It is very important to know that cough is not an illness but a symptom of a disease condition or illness. It often comes on as the last symptoms of a retreating viral flu or cold and can be a normal cough or chronic cough. It can also be triggered by some factors such as environmental factors and the immune system. For example, whooping cough (also called Pertussis) is very different from normal cough. Whooping cough is caused by serious bacterial infection and is a highly contagious respiratory tract infection caused by the bacterium “Bordetella pertussis”. Also, coughing can be carried out deliberately or as part of reflex. However, it can also be a sign of serious illness, usually, it can suppress on its own without the use of medications.
In this article, we will discuss broadly on possible causes, diagnosis and treatment for coughs.
WHAT IS COUGH?
Cough otherwise known as tussis, involves voluntary or involuntary act that clears the throat and respiratory passage of foreign particles, mucus, microbes, irritants and fluids.
A person tends to cough when the cells along the air passages get irritated and this triggers a chain event. A cough is said to be an action the body takes in other to get rid of substances that are irritating to the air passages. The substances can be foreign particles, irritants, mucus, dust, smoke, microbes and bacteria. When an individual coughs by forcing air out of the lungs under high pressure, this tends to clear the throats of these foreign particles. It is a rapid expulsion of air from the lungs.
It is also the body’s natural mechanism for clearing up the air passageways. When an individual is exposed to respiratory irritants (i.es trachea irritants), coughing is a reflex action that aims to free or unblock the air passage to enable the person to breath more comfortably. Exposure to environmental irritants such as dust, pollen, pet dander, particulate matter and chemicals can lead to cough.
TYPES OF COUGHS
There are two major types of coughs. They are:
- Acute cough otherwise known as short-term cough
- Chronic cough otherwise known as persistent cough
ACUTE COUGH
Acute cough which happens to be a short-term cough can be caused by some certain health conditions. In some cases, acute coughs may be the first sign of an illness that causes a chronic cough.
CAUSES OF ACUTE COUGH
Acute cough causes can be divided into two:
- Infectious causes
- Noninfectious causes
INFECTIOUS CAUSES
Infectious causes of acute cough are caused by an infection such as viral upper respiratory infections (common cold), acute bronchitis, whooping cough, sinus infection and pneumonia.
NON-INFECTIOUS CAUSES
Noninfectious causes of acute cough can result from a flare-up of chronic conditions such as emphysema, asthma, chronic bronchitis and environmental allergies.
Others common categories of acute cough include:
- Lower Respiratory Tract Infection :- LRTI affects an individual’s lungs or lower air passages such as Pneumonia or acute bronchitis
- Upper Respiratory Tract Infection (URTI):- URTI affects your throats, sinuses or windpipe such as laryngitis, cold, flu, sinusitis or whooping cough.
- When an individual inhaled smoke or dust may result to acute cough
- A flare-up of chronic conditions such as chronic obstructive disease (COPD) or chronic bronchitis and asthma
- An allergy condition such as hay fever or allergic rhinitis
SIGNS AND SYMPTOMS OF INFECTIOUS ACUTE COUGH
The signs and symptoms of acute cough include:
- Nausea
- Vomiting
- Headache
- Sore throat
- Runny nose
- Postnasal drip
- Night sweats
- Sinus pressure
- Body aches
SIGNS AND SYMPTOMS OF NONINFECTIOUS ACUTE COUGH
Noninfectious acute cough signs and symptoms include:
- Cough that occurs when an individual is exposed to some certain forms of chemicals or irritants in the environment
- Coughs that comes with wheezing
- Coughs that improve with allergy medications or inhalers.
CHRONIC COUGH
Chronic cough otherwise known as persistent cough is a cough that persists over time. A persistent cough is not a disease but symptoms of an underlying health problem.
The best way to categorize the causes of chronic cough or persistent cough is to group them with respect to their location in the lungs.
Categorically chronic cough causes can be grouped as follows:
- Environmental irritants
- Condition within lungs
- Along the passages that carries air from the lungs to the environment
- Within the chest cavity which is outside the lungs
- Digestive causes
Other common causes of chronic or persistent cough include:
- Postnasal drip. This is a situation whereby the nasal passage is congested, resulting in mucus dripping down the throat from the back of the nose which prevents breathing, and it is caused by a condition like sinusitis or rhinitis
- Gastro oesophageal Reflux Disease (GORD). It is happens when the throats becomes irritated by leaking stomach acid. It occurs as a result of rising of hydrochloric acid in the stomach up to the oesophagus which causes irritation of oesophagus and larynx and trigger cough.
- A prolonged respiratory tract infection such as chronic bronchitis
- An allergy reaction
- Asthma also has other symptoms like shortness of breath, wheezing and chest tightness.
- People who smoke tend to cough as a result of COPD
- Bronchiectasis -This is a condition when the airways or air passage of the lungs become abnormally widened
- Some prescribed medication like angiotensin converting enzyme inhibitor (ACE inhibitor), which is often used to treat cardiovascular disease and high blood pressure or hypertension.
Also, chronic cough can be symptoms of underlying health condition such as heart failure, lung cancer, tuberculosis or a pulmonary embolism (blood clot on the lungs).
TYPES OF CHRONIC COUGH (PERSISTENT COUGH)
- Dry Chronic Cough: A dry chronic cough is one that doesn’t produce any mucus and causes irritation to the lungs and throats. A dry chronic or persistent cough may be symptoms of a viral infection or sinus problems.
- Stress Cough: This is a reflexive spasm of the air passages and it happens when an individual is under stress. Just like dry chronic cough, it produces no mucus. However, it is not generally related to infections.
- Wet chronic Cough: This is a cough that produces mucus (sputum). Depending on the color of the mucus may indicate whether it is a bacterial infection or fluid in the lungs (congestive heart failure).
- Whooping cough: Whooping cough also known as pertussis is caused by serious bacterial infection and is highly contagious respiratory tract infection caused by the bacterium called “Bordetella pertussis”.
SYMPTOMS OF CHRONIC COUGH
- Sore throat
- Heartburn
- Stuffy or runny noise
- Phlegm
- Hoarseness
- Difficulty in breathing
- Chest Pain
- Fever
- Weight loss
- Coughing out colored phlegm
- Sour taste in your mouth
TREATMENT FOR CHRONIC COUGH CAUSED BY UNDERLYING HEALTH CONDITIONS
Chronic cough can be treated by treating the underlying disease condition. Symptoms can be relieved with medications, sold over-the-counter (OTC). Cough medicines containing dextromethorphan or guaifenesin can be found in cough reliever.
Chronic cough caused by medication or diseases can be treated as follows:
- Gastro esophageal Reflux Disease (GERD). Chronic cough caused by Gastro esophageal Reflux Disease can be treated by avoiding foods that increase reflux, elevating the head while sleeping, avoid eating foods while lying down and taking medication such as cimetidine (tagament), famotidine (Pepcid), lansoprazole (Prevacid), ranitidine (Zantac), omepra zole (prilosec), rabeprazole (Aciphex), esomeprazole (Nexium) in other to decrease stomach acidity.
- When an individual suffering from asthma inhales, bronchodilators and steroids, decreases inflammation of the airways and also decreases the rate of wheezing. Also, short-term steroids are often prescribed to relieve chronic cough.
- In severe condition of chronic cough, codeine or other narcotic medication which are effective as cough suppressants may be prescribed.
- Postnasal dripping and sinus problems. The use of decongestants like antihistamines such as diphenhydramine or pseudoephedrine (Sudafed) may increase the symptoms of postnasal drip or runny nose, which can cause persistent cough. However, inhaled nasal steroids are often effective in treating allergic rhinitis, also referred to as hay fever, which is a common cause of cough. Other nasal inhalers like ipratropium bromide (Atroveny) can help to relieve postnasal dripping. Antibiotics may be prescribed by health provider if it is caused by sinusitis.
TREATMENT FOR CHRONIC COUGH CAUSED BY INFECTIONS
INFECTIONS
Bacterial pneumonia and bronchitis are exemplary infections treated with antibiotics like cephalosporins, azithromycin (Zithromax), and some other antibiotics. When pneumonia is close to the wall of the chest, inflammation surface of the lung can cause pain which is called pleurisy and pain. Analgesics reliever can help suppress the pain. However, cough suppressants are used cautiously in these situations because clearing the lung of the infected mucus by coughing will help to clear the infection. Bronchitis which is caused by viral infection occurs mostly in adults. In this case, treatment of bronchitis is quite the same as that of the common cold such as fluids, pain relievers, humidification and rest. Some people use expectorant cough reliever containing guaifenesin to alleviate their discomfort. Therefore, it is sometimes difficult to differentiate a viral bronchitis from a bacterial bronchitis and antibiotics are often prescribed.
CAUSES OF COUGH
- VIRAL INFECTION: Viral infection is also one of the most common causes which usually appears as the flu symptoms retreats. Productive cough tends to eliminates germ mucus from the lungs and it shouldn’t be suppressed.
- The airways that connect the lungs to the external environment are known as the upper respiratory tract. Chronic postnasal drip, chronic sinus infections, infections of the throat, diseases of the external air and use of ACE inhibitor medications for high blood pressure have all been the cause of chronic cough.
- Any form of environmental substance that irritates the airways or the lungs is capable of causing a chronic cough with continuous exposure. Smoking of cigarette is the one of the most common causes of chronic cough. Others include pollens, pet dander, pollution, particle, dusts, pipe smokes and industrial chemicals.
- Apart from the disease caused within the airways and lungs, diseases elsewhere within the chest cavity may also result to chronic cough such as an abnormal increase in size of the aorta, unusual growth of a lymph and cancer.
- Common cold is an infection that affects the upper respiratory system. It is usually caused by a virus which affects the nasal passage, sinuses, trachea, throat and Eustachian tubes.
- Chest infection is the term used to describe lungs or airways infection. When it affects the alveoli, it is referred as pneumonia. However, if it affects the airways it is referred to as bronchitis. It is contagious when an infected person sneezes or coughs next to you.
- Heart failure, lung inflammation and whooping cough (pertussis) can result to cough.
ARE COUGHS TRANSFERABLE?
They are said to be a reflexive action of the body, cough itself is not transferrable i.e they are not contagious. However, the cause of the cough can make it contagious. Normal coughs are not contagious.
Coughs caused by bacteria or virus are contagious and preventive measure should be observed to prevent spreading of the infection, because disease caused by bacteria is contagious through sneezing and coughing such as whooping cough caused by bacteria called “Bordetella pertussis bacterium and Bronchitis is the inflammation of the bronchi etc.
However, coughing is a way of clearing airways of irritants and to clear obstructed airway.
WET OR DRY COUGH
Dry coughs are often not associated with phlegm. A dry cough is usually accompanied with a tickle at the back of the throat and it is often irritating.
While wet cough also known as chesty coughs is often accompanied with phlegm. When a person is exposed to irritants or infection, it can cause excessive mucus production in the body which clogs up in the air passage. Common wet cough symptoms include:
- Having difficulties breathing
- Congested chest
- Sticky mucus is produced
- Coughing more than usual in the morning
- Restless night
HOW TO CARE FOR YOURSELF WHEN COUGHING
- STAYING HYDRATED. By staying hydrated, it will help relieve your dry throat. When coughing, water is your best drink to take. Try to drink lots of warm water as this will make you stay hydrated and prevent you from being dehydrated. By drinking plenty water which will help to reduce the cough reflex and also help to thin out the mucus.
Drinking water will also help to make it easy for you to cough out the phlegm. Always have a flask full of warm water on your bedside table. In this case, you will be able drink it anytime you want to cough.
Warm tea or soup can also help you get the fluid needed and is one of the best ways to soothe sore throat. Try to avoid caffeinated and sugary drinks and also drinks high in calories as they tend to dehydrate your body. Stay clear of dairy products as they tend to thicken phlegm.
Also try and gargle with warm saltwater in other to cleanse the throat and get rid of mucus. It can also clear away allergens and bacteria.
- HEALTHY DIET. Eating nutritious food will help to fortify your body and protect your body against foreign substances such as bacteria or virus that is capable of initiating cough.
Eat diet rich in Vitamin C because food rich in vitamin C can help your body to recuperate better. Food rich in Vitamin C includes kiwi, bell peppers, broccoli and other citrus fruits. Fruits and vegetables such as oranges, cranberries, pineapples and apples are amazing health boosters.
Eating chicken soup can also help to soothe and loosen congestation.
- STAY CLEAR OF ALCOHOL AND SMOKING. Alcohol tends to dehydrate the body unlike water that hydrates the body. Alcohols can wreak havoc and have a negative effect on your immune system. Alcohol tends to cause acids build up in the stomach, as in the case of Gastroesophageal Reflux Disease (GERD) and this will bring about coughing. In addition, Alcohol tends to have severe adverse reactions with the cough medications. Taking alcohol with cough medication is like putting pepper on a fresh wound, it may lead to unconsciousness, vomiting or severe headache.
A person suffering from cough and still continues to smoke will only aggravate their cough by irritating the air passage. Smoking paralyzes the tiny hairs lining the lung which is referred to as “Cilia” which helps to clear out mucus and dirt. Exposure to smog, particular matters, industrial chemicals or other air pollutants will also have the same effects in your airways. Perfumes with strong scents will also trigger irritation and cough.
- AVOID STRESSING YOURSELF: Stay clear from anything that can lead to stress and try as much as possible to relax. By avoiding stress or any exhausting activity, your body will be able to relax and also will be able to protect you against foreign bodies and get rid of infection.
Always elevate or raise your head when sleeping. In other to avoid postnasal dripping, add pillows to your head and it will also help to prevent mucus from flowing down to your throats thereby causing irritation. If possible stay at home when you have a fever or bad cough because this will prevent you from infecting others.
Try not to go to polluted environment when going out and remember to go out with nose cover or handkerchief.
- ENSURE YOUR ENVIRONMENT IS NOT POLLUTED. Make sure that you are staying in a clean and arranged environment. Stay in a clean, smoke free and dust free environment always as this can prevent throats irritation which can lead to further coughing. Have your environment cleaned and disinfected as a polluted environment harbors bacteria and viruses.
Use a hand sanitizer to sanitize your hands when you are far away from water and soap. Air dry your hands when you use soap and water to wash your hand, as this will prevent you from inviting another bacterium to the already washed hands.
Avoid seating in high polluted environments or using coal heating or cooking as this tends to increase your risk of cough.
- ADJUST YOUR ROOM TEMPERATURE AND HUMIDITY. Always keep your room warm and not overheated. If the air is too dry, a ventilator or a cool-mist humidifier can help moisten the air and help soothe coughing and congestion. Also keep the ventilator clean as directed by the manufacturer to prevent the growth of molds, fungi and bacteria.
- ALWAYS KEEP THINGS CLEAN. Cleanliness they say is next to Godliness. Cleanliness will help you to keep the virus under control and also help to prevent cold from spreading. Ensure to keep things clean and disinfect frequently touched surfaces at home, school or workplace.
- ALWAYS KEEP YOUR NOSE CLEAN. When you rinse your nose with water, it helps to flush out cough inducing mucus and allergens from your nasal passages and airways. You can use a saline spray or nasal irrigation.
In addition, we will like to throw in some low cost natural remedies for cough. These remedies have been proven to be effective in reducing and eliminating coughs completely.
NATURAL REMEDIES FOR COUGH
- Honey is an easy and effective way to suppress cough and soothing throat. If possible, add ginger powder to the honey for quick suppression. Honey helps soothe and coat mucus membranes. Honey is as effective as cough reliever such as dextromethorphan.
- THYME TEA. Thyme is used as respiratory ailment. Its helps to relax the throat muscles and decrease inflammation. Get hot water and place the water in a cup, add two tablespoons of crushed thyme in the cup and leave for at least 10 minutes before straining and then drink. You can add honey to the strained thyme tea before drinking.
- TURMERIC POWDER. Turmeric helps to relieve cough and it is very effective. You can use turmeric powder and a tablespoon of honey for dry cough.
- GINGER AND PEPPERMINT. Ginger has the ability to loosen mucus when taken. Ginger and peppermint helps suppress the irritation in the back of the throat which triggers or causes coughs. You can also add honey to the mixture for an effective result.
Consistent use of these highlighted remedies will improve the causes of your cough. However, if the cough persists, do not hesitate to visit your doctor.