A ‘Cough’ of Concern

Coughing Every Now & then Disturbs Everyone!

Coughing occasionally during winter, after getting drenched in the rain or affected by common cold are common causes of coughing and no one cares! Let the cough last for more than a week and you start taking some medication or trying home remedies as treatment. When the same cough remains for more than 3-4 weeks, it becomes a matter of concern and panic arises in the individual. Nowadays chronic coughing makes the individual worry about heart disease and cancer!
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Cough
A cough can be a reflux one, consciously done or a voluntary act that starts with a gasp that sucks air into the lungs. Is there anyone who has never coughed? There can be none at all! Everyone coughs and none of us bother about it until it is an occasional one caused due to acute illnesses such as hay fever, common cold, bronchitis or pneumonia which resolve in a couple of days. On the contrary, a chronic cough lasts for few weeks, months or even years together.

Coughing is as common as sun and moon, but chronic cough interrupts our daily activities, sleep, causes fatigue, affects job performance and we lose the ability to focus on the work at hand. We live in an era of scary viruses and social interactions become greatly affected due to persistent coughing. Moreover, coughing affects a person physically too in the form of urinary incontinence, fainting and broken ribs. Severe chronic cause can even cause vomiting, lightheadedness and rib fractures sometimes. But the entire episode of chronic coughing vanishes away once the underlying problem is diagnosed properly. Chronic cough can occur along with other symptoms such as runny nose, a sensation of liquid running down the back of your throat (postnasal drip), frequent sore throat, wheezing, breathlessness, heartburn, sour taste in the mouth and rarely, coughing up blood too happens.

Common Causes of a Chronic Cough
Any physician would spontaneously quote smoking as the leading cause for chronic cough. It starts as a simple chronic cough but can lead to far serious conditions such as bronchitis, emphysema, pneumonia and lung cancer which becomes a matter of concern for chain smokers. While there are numerous conditions that can cause a chronic cough, five conditions top the list and include:

• Asthma: Wheezing might be the prime symptom of asthma but not all patients do it and some just cough. Air that moves into the lungs makes a wheezing or whistling sound in asthma patients. In one type of asthma called as cough-variant asthma, coughing is the primary symptom. While dry cough might occur all through the day, it is much more pronounced during the night and accounts for almost one-quarter of all chronic coughs. Allergens such as pollens, dust, exercise or cold air triggers coughing. A pulmonary function test or inhaling small doses of methacholine can confirm the presence of the illness which is treated using anti-asthmatic treatments.
• Postnasal drip: Over-production of mucous by the nose or sinus causes the mucus to drip down the back of the throat and make you cough. This is also called as upper airway cough syndrome (UACG). The best way to find if a postnasal drip is the cause for the chronic cough is to try treatment options. Using nonprescription decongestant or antihistamine tablets are the first step. Saline nose sprays, home remedies such as inhaling steam or a hot shower can prove to be fruitful.
• Gastroesophageal reflux disease (GERD): Just as asthma causes coughing without wheezing, GERD can cause coughing without heartburn. The stomach contents travel upwards into the esophagus instead of going down into the intestines. This irritation can cause chronic coughing and coughing can in turn aggravate GERD. Refer the checklist of foods that can/cannot be taken when a person suffers from GERD by visiting the website www.firsteatright.com.
• Chronic bronchitis: Firstly, most people with chronic bronchitis are current or past smokers. This is one of the smoking-related lung diseases that fall under the chronic obstructive pulmonary disease (COPD) category. Chronic bronchitis causes long-term inflammation of the major airways which triggers a cough and brings up colored sputum.
• Treatment with ACE inhibitors: Medications called as angiotensin-converting enzyme (ACE) inhibitors can cause a chronic cough in some individuals. Used to treat high blood pressure and then used mainly to treat heart failures and heart attacks too, ACE inhibitors are favored over other medications due to their good performance and minimum side effects except for the fact that they can lead to a persistent cough. If a person coughs minimally and is able to manage, the patient might choose to continue with the medications. If the cough is severe, the way to stop coughing is by switching over to another type of antihypertensive medication.
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Other less-common conditions of a chronic cough include:

• Lung infections
• Lung cancer
• Any lung disease
• Psychological disorders
• Airborne irritants
• Whooping cough
  
  

A ‘Cough’ of Concern
A chronic cough isn’t all that serious until you experience symptoms such as fever (consistently high or prolonged), shortness of breath, weight loss, night sweats, wheezing, weakness, fatigue, chest pain that’s not due to the cough itself, coughing up blood, copious sputum production and loss of appetite which immediately calls for a physician’s attention.

Although not dangerous mostly, when you cough persistently it can land you in various problems including disturbed sleep, dizziness, excessive sweating, fractured ribs, urinary incontinence and passing out too!

A cough might be ‘dry’ or ‘wet’. A dry cough does not produce mucus and is predominantly visible in people who smoke and use ACE inhibitors whereas a wet cough produces mucus or sputum and is visible amongst people using a postnasal drip or having cystic fibrosis.

Diagnosis & Treatment
The doctor begins the diagnosis by questioning on the patient’s initial symptoms, time of appearance of the cough, what makes the cough better or worse and also about the patient’s history and lifestyle habits (mainly for smoking). Sometimes, the doctor suggests the patient to go for a bronchoscopy (lung view to check for irritation or disease), imaging scan or sputum sample test to check for any complications.

Treatment depends on the underlying cause. Doctor suggests decongestants or antihistamines for treating postnasal drip, lifestyle changes for GERD that include going to bed two hours post-meal, eating several small meals and sleeping with your head in a raised position, antibiotics, cough suppressants, inhaled-asthma drugs and acid blockers.

Home remedies that can be easily practiced by most people include sucking on cough drops, using a vaporizer to steam and drinking warm liquids such as warm water, tea, coffee or hot soup.