Cough

With Dr. Faosat Aragbaiye
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A cough is the body’s way of responding to irritants in the throat or airways. An occasional cough is normal and healthy. A cough that persists for several weeks or one that brings up discoloured or bloody mucus may indicate a condition that needs medical attention.

Causes

While an occasional cough is normal, a cough that persists may be a sign of a medical problem. A cough is considered” acute” if it lasts less than three weeks. It is considered “chronic” if it lasts longer than eight weeks (four weeks in children.

Some causes of coughs include:

Common causes- acute

• Viruses such as common cold and influenza
• Pneumonia
• Bacterial infections
• Whooping cough
• inhaling an irritant ( such as smoke, dust, chemicals or foreign body)

                Common causes-chronic

• Allergies
• Asthma ( most common in children)
• Bronchitis
• Gastroesophageal reflux disease (GERD)
• Postnasal drip

Other causes:

• Acute sinusitis
• Bronchiectasis (a chronic lung condition)
• Bronchiolitis ( especially in young children)
• Choking: first aid (especially in children)
• Chronic sinusitis
• Chronic obstructive pulmonary disease (COPD)
• Croup (especially in children)
• Cystic fibrosis
• Emphysema
• Heart failure
• Laryngitis
• Lung cancer
• Pulmonary embolism( blood clot in an artery in the lungs)
• Respiratory syncytial virus RSV especially in young children
• Medications called angiotensin-converting enzyme (ACE) inhibitors
• Neuromuscular diseases that weaken the coordination of upper airway and swallowing muscles
• Sarcoidosis
• Tuberculosis

Symptoms

Acute coughs are divided into infectious and non-infectious causes. Acute cough signs and symptoms that point to an infection include:

• Fever
• Chills
• Body aches; chest pain
• Sore throat
• Nausea
• Vomiting
• Headache
• Sinus pressure
• Runny nose
• Night sweats
• Sputum, or phlegm

Signs and symptoms of chronic or persistent cough point to non-infectious causes include:

• Coughs that occur with exposure to certain chemicals or irritants in the environment
• Coughs with wheezing
• Coughs that routinely worsen with locations or certain activities.
• Coughs that improve with inhalers or allergy medications.

Diagnosis

The diagnosis is based largely on the information the patient provides. Information necessary to help make an accurate diagnosis includes the duration of the cough, associated signs and symptoms, activities or locations that make the cough worse or better, relation between the cough and time of the day, past medical history, and any home therapies already attempted

In case of chronic cough, chest X-ray and other tests can be carried out for further diagnosis.

Treatment

The treatment of acute cough is directed primarily at decreasing the cough in addition to treating the underlying cause.

• Symptomatic cough relief can be provided by using cough suppressants or cough syrup
• Narcotic medications can be prescribed for severe coughs that interfere with sleep
• If bacterial infection is suspected, antibiotics can be prescribed
• People suspected of having viral infection will not benefit from antibiotics, and treatments are directed at the symptoms

The treatment of chronic cough will also be directed at treating the underlying condition. It is important to recognize that treatment may be difficult, may employ multiple approaches, and may not completely eliminate the cough.

Prevention

Prevention of a cough is based on avoiding the medical problems that cause the cough. The most important aspect of prevention is to stop smoking and avoid second hand smoke particularly for people with asthma, chronic lung disease, and environmental allergies.

• For people with GERD, prevention is aimed at diet modification, sleeping with head of the bed elevated, and taking all medications as prescribed
• For chronic lung disease, the best prevention is strict adherence to prescribed treatments.