Definition: A cough is our body’s way of responding to irritants in our throat and airways. An irritant stimulates nerves there to send a cough impulse to the brain. The brain signals the muscles of our abdomen and chest wall to give a strong push of air to our lungs to try to expel the irritant.
It is a sudden and often repetitively occurring reflex which helps to clear the large breathing passages from secretions, irritants, foreign particles and microbes. The cough reflex consists of three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound. Coughing is either voluntary or involuntary.
A coughing attack can be very forceful — the velocity of air from a vigorous cough through the nearly closed vocal cords can approach 500 miles per hour. Prolonged, vigorous coughing is exhausting and can cause sleeplessness, headaches, urinary incontinence, and even broken ribs.
Frequent coughing usually indicates the presence of a disease. Many viruses and bacteria benefit evolutionarily by causing the host to cough, which helps to spread the disease to new hosts. Most of the time, irregular coughing is caused by a respiratory tract infection but can also be triggered by choking, smoking, air pollution, asthma, gastroesophageal reflux disease, post-nasal drip, chronic bronchitis, lung tumors, heart failure and medications such as ACE inhibitors.
An occasional cough is normal and healthy. A cough that persists for several weeks or one that brings up discolored or bloody mucus may indicate an underlying condition that requires medical attention. A cough rarely requires emergency care.
Cough is a helpful phenomenon, it is the body’s natural reflex to irritation in the throat. There are two kinds of cough, one which is wet and associated with mucus (productive cough); and the other which is dry and there is no mucus (unproductive cough). It is important to differentiate between the two, because the treatments are entirely different.....CLICK & SEE
Causes: The list of possible causes of cough is long and highly varied. Doctors classify coughs into 2 categories, acute and chronic. Many doctors define an acute cough as one that been present for less than 3 weeks. Chronic coughs are those present for more than 3 weeks.
- Acute coughs can be divided into infectious (caused by an infection) and noninfectious causes.
- Infectious causes of acute cough include viral upper respiratory infections (the common cold), sinus infections, pneumonia, and whooping cough.
- Noninfectious causes of cough include flare-ups of the following chronic conditions: chronic bronchitis, emphysema, asthma, and environmental allergies.
- The easiest way to simplify the causes of chronic cough is to divide them into their locations with respect to the lungs. The categories are environmental irritants, conditions within the lungs, conditions along the passages that transmit air from the lungs to the environment, conditions within the chest cavity but outside of the lungs, and digestive causes.
- Any environmental substance that irritates the air passages or the lungs is capable of producing a chronic cough with continued exposure. Cigarette smoke is the most common cause of chronic cough. Other cough-producing irritants include dusts, pollens, pet dander, particulate matter, industrial chemicals and pollution, cigar and pipe smoke, and low environmental humidity.
- Within the lungs both common and uncommon conditions cause chronic cough. Common causes include asthma, emphysema, and chronic bronchitis. Less common causes of lung-induced chronic cough include cancer, sarcoidosis, diseases of the lung tissue, and congestive heart failure with chronic fluid build-up in the lungs.
- The passages that connect the lungs to the external environment are known as the upper respiratory tract. Chronic sinus infections, chronic postnasal drip, diseases of the external ear, infections of the throat, and use of ACE inhibitors for high blood pressure have all been implicated in chronic cough.
- In addition to disease processes within the lung and air passages, diseases elsewhere within the chest cavity may also be responsible for chronic cough. Conditions within the chest known to cause chronic cough include cancer, unusual growth of a lymph node, and an abnormal enlargement of the aorta, which is the main blood vessel leaving the heart.
- An often-overlooked cause of the chronic cough is gastroesophageal reflux (GERD). GERD occurs when acid from the stomach travels up the esophagus. This abnormal condition can cause irritation of the esophagus and larynx resulting in the reflex production of a cough.
In the case of productive cough, coughing helps in removing excess mucus or phlegm which has come up in the back of the throat from the lungs or the nose and sinuses. A common cause of coughing in the night is mucus dripping from the nose into the back of the throat. Expectorant syrups , specially herbal base cough syrup can be used to get rid of the phlegm. Note that productive coughs should never be suppressed since they serve a very useful purpose. Night-time irritation of a chield can be eased by turning the child on his side or his front. A doctor should be consulted in case the cough lasts for more than 48 hours.
Unproductive coughs on the other hand serve no useful purpose, and can be very irritating to a small child, sometimes to the extent of preventing sleep. In this case, cough suppressants can help ease the discomfort.
Complications: The complications of coughing can be classified as either acute or chronic. Acute complications include cough syncope (fainting spells due to decreased blood flow to the brain when coughs are prolonged and forceful), insomnia, cough-induced vomiting, rupture of blebs causing spontaneous pneumothorax (although this still remains to be proven), subconjunctival hemorrhage or “red eye”, coughing defecation and in women with a prolapsed uterus, cough urination. Chronic complications are common and include abdominal or pelvic hernias, fatigue fractures of lower ribs and costochondritis.
Diagnosis: The diagnose of the cause of a cough usually begins by determining if it is specific or nonspecific in nature. A specific cough is one associated with other symptoms and further workup is dependent on these symptoms while a non specific cough occurs without other signs and symptoms. Further workup may include labs, x rays, and spirometry.
Treatment: Treatment should target the cause as per diagnosis; for example, smoking cessation or discontinuing ACE inhibitors. Cough suppressants such as codeine or dextromethorphan are frequently prescribed, but have been demonstrated to have little effect. Other treatment options may target airway inflammation or may promote mucus expectoration. As it is a natural protective reflex, suppressing the cough reflex might have damaging effects, especially if the cough is productive.
In children half of cases go away without treatment in 10 days and 90% in 25 days.
According to the American Academy of Pediatrics the use of cough medicine to relieve cough symptoms is supported by little evidence and thus not recommended for treating cough symptoms in children. There is tentative evidence that the use of honey is better than no treatment or diphenhydramine in decreasing coughing. It appeared similar to dextromethorphan. A trial of antibiotics or inhaled corticosteroids may be tried in children with a chronic cough in an attempt to treat protracted bacterial bronchitis or asthma respectively.
Home Care for prevention :
If one has asthma or another chronic lung disease, he or she should make sure to taking medicines prescribed by the doctor.
Some helpful tips to ease cough:
*If one has a dry, tickling cough, try cough drops or hard candy. Never give these to a child under age 3, because they can cause choking.
*Use a vaporizer or take a steamy shower. These increase moisture in the air and help soothe a dry throat.
*Drink plenty of fluids. Liquids help thin the mucus in your throat making it easier to cough it up.
*Do not smoke and stay away from secondhand smoke
Medicines can be bought on own include:
*Guaifenesin helps break up mucus. Drink lots of fluids if you take this medicine.
*Decongestants help clear a runny nose and relieve postnasal drip. Check with your doctor before taking decongestants if you have high blood pressure.
* In case of children the doctor should be consulted before giving a child 6 years old or younger an over-the-counter cough medicine, even if it is labeled for children. These medicines likely do not work for children, and can have serious side effects.
If one has seasonal allergies, such as hay fever:
*Stay indoors during days or times of the day (usually the morning) when airborne allergens are high.
*Keep windows closed and use an air conditioner.
*Do not use fans that draw in air from outdoors.
*Shower and change clothes after being outside.
If one has allergies year-round, cover pillows and mattress with dust mite covers, use an air purifier, and avoid pets and other triggers.
Sometimes Homeopathic medication works well.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.