Coughing is a reflex action to clear your airways and throat. A cough may be annoying at times but it helps the body protect or heal itself. Coughs may be classified as acute or chronic. Coughs are acute when they start suddenly and typically last not more than 3 weeks. Acute coughs are the kind you often get with the flu, cold, or acute bronchitis. Chronic coughs usually last longer than 8 weeks and can be caused by postnasal drip from sinus infections or allergies, gastroesophageal reflux disease, or chronic lung conditions such as chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary fibrosis.
Common irritants include mucus, smoke, or allergens such as mold, pollen, or dust. Some medicines or medical conditions tend to irritate the nerve endings in the airways to cause coughing.
Water can ease your coughing – whether consumed as a drink or added to the air in the form of vaporizer or a steam in the shower. If you have the flu or a cold, antihistamines could work better than over-the-counter cough medicines. Children under the age of four must not be given cough medicine. For children over the age of four, use caution and read the labels of cough medicine carefully.
A cough can be caused by many conditions, both temporary and permanent.
Clearing the throat
Coughing is the usual way of clearing your throat. When your airways get clogged, usually foreign particles such as dust or smoke or mucus, a cough is a reflex attempt to clear the particles and make breathing a lot easier.
This type of coughing is usually infrequent, but coughing may increase with exposure to irritants such as smoke.
Viruses and bacteria
The leading cause of coughing is an infection in the respiratory tract, such as the flu or a cold.
Respiratory tract infection is usually due to a virus and may last for a few days to a week. Infections caused by the flu may take a little longer to clear up and can sometimes require antibiotics.
Smoking is a common cause of coughing. A cough caused by smoking is usually a chronic cough with a distinctive sound. It is also known as a smoker’s cough.
A common cause of coughing, especially in young children is asthma. Typically, coughing due to asthma comes with wheezing, which makes it easy to identify.
The exacerbations of asthma must be treated using an inhaler. Children can out grow their asthma as they get older.
Some medications may cause coughing, although this is generally a rare side effect. Angiotensin-converting enzyme inhibitors that are typically used to treat high blood pressure and heart conditions can cause coughing.
Two of the more common ACE inhibitors are Zestril and Vasotec.
Other conditions may cause a cough include:
- Damage to the vocal cords
- Bacterial infections such as whooping cough, pneumonia, and croup
- Postnasal drip
- Serious conditions such as pulmonary embolism and heart failure
Gastrointestinal reflux disease or GERD is another condition that can cause a chronic cough. In this condition, the contents of the stomach flow back into the esophagus. The acid backflow stimulates a reflex in the trachea, resulting in the person coughing.
Diagnosis and Treatment
Your doctor will inquire about your medical history and perform a physical exam. A complete medical history and thorough physical exam will provide many clues about your chronic cough. The doctor may also order several tests to identify the cause of your chronic cough.
Many doctors choose to begin the treatment for the most common causes of chronic cough instead of ordering tests that could be expensive. If the treatment does not work, however, you may undergo testing for less common causes.
- X-rays – While routine chest X-rays do not always reveal the real reason for a cough, such as acid reflux, asthma, or postnasal drip, they could be used to check for lung cancer, lung disease, and pneumonia. An X-ray of your sinuses may reveal evidence of a sinus infection.
- CT scans – CT scans may also be used to check for lung conditions that could produce chronic cough or check sinus cavities for infection.
Lung function tests
There are simple tests, such as spirometry, that are used to help diagnose COPD and asthma. They measure the volume of air that your lungs can hold and how fast you can exhale.
Your doctor may order the asthma challenge test to check how well your breathing is before and after you inhale the drug methacholine.
If the mucus that you cough up is colored, your doctor may want to test a sample of it for bacteria.
If your doctor cannot determine the causes of your cough, he may use some scope tests to look for the possible causes. These tests may include:
- Bronchoscopy – Using a thin, flexible tube equipped with a light and camera, your doctor can look at your lungs and air passages. A biopsy can also be taken from the inside lining of your airway to look for abnormalities.
- Rhinoscopy – Using a fiberoptic scope, your doctor can look at your sinuses, nasal passageways, and upper airway.
A chest X-ray and spirometry, at a minimum, are typically ordered to find the cause of chronic cough in children
Determining the cause of chronic cough is essential to effective treatment. In many cases, more than one underlying condition may be the cause of your chronic cough.
If you are a smoker, your doctor will discuss with you your readiness to quit and offer assistance to achieve this goal.
If you have been prescribed an ACE inhibitor medicine, your doctor may ask you to stop taking it and recommend another medicine that does not have cough as a possible side effect.
Medications for the treatment of chronic cough may include:
- Antihistamines, decongestants, and corticosteroids – These medications are the common treatment for postnasal drip and allergies.
- Inhaled asthma drugs – The most effective treatment for asthma-related cough are bronchodilators and corticosteroids, which open up your airways and reduce inflammation.
- Antibiotics – If your chronic cough is caused by bacterial, mycobacterial or fungal infection, your doctor may prescribe medications to address the infection.
- Acid blockers – When lifestyle changes do not take care of acid reflux, you may be given medications that block acid production. Some people may require surgery to resolve the problem.
While infrequent coughing is necessary to clear the airways, there are ways to prevent other types of cough.
- Quit smoking – Smoking a common contributor to a chronic cough. It is difficult to cure a smoker’s cough. There are several methods to help you quit smoking, from gadgets to support networks. After you stop smoking. You will be much less likely to catch colds or experience a chronic cough.
- Dietary changes – People whose diets are high in fiber, fruit, and flavonoids are less likely to have chronic respiratory symptoms including coughing. If you need to adjust your diet, you can ask your doctor for advice or a referral to a dietitian.
- Medical conditions – As much as possible, anyone with a contagious diseases, such as bronchitis, should be avoided so as not to get into contact with germs. Wash your hands frequently and do not share utensils, pillows, or towels. If you currently have medical conditions that can increase the chances of you developing a cough, such as asthma or GERD, ask your doctor about different management strategies. Once the condition is managed, you may find that your cough disappears, or becomes much less frequent.
Risks of Having Cough
Risk factors for developing a chronic cough include:
- Smoking – Current or former smoking is a major risk factor for chronic cough. This is due to the inhalation of toxins from cigarette smoke or secondhand smoke inhalation.
- Allergies – People with allergies have an increased risk of developing cough when exposed to a specific allergy trigger.
- Environmental – Some workplaces could have various irritants in the air that may cause cough. Highly polluted areas or the use of coal for cooking or heating can also increase the risk of cough.
- Chronic lung diseases – People with bronchiectasis, asthma, COPD, and a history of lung infection with scars are at an increased risk of developing a cough.
- Female gender – Women have a more sensitive cough reflex, which increases their risk of developing a chronic cough.
When to Seek Medical Attention
Most coughs will clear up, or significantly improve within two weeks. If you have a cough that has not improved in two weeks, you should see a doctor as the cough may be a symptom of a more serious problem.
Most coughs that linger are typically harmless. But you cannot identify out the causes on your own. When your cough persists after 1 week, it is time to see your doctor, especially if your cough interferes with your daily life and ability to work.
If additional symptoms develop, contact your doctor as soon as possible. Watch out for the following symptoms:
- Chest pains
A cough with blood or difficulty in breathing requires urgent medical attention. Call emergency medical services right away.