Cough:
A cough is the body's reflex to keep the throat, and airways clear of mucus and irritants like dust or smoke. It is rarely a sign of anything serious. While coughing can be annoying, it helps the body heal and protect itself. Coughing can be acute or chronic. Acute cough starts suddenly and usually lasts for no more than two to three weeks. Acute cough is commonly caused by a cold, flu, or acute bronchitis. Chronic cough persists for 8 weeks or more.
Types of Cough:
- Dry Cough: Annoying and does not produce any mucus (thick phlegm).
- Chest Cough: Produces phlegm to help clear the airways.
Causes:
Acute (Short-Term) Cough: Common causes include:
- Upper respiratory infections affecting the throat, trachea, or sinuses, such as colds, flu, laryngitis, sinusitis, or whooping cough.
- Lower respiratory infections affecting the lungs or lower airways, such as acute bronchitis or pneumonia, or allergies like allergic rhinitis or hay fever.
- An exacerbation of a long-term condition like asthma, chronic obstructive pulmonary disease (COPD), or chronic bronchitis.
- Inhalation of dust or smoke.
In rare cases, a short-term cough may be the first sign of an underlying condition causing persistent coughing.
Chronic (Persistent) Cough: Possible causes include:
- Long-term respiratory infections, such as chronic bronchitis.
- Asthma, which also causes other symptoms like wheezing, chest tightness, and shortness of breath.
- Allergies.
- Smoking. A smoker's cough can also be a symptom of COPD.
- Bronchiectasis, where airways in the lungs become abnormally dilated.
- Post-nasal drip from conditions like rhinitis or sinusitis.
- Gastroesophageal reflux disease (GERD), where stomach acid irritates the throat.
- Medications, such as ACE inhibitors, which are used to treat high blood pressure, heart disease, and vascular conditions.
- In rare cases, a persistent cough may be a symptom of more serious conditions like lung cancer, heart failure, pulmonary embolism (blood clot in the lung), or tuberculosis.
- Eosinophilic bronchitis, a rare form of inflammation in the airways that can cause chronic coughing, is less common than asthma.
When to See a Doctor:
- Cough lasting more than 3 weeks (chronic cough).
- A severe cough that worsens rapidly.
- Severe malaise or fatigue.
- Chest pain.
- Unexplained weight loss.
- Swelling on one side of the neck and pain (swollen lymph nodes).
- Difficulty breathing.
- Weakened immune system due to chemotherapy or diabetes.
- Cough accompanied by blood.
Diagnosis:
The doctor may order tests, such as chest X-rays, allergy tests, lung function tests, and sputum analysis, to check for infections, and perform acid reflux tests to check for gastroesophageal reflux disease. A medical history will also be considered.
Treatment:
Treatment is not always necessary for acute cough as it usually improves on its own within a few weeks. Self-care measures include resting, drinking plenty of fluids, and taking pain relievers like paracetamol. Warm lemon and honey drinks (not suitable for children under one year) can provide a similar effect to cough medicines.
Cough Medications:
- Cough medicine (certain types should not be given to children under 12).
- Decongestants and cough medications containing codeine (they will not stop the cough).
- Antibiotics are not typically prescribed for coughs unless the patient has a bacterial infection or is at risk of complications.
Although some patients find them helpful, medications claiming to suppress the cough or reduce mucus production are not usually recommended due to limited evidence of their effectiveness over simple home remedies. They are not suitable for everyone.
Addressing the Underlying Cause:
- Asthma can be treated with inhaled bronchodilators (steroids) to reduce airway inflammation.
- Allergies can be treated by avoiding triggers and taking antihistamines to relieve allergic reactions.
- Bacterial infections can be treated with antibiotics.
- Gastroesophageal reflux disease (GERD) can be managed with antacids to reduce stomach acid production, and lifestyle changes can help reduce reflux, such as:
- Avoiding foods that increase reflux, such as fatty foods, chocolate, carbonated beverages, and citrus juices.
- Avoid eating for 2 to 3 hours before sleeping.
- Elevating the head of the bed by 6 to 8 inches.
- Losing weight if overweight.
- Chronic obstructive pulmonary disease (COPD) can be managed with bronchodilators to widen the airways.
- If the patient is a smoker, quitting smoking may help improve the cough.
- Eosinophilic bronchitis is treated with inhaled glucocorticoids, which are also used to treat asthma and reduce airway inflammation.