Cough


βήχαςWhat is cough?

Cough is an important reflex that helps the human body to ‘cleanse’ the airways (the set of tubes that lead to the lungs). It is useful to help people be protected from inadvertent entry of objects within the airways and within the lungs, which would have very significant adverse effects on health. It is normal for a person to have to cough infrequently, but several times, chronic cough hides a serious condition or illness. By the term “dry cough”, we mean cough that is not accompanied by sputum (phlegm). In contrast, productive cough is by definition, accompanied by sputum. Also cough can be mild and not causing particular problems, or, conversely, can be so severe to the point that causes breathing disorders.

What are the common causes of cough?

In adults the most common causes are:

  • Respiratory infection (eg common cold, pneumonia etc.)
  • Postnasal discharge – mucus from the nose drops to the throat. This situation usually accompanies the following:
  1. The common cold
  2. Allergies
  3. Sinusitis – The sinuses are cavities within the facial bones that communicate with the nose.
  • Pulmonary diseases that cause shortness of breath, like asthma and chronic obstructive pulmonary disease (COPD).
  • Gastroesophageal reflux disease (GERD) – The GERD happens when acid that is normally present in the stomach reflux up into the esophagus (the tube which intervenes between the mouth and stomach).
  • Side effects of antihypertensive drugs (angiotensin converting enzyme inhibitors – ACE inhibitors)
  • Smoking

When to consult your doctor?

  • When you breathe with difficulty or have noisy breathing (stridor).
  • When you have chest pain or fever.
  • When you expectorate  blood, yellow or green phlegm with your cough.
  • When the cough is so persistent that makes you vomit.
  • If your cough persists or worsens over 10 days.
  • When you lose extra weight, although you do not try that.

Will I need any tests?

Maybe. To determine the cause of your cough, your doctor will ask you some questions (medical history) and will examine you clinically. Depending on your symptoms and other factors, your physician may request additional tests. These may include the following:

  • Chest X-ray
  • Breathing tests (blowing into a special tube). These tests show the function of your lungs.
  • Allergy skin tests to detect any allergies you have and are not aware of. For these skin tests, the doctor puts a drop of the potential allergens to your skin and then makes a slight tweak to your skin. After the next few minutes your skin will be examined for any curved at  reaction to the allergen.
  • CT of chest and sinuses. Computed tomography is an imaging test that creates images from inside the body.
  • Laboratory tests of your sputum.
  • Bronchoscopy – laryngoscopy. With a fine instrument your doctor can have an overview of the larynx and bronchi.
  • Tests to check for GERD. These usually involve placement of a fine instrument through the mouth into the esophagus and stomach.

Is there anything I can do myself to get rid of cough?

Yes, to reduce or even get rid of the cough, you can do the following:

  • Drink a great amount of liquids
  • Antitussive syrup
  • Stop smoking

If you suffer from acid reflux, your doctor will advise you about some changes in your lifestyle that may reduce your symptoms.

What is the treatment of cough?

Treatment depends on the underlying etiology. For example:

  • Some infections are treated with antibiotics. If the infection is caused by bacteria, your doctor may prescribe antibiotics. If the infection is caused by a virus (eg common cold), your doctor will not give you antibiotics because viruses are not suppressed by antibiotics.
  • The postnasal discharge is treated by various means eg pills or nasal spray.
  • Asthma and COPD are usually treated with inhalers.
  • The GERD can be cured by treatment that reduces or neutralizes the acid in the stomach.
  • If you have cough because of an antihypertensive drug, your doctor may change your current medication.
  • If the cause of cough is still not clear, your doctor may prescribe you some medications to help you get rid of the cough, or reduce its intensity. However, your doctor may take such action only when the previous therapeutic measures have not helped you.

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