around half a billion rand on cough syrups alone.

"But if you look at the evidence, it really doesn't support using those products," said Malesker, a professor at Creighton University in Omaha.

A hacking cough

Malesker's team looked at trials of cold products that combine decongestants and antihistamines, or decongestants and painkillers. They found no consistent evidence that any quash a cough.

The same was true when they analysed studies of nonsteroidal anti-inflammatory drugs, which include naproxen (Aleve) and ibuprofen (Advil, Motrin).

So what do you do when a hacking cough keeps you up all night?

A couple of studies have found that honey may bring some relief to children age one and up. (Honey should not, however, be given to babies younger than one year, the physicians' group says.)

There was also "weak evidence" that zinc lozenges might help ease adults' coughing – but it wasn't enough to recommend them, according to the report. Plus, it says, zinc can have side effects, including a bad taste in the mouth, stomach cramps and vomiting.

What about home remedies?

What about storied home remedies, like Grandma's chicken soup or neti pots for nasal irrigation? There's no strong evidence for them, either, the review found.

On the other hand, Malesker said, if your favourite tea or soup makes you feel better, use it.

"It's very frustrating that we haven't found a good way to address this," said Dr David Beuther.

Beuther is a pulmonologist at National Jewish Health, a Denver hospital that specialises in respiratory diseases.

A simple cold-related cough is generally something healthy people can wait out – but it can be miserable, Beuther pointed out.

"It can affect your sleep and quality of life," he said. "So people are looking for ways to make it more bearable."

Varying ingredients

And while a quick fix might be tempting, simply slowing down could help, Beuther said.

"Sometimes you just need to take a day off and let yourself rest," he noted.

Beuther also recommended that people drink enough water to stay hydrated – which may help break up any thick mucus that is causing the cough.

As for healthy adults, Beuther said that if they have found an over-the-counter product to be useful in the past, he wouldn't discourage them from trying it again.

There are many products, with varying active ingredients, he said. So a doctor or pharmacist may be able to steer you toward the most appropriate one.

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