Chronic cough: A General Overview

Overview

What is chronic cough?

Chronic cough is a cough that is irritating, uncontrollable and continues for a long time. It lasts over eight weeks in grown-up persons and four weeks in youngsters. It is not an illness but an indication of a primary medical condition that is often treatable.

Facts

Facts about cough

• Cough is the body’s defense response for clearing any inspired foreign particles entering our body.
• Cough can be of three types viz; acute, subacute and chronic
• An acute cough is a cough due to respiratory tract infection viz; cold or pneumonia and continues for about three weeks
• Subacute cough is the cough that occurs after a respiratory infection and continues for around 3-8 weeks but often subsides
• Chronic is the irrepressible cough that continues longer than eight weeks
• The best way to treat any cough is to eliminate its cause ¹Facts about cough | Researched based study from Nlm.nih.gov .

Symptoms

Symptoms of chronic cough

• Painful throat
• Frequent throat clearing
• Runny nose
• Harsh voice
• Difficult breathing
• Whistling sound while breathing
• Excess mucus secretion from the back of the nasal cavity (Postnasal drip)
• Thick stuff hangs from the back of the throat (Phlegm)
• Terrible taste in the mouth
• Burning sensation in the chest

Serious Symptoms of chronic cough

• High fever ( greater than 103 degree Fahrenheit)
• Blood while coughing
• Excessive night sweating
• Lightheadedness and faint
• Continuous chest pain
• Excessive tiredness
• Appetite loss
• Weight loss
• Severe breathing problem
• Vomiting while coughing ²Symptoms of chronic cough | Researched based study from Nlm.nih.gov .

Such severe symptoms require immediate medical attention and should never be ignored

Classification

Types of chronic cough

There are five types of chronic cough. They are:

Wet cough (productive cough)

• Occurs due to excess mucus accumulation in the airways to the lungs
• Mucus color may indicate the type of infection (either bacterial, lung infection or cardiac failure)

Dry cough (non-productive cough)

• It does not produce any mucus
• Irritates lungs and throat
• Usually, indication for other infections such as sinusitis or viral infection

Whooping cough

• It is a severe bacterial infection of the respiratory tract which produces high-pitched yelling (shouting) sounds while coughing.
• It causes coughing fits (sudden disturbances in the brain causing a change in a person’s behaviour and level of consciousness)
• It is infectious and can spread from person to person

Barking cough (Croup)

• It occurs due to an infection of the upper respiratory tract
• It causes swelling and pain in the windpipe, voice box and air tubes to the lungs
• Coughing produces a loud sound of barking (growling)

Stress cough

• Usually occurs when one is under tension and anxiety
• Stress causes the narrowing of the airways while breathing, resulting in coughing
• No mucus secretion occurs
• Not related to any illness

Causes

Causes of chronic cough

• Upper respiratory tract infections such as pneumonia, flu .
• Gastroesophageal reflux disease, stomach acid comes back to the throat, causing throat irritation .
• Asthma is a disease in which airways swell and narrow, causing difficult breathing and cough.
• Bronchitis is swelling and pain of the tubes that carry air to and from the lungs
• Sinusitis causing postnasal drip and results into cough. sinuses are vacant spaces that make mucus pass out through the nose. in sinusitis, tissues covering the sinus become swelled and painful, with slime hanging from the back of the nasal cavity (postnasal drip)
• Angiotensin-converting enzyme inhibitors causes dry cough even in non smokers , incidence of this side effect is higher in women Benazepril, Ramipril, and Quinapril are common ACE inhibitors.
• Infections like tuberculosis (a serious bacterial illness that attack the lungs),fungal lung infection, and whooping cough(highly infectious bacterial disease) causing severe cough.
• Upper airway cancer (in rare cases)
• Bronchospasm inducing cough, muscles in the airway to the lungs constrict and tighten and causing difficult breathing, bronchospasm usually happens after an infection

• Chronic obstructive pulmonary disease lung disease that causes hindrance of airflow from the lungs causes difficulty breathing and cough
• Dust and animal dander (material shed from an animal’s body)
• Inhaling foreign substances(generally by youngsters)
• Smoking toxins in cigarette smoke damage the airways to the lungs , it causes throat irritation and cough

Unusual causes of chronic cough includes:

Cystic fibrosis

• It is a disorder that damages the lungs
• Excess mucus secretion in the lungs causes chronic cough

Interstitial lung disease

• It is the scarring and stiffness of the lungs
• Causes difficulty breathing and cough

Bronchiolitis

• It is a viral infection causing constriction of the bronchioles (tubes carrying air to the lungs)
• It causes swelling, redness, and pain
• Mucus accumulates in the bronchioles leading to difficulty in breathing

Sarcoidosis

• Disease-forming granulomas (mass of swollen cells viz; white blood cells and other tissues) in various body parts, particularly lungs
• Causes cough and difficulty breathing

Lung cancer

• Unrestrained cell division in the lungs forms tumor
• It causes shortness of breath and chronic cough

Cardiac (heart) failure

• The heart cannot pump adequate blood to meet the body’s requirement
• Fluid accumulates in the lungs causing chronic cough ³Causes of chronic cough | Researched based study from biomedcentral.com .

Treatment

Treatment of chronic cough

Nasal sprays

• Nasal sprays are anti-allergic sprays
• It lessens the itchiness of the stuffed nose and sneezing

Bronchodilators

• Are medicines to treat difficult breathing
• Reduces asthma-related swelling of the airways

Inhaled steroids

• Inhaled steroids are corticosteroid (synthetic steroid drug) inhalers to treat inflammation.
• Used to treat asthma-related swellings of airways to the lungs

Decongestants

• Are medicines to treat blocked-up nose and relieve nose congestion(fullness)
• Shrinks the swollen tissue in the nose

Antibiotics

• Are medicines to combat bacterial infections
• Certain antibiotics may be recommended to treat chronic cough

Acid Reflux medicines

• A physician may recommend medicines to neutralize or inhibit stomach acid secretion.
• Some examples of such medicines are antacids and proton pump inhibitors ⁴Treatment of chronic cough | Researched based study from ajmc.com .

Other treatments for chronic cough

• Taking cough suppressants such as dextromethorphan(used to treat dry cough and gives momentary cough relief)
• Taking prescribed cough suppressants such as benzonatate(numbs the throat and lessens the cough reflex)
• Taking medicines such as famotidine(relieves cough and stomach pain and eases swallowing) and cimetidine(reduces cough, stomach acid, and heartburn)
• Taking gabapentin(anticonvulsant medicine) has been found to relieve chronic cough symptoms.
• Eating meals in small parts during the day
• Avoid sleeping for at least two hours after each meal
• Using elevated (raised) pillows for sleeping
• Avoid foods such as high-fat food, citrus food and caffeine-containing food ⁵Treatment of chronic cough | Researched based study from Tandfonline.com .

Home remedies

Home remedies for chronic cough

• Gargle with warm saline water to get rid of pain and mucus in the throat
• Taking enough fluids during the day
• Taking cough lozenge that relieves throat irritation
• Avoid overeating before bed during the night to keep away from stomach acid coming back to the throat .
• Avoid inhaling dust and other pollutants that irritate the throat
• Ginger tea (ginger mixed in tea) gives relief to the throat and reduces cough
• Honey added to boiling tea can relieve the continual cough
• Complete cessation of smoking
• Inhaling steam can relieve dry cough
• Eucalyptus herb can relieve cough symptoms to some extent

Complications

Complication of chronic cough

• Sleepless night due to excessive cough
• Headaches
• Lightheadedness
• Excessive tiredness
• slight bleeding in the eyes(subconjunctival hemorrhage)
• Difficulty in performing work in the home or office
• In severe cases, coughing can lead to
• Loss of consciousness
• Ribs breaking
• Loss of urinary bladder control

Prevention

Prevention of chronic cough

• Treating asthma or other respiratory infections immediately to avoid turning into a chronic cough
• Taking fibrous fruits like apples, bananas, pear
• Taking flavonoid-containing fruits like oranges, grapes, lemon
• Staying away from pneumonia and bronchitis patients
• Ensuring that one’s child has taken all the necessary vaccines