What is a cough?
Cough is an involuntary action that helps to clear the throat of mucus and foreign body irritants. Although people cough to clear the throat, other conditions may also trigger an episode.
Depending on the duration, cough can be classified as acute, sub-acute, or chronic.
An acute cough is one which lasts less than three weeks, sub-acute cough lasts between three to eight weeks, while a chronic cough is one which lasts greater than eight weeks.
You must see a doctor if you have a barky cough, are coughing blood, or have a persistent cough that is not improving.
What causes a cough?
The cause can be temporary or permanent.
When the airway becomes clogged with mucus or foreign bodies such as dust or smoke, the body responds in a reflex manner by coughing. This is usually not frequent but when the offending agent is an irritant such as smoke, it could become more frequent.
Viruses and bacteria can cause respiratory tract infections and this is the commonest cause. Viral respiratory tract infections are short-lasting, usually within a few days to a week while respiratory tract infection caused by bacteria may last longer and usually requires antibiotics.
Smoking is another common cause. Smoking usually causes chronic cough which has a distinctive sound and it is called a smoker’s cough.
Asthma typically causes cough in children. This is usually associated with a wheeze thereby making it easy to recognize.
Asthma can be controlled using an inhaler but children can outgrow asthma.
This condition can also be a side effect of some medications such as Angiotensin-converting enzyme (ACE) inhibitors which are anti-hypertensive medications with the very common ones being lisinopril and enalapril. The cough here usually stops after the medications are discontinued.
Other conditions that can cause this condition include:
- Damage to the vocal cords
- Postnasal drip
- Heart failure
- Pulmonary embolism
- Bacterial infections such as croup, whooping cough, and pneumonia
- Gastroesophageal reflux disease (GERD)
How do you know if your cough is an emergency?
In most cases, this condition usually clears up or improve within two weeks. If it hasn’t improved within two weeks, then you should see your healthcare provider. Furthermore, the following symptoms should be watched out for if they occur alongside the condition:
- Chest pain
Cough with associated difficulty in breathing or blood-stained sputum is a medical emergency that requires urgent attention.
There are different modalities of treatment ranging from home remedies to medical treatment.
Viral coughs are self-limiting and usually doesn’t require treatment with antibiotics. The following home remedies can help:
- Drink plenty of water to stay hydrated
- Sleep on a pillow
- Take cough drops
- Regular gargling with warm salt water
- Avoidance of irritants such as smoke and dust
- Add honey or ginger to hot tea to relieve and clear the airway
- Unblock your nose to ease breathing by using decongestant sprays
This involves a detailed history taking, examination including throat examination, and listening to the cough.
If caused by bacteria, then it would require antibiotics which you may take for up to a week. Syrups that contain either expectorants or codeine may also be prescribed.
Additional tests may be required where the cause is difficult to determine and these tests include:
- Chest X-ray
- Blood and skin tests for suspected allergies
- Sputum analysis for the presence of bacteria
Very rarely will an isolated cough be the only symptom of a heart problem. A doctor may however request an echocardiogram to ensure that the heart is functioning well and not a direct or indirect cause.
Very difficult cases will require more testing which includes:
- CT scan: it is useful for determining the cause. It gives a clearer view of the chest and airways.
- Esophageal pH monitoring: this is used when the suspected pathology is GERD and CT scan was unable to show the cause.
Cough suppressants may also be prescribed for cases of failed treatments, or if the condition is expected to resolve without intervention.
What happens if a cough is left untreated?
It usually resolves within two weeks. A chronic case can however cause transient complications such as tiredness, headaches, dizziness, and fractured ribs. These symptoms rarely occur and mostly cease after the condition resolves.
A cough that is a symptom of a more serious condition is usually not self-limiting. It will likely stay on to cause more problems.
Prevention of cough
The following methods are essential for preventing the condition.
Smoking is a common cause of the condition. One is less likely to have a chronic cough or catch a cold if they cease smoking. Advice groups and support networks are available to help someone to stop smoking.
Chronic respiratory symptoms such as cough are less likely to develop in people who take diets rich in fiber, fruit, and flavonoids. A dietician may be recommended for those who need help with adjusting their diet.
Stay away from anyone with a communicable illness, such as bronchitis, to avoid contact with germs, maintain good hygiene by washing hands frequently, and avoid sharing utensils, towels, or pillows. Those with existing medical conditions, such as asthma or GERD, that increase the likelihood of developing the condition should see a doctor so that the condition is effectively managed.