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Cough: Symptoms, causes, diagnosis and treatment
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Cough: Symptoms, causes, diagnosis and treatment

Acute cough can be the result of an upper respiratory tract infection
man coughing
Representational image | Shutterstock

A cough, also called tussis, is a reflex of the body to dislodge an irritant in the throat or air passage. The irritant or object can be smoke, mucus, excess water or even a piece of food.  

 A cough disperses microbes like viruses, which are present in the droplets that are expelled, and which transmit from one person to another. 

 A cough can be wet or dry. A wet cough is accompanied by mucus, and a dry cough does not bring up mucus but feels more like an irritation in the throat. 

 Frequent coughing among children can be caused by: 

Bronchiolitis – a mild viral infection of the lungs causing cough and wheezing. 

Paroxysmal cough – occurs intermittently and is uncontrollable. It is accompanied by vomiting.  

Pertussis or whooping cough – is caused by a bacterial infection that leads to violent coughing episodes. It is especially risky in babies and may be fatal. It can be prevented by vaccination. 

Croup or barking cough – is a viral infection that causes irritation and swelling of the upper airway. It is typically seen in children below the age of five.  

Symptoms 

 Cough by itself is a symptom and may require no treatment if it is an acute bout of reflex cough, which is a reaction to an irritant in the throat and airway.  

 If the cough is persistent and uncontrollable, it might require medical care. Usually this is accompanied by other symptoms like: 

  • Difficulty in breathing 
  • Fever and chills 
  • Thick sputum or mucus which is yellow or green and contains blood 
  • Vomiting 
  • Chest pain 
  • Choking sensation 

Choking on something, or any obstruction to the airway may have the following signs: 

  • The skin turns blue followed by loss of consciousness 
  • An inability to speak, or odd noises while breathing 
  • Panic 

Causes  

The characteristics of a cough including its duration and severity give indications of the underlying cause.  

Acute cough is usually a symptom of an upper respiratory tract infection like a flu attack, common cold or sometimes due to pollutants in the air.   

When coughing is irregular or chronic, it may be due to conditions like: 

  • Smoking 
  • Asthma 
  • Chronic bronchitis and pneumonia 
  • Post-nasal drip – the nose and sinuses produce mucus to help trap microbes and foreign particles. When the mucus produced is excessive or too thick, it may start dripping down the throat, causing a cough and sore throat 
  • Gastroesophageal reflux disease (GERD) – Sometimes excessive gastric acid washes back up till the throat, causing irritation and cough 
  • COVID-19, and long COVID (unexplained, recurring symptoms) 
  • Heart failure 
  • Certain medicines like ACE (Angiotensin-converting enzyme) inhibitors, which are prescribed for high blood pressure 
  • Tumour of the lungs 
  • Tuberculosis

Diagnosis 

 Most cases do not require any special diagnostic test. When there is suspicion of something serious, a few tests may be performed. These include: 

  • Chest X-ray 
  • Mucus or phlegm culture to determine an infection 
  • Spirometry helps to determine how effectively the lung is functioning. It measures the airflow which goes in and out of your lungs 
  • Other lung function tests may be done if there is chronic cough 

Treatment  

Most of the time, a coughing episode requires no special attention. But the following steps help to provide relief:  

  • Rest and plenty of fluids 
  • Painkillers may be taken if needed 
  • Viral infections usually run their course, and the cough clears in a week or two 
  • Honey is a good home remedy that soothes the throat and reduces irritation 
  • Cough suppressants are given for dry cough to suppress the cough reflex 
  • Expectorants loosen the mucus and facilitate bringing it up for easy ejection

But treating the underlying cause of a persistent cough is important. This can include: 

  • Quitting smoking 
  • Substituting medicine by your doctor that has no side effects such as cough 
  • Inhalational steroids advised by your doctor for inflammation due to asthma 
  • Antihistamine medicines directed by your doctor to reduce the effects of allergic reactions 
  • Antibiotics prescribed by your doctor to manage infections 
  • Antacid tablets and syrups directed by your doctor to curb and neutralise gastric acid  
  • The use of bronchodilators that relax and widen the bronchi prescribed by your doctor to manage COPD or congestive obstructive pulmonary disease 

Sources: 

1.https://www.lung.org/lung-health-diseases/warning-signs-of-lung-disease/cough/learn-about-cough 

2.https://www.cdc.gov/healthywater/hygiene/etiquette/coughing_sneezing.html 

3.https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/cough 

4.https://www.ncbi.nlm.nih.gov/books/NBK493221/ 

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