What Causes Violent Coughing Fits And How Can I Stop Them?

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What Causes Coughing Fits and How Can I Stop Them?

Medically reviewed by Thomas Johnson, PA-C — Written by Tim Jewell — Updated on July 10, 2024

Causes
Respiratory infection
Pneumonia cough
Diagnosis and treatment
Home remedies
Prevention
Seeking medical help
Takeaway

Forceful coughing, also known as paroxysmal coughing, usually results from bacteria, although there are other causes. If it affects your breathing or lasts more than a few days, immediate medical care is advised.

Paroxysmal coughing involves frequent and uncontrollable coughing that can make it hard to breathe.

Coughing is an automatic reflex that helps your body to get rid of extra mucus, bacteria, and other foreign substances.

With some infections, like pertussis, cough may persist for a long time, making it hard to get enough oxygen or catch your breath. These episodes can lead you to inhale sharply and gasp loudly for air, which is why pertussis is also known as whooping cough.

Paroxysmal coughing is the second stage of whooping cough. According to the Centers for Disease Control and Prevention (CDC), it occurs about 2 weeks after infection.

A typical case of paroxysmal coughing lasts from 1 to 6 weeks.

In severe cases, episodes of paroxysmal coughing can become so intense that you vomit, and your lips or skin can turn blue from a lack of oxygen in the blood. Emergency medical care is advised if you experience these symptoms.

Common causes of paroxysmal coughing

Paroxysmal coughing is commonly caused by Bordetella pertussis bacterium. This extremely contagious bacterium infects the respiratory tract (nose, throat, windpipe, and lungs) and causes whooping cough.

Other possible causes of paroxysmal coughing include:

asthma, a respiratory condition in which your airways become swollen and filled with excess mucus
bronchiectasis, a condition in which tubes in your lungs are permanently widened with thickened walls due to inflammation, causing a buildup of bacteria or mucus
bronchitis, an inflammation in the bronchi of the lungs
gastroesophageal reflux disease (GERD), a condition in which acid from your stomach comes back up your esophagus (food pipe) and into your throat. Sometimes it comes into your airways.
pneumonia, a type of lung infection and a complication of bronchitis
tuberculosis (TB), a bacterial infection of the lungs that can spread to other organs if left untreated
lung injury from trauma, smoke inhalation, or substance use

How do you know if your cough is a chest infection?

If your cough is caused by a respiratory infection in your chest, such as pneumonia or bronchitis, you may have the following symptoms:

a wet or productive cough
yellow or green mucus when you cough
a persistent feeling of being out of breath
wheezing when you cough or breathe
chest discomfort
fever
headache

A chest infection may last 7 to 10 days before going away on its own. A wet cough can last up to 3 weeks.

What does a pneumonia cough sound like?

A cough due to pneumonia may be louder than other types of coughs, according to a small 2021 study.

Researchers collected cough sounds from 30 adults and then used an artificial intelligence (AI)-based algorithm to diagnose those with pneumonia, with about 85% accuracy.

The pneumonia cough sounds were louder, especially at the end of the cough. Only a healthcare professional can provide an accurate diagnosis, which usually involves X-rays.

Diagnosis and treatment of forceful coughing fits

If you see a doctor about a coughing fit, they may order one or more of the following tests to establish the cause:

nasal or throat swab to test for the presence of infectious bacteria
blood test to check for a high white blood cell count, which can indicate an infection
X-ray or CT scan of the chest or sinuses to look for symptoms of respiratory infections, damage, or abnormalities
spirometry or other lung function tests to assess how your body takes in and expels air, to diagnose asthma
bronchoscopy with a thin, lighted tube and camera that can show real-time images of the inside of your lungs
rhinoscopy to see real-time images of the inside of your nose and nasal passages
upper gastrointestinal endoscopy of your digestive tract to check for GERD

Once a doctor diagnoses a cause, they may prescribe a variety of treatments. These may include:

antibiotics, including azithromycin (Z-Pack), to help your immune system fight infectious bacteria
decongestants, such as pseudoephedrine (Sudafed), or the cough expectorant guaifenesin (Mucinex), to reduce mucus buildup, coughing, and other symptoms
antihistamines, such as cetirizine (Zyrtec), to reduce allergy symptoms that may worsen coughing, such as congestion, sneezing, and itching
an inhaler or nebulized bronchodilator treatment to help open airways during coughing fits or asthma attacks
antacids for symptoms of GERD
proton pump inhibitors like omeprazole (Prilosec), which reduce stomach acid production, to help your esophagus heal from GERD
breathing exercises for conditions like bronchitis

Home remedies for coughing fits

You may want to try the following tips to reduce paroxysmal coughing:

Drink at least 64 ounces of water a day to keep yourself hydrated.
Bathe regularly to keep your body clean and limit bacterial spread.
Wash your hands often to keep bacteria from building up and spreading.
Use a humidifier to keep your airways moist, which can help loosen mucus and make it easier to cough up. Don’t overuse your humidifier, as this can make it easier for bacteria to reproduce.
If you are vomiting, eat small portions at meals to reduce the volume of vomit.
Reduce or eliminate your exposure to smoke from tobacco products or fumes from cooking and fireplaces.
Stay isolated from others as much as possible to keep the bacterial infection from spreading. This includes 5 days of isolation while you’re taking antibiotics. Wear a mask if you plan to be around others.
Don’t use heavily scented products, such as air freshener sprays, candles, cologne, or perfume, which can irritate your airways.

Preventing paroxysmal coughing

Paroxysmal coughing from whooping cough is common in young children. The diphtheria-tetanus-pertussis (DTaP) or tetanus-diphtheria-pertussis (Tdap) vaccine reduces the chances of infection by pertussis bacteria.

If someone close to you has whooping cough, it’s a good idea to avoid touching or being near them until they’ve taken antibiotics for at least 5 days.

Here are other ways to help prevent paroxysmal coughing:

Avoid smoking tobacco products or other inhaled substances.
Sleep with your head elevated to keep mucus or stomach acid from moving up your airways or throat.
Exercise often to make it easier to breathe and to prevent unwanted weight gain that can contribute to acid reflux and GERD.
Eat at a slow pace and chew at least 20 times per bite for easier digestion.
Use an essential oil diffuser to help open your airways. Certain oils can be more potent than others, so be careful if you try this for relief. If this worsens your coughing, avoid using them.
Try relaxation techniques, such as yoga or meditation, to gain control of your breathing, strengthen your immune system, and prevent acid reflux.

When to see a doctor

See a doctor as soon as possible if paroxysmal coughing fits last longer than a week and become increasingly frequent or violent.

Some symptoms may mean you have a severe infection or underlying condition causing your coughing fits. Seek emergency medical help if you experience any of the following:

coughing up blood
vomiting
not being able to breathe or breathing quickly
lips, tongue, face, or other skin turning blue
losing consciousness
fever
chills

Takeaway

Paroxysmal coughing can have a variety of causes, but it’s commonly a result of a pertussis infection. In some cases depending on the cause, it will go away on its own. Some causes, such as asthma and TB, require immediate treatment or long-term management.

See a doctor if you have a persistent cough that’s disrupting your life or regularly making it difficult for you to breathe. Many causes can be treated without the risk of complications if they’re diagnosed early.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Tuberculosis (TB). (n.d.).https://www.cdc.gov/tb/
Bronchiectasis. (n.d.).http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/bronchiectasis/
Chest infection. (2020).https://www.nhs.uk/conditions/chest-infection/
Chung Y, et al. (2021). Diagnosis of pneumonia by cough sounds analyzed with statistical features and AI.https://pubmed.ncbi.nlm.nih.gov/34770341/
Clinical features of pertussis. (2024).https://www.cdc.gov/pertussis/hcp/clinical-signs/
Pertussis surveillance and trends. (2024).https://www.cdc.gov/pertussis/php/surveillance/

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Medically reviewed by Thomas Johnson, PA-C — Written by Tim Jewell — Updated on July 10, 2024

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