Coughing is a common problem of the respiratory tract and often indicates a deeper problem. It can be very irritating and can affect eating habits and socialization. A cough which persists for more than 4 weeks is believed to be chronic in nature. Tuberculosis (TB) is the most common cause of chronic cough in India. TB is an airborne bacterial infection caused by the organism - 'Mycobacterium tuberculosis', that primarily affects the lungs, although other organs and tissues may be involved. Cardinal features are: 

Chronic cough with or without sputum.
Fever more in the night time. 
Poor appetite. 
Unintentional weight loss. 
Read on to know about other common causes of chronic cough and how to manage them.

Allergies: People with allergies usually have a chronic cough, which gets aggravated when exposed to the allergens such as pollen or environmental dust. Staying away from allergen provides relief. Antihistamines are also useful, which most people detected with allergies keep in handy. Inhalers might be required, if there is associated congestion or shortness of breath.
Asthma: This is a very common chronic condition, caused by inflammation and swelling of the lungs, in addition to wheezing and shortness of breath. Asthma patients often suffer from a chronic cough. An asthma attack usually happens during the night or early morning, and is triggered by colds, cigarette smoke, air pollutants or allergens, which can even include certain foods. Most asthmatics usually carry their steroids, inhalers, and bronchodilators, as the onset of attack can be unpredictable.
Bronchitis: This condition of inflammation of the bronchial region is very common among smokers and among the elderly. There is excessive mucus accumulation, which the body tries to clear via coughing. The lungs are weakened and therefore, the coughing is painful.
Gastroesophageal reflux disease (GERD): This is a problem of the digestive system, but regurgitation of food into the airway induces cough. GERD is a chronic issue and so most people also end up with a chronic cough. It is worse with sitting up than with sitting down. Treatment includes H2 blockers to suppress acid production and dietary changes including small, frequent meals and avoiding spicy food items.
Upper airway cough syndrome: There could be multiple problems in the upper airway, which leads to a constant postnasal drip. Here, there is constant dripping of the sputum into the air passage, which can lead to a chronic cough whenever there is impaired air flow. This can be caused by various forms of chronic sinusitis and rhinitis. People diagnosed with this condition usually resort to antihistamines and decongestants for relief.
Other causes: There are a number of other causes as noted below. Smoking, tuberculosis, congestive heart failure, pertussis or whooping cough, foreign body in the airway, cancer in the airway passage, chronic aspiration of foods, etc. can all lead to chronic cough.
The key is to identify the reason that is causing the chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers.

Suffering from Chronic Cough - How to Manage it?

Seasonal changes can be very exciting for most people. Each season brings with it a new set of colours and nature takes a new turn. However, for people with seasonal allergies, a seasonal change also comes with a set of allergies. From skin rashes to wheezing to breathing difficulties, the list of symptoms can be quite long. Asthma is the most common problem, and the attacks can be quite bothersome with wheezing attacks and breathing troubles.

With advancements in the field of medicine, there is a lot of relief for asthma patients. A little understanding on how asthma attacks happen will help in understanding how to control it. Asthma is an allergic reaction caused by narrowing of the airway with thick mucus, which makes breathing difficult. During an attack, the person can have a dry cough, face shortness of breath and wheezing.

Asthma is often triggered or worsened by some factors, and being aware of these can help prevent or manage an attack:

Common allergens like pollen, mites, ticks, furs of animals, bird feathers, specific foods (peanuts, milk products, eggs, etc.) and mold spores appear during change of season.
Environmental chemicals like cigarette smoke, car fumes, dust, etc., can also trigger an attack.
Attacks of cold or flu can lead to an asthma attack.
Workout during cold weather can be problematic, but exercise can also help control asthma attacks. Lung function improves sufficiently, but an exercise regime should be drawn up for the patient based on his condition.
Stressful emotions like anger and anxiety can also lead to an attack or make it worse.
Some medications like aspirin, beta blockers, glaucoma drops can aggravate attacks of asthma.
Once you know the triggers, here are some common measures that can help prevent and relieve the wheezing.

The preventers reduce the inflammation in the airway tube and the swelling. While they do not provide immediate relief during an attack, using these in the long term helps avoid attacks. These are low-dose inhaled corticosteroids such as beclomethasone, fluticasone, and budesonide. Doctors would advise their usage even when there are no symptoms, as asthma attacks can be triggered when they are not taking these medications for a while. Newer drugs include leukotriene antagonists like montelukast and zafirlukast. Relievers are used for symptom relief and include Salbutamol (short acting) and Salmeterol/Formoterol (long acting). Peak flow meter may be useful in acute attacks, wherein the peak flow rates can be reduced.
A good strategy is to use preventers regularly and rely on relievers during an attack. The first one helps build resistance and so reduces the incidence of attacks. Reach out to a doctor if a severe attack ensues (lasts more than 3 hours).


Tips to Control Allergy Driven Wheezing this Season


Lung cancer may not always give out noticeable symptoms in the early stages. Most cases get diagnosed in later stages. It can happen to anybody irrespective of age or geographical location although smokers fall under high risk groups. Prevention and awareness can help. Check these lung cancer symptoms as early screening/diagnosis may help people fight the disease.

1) Unstopable Cough: Be cautious if your cough lingers. While a cough associated with a cold or respiratory infection will go away in a week or two, a persistent cough that lingers can be a possible sign of lung cancer. Don't dismiss a stubborn cough, whether it is dry or mucus-producing, as "just a cough."  See your doctor right away.

2) Disrupted Chronic Cough: Pay attention to any changes in a chronic cough, esp. if you smoke. If you are coughing more often and it has gone deeper or hoarse, or you are coughing up blood or more mucus than usual, it’s time to make a doctor’s appointment.

3) Short breath: Shortness of breath or becoming easily winded is also a possible symptom of lung cancer. This symptom occurs if lung cancer blocks or narrows an airway, or if fluid from a lung tumor builds up in the chest. Keep a track of how quickly you go short on breath. Does it happen while taking stairs or doing routine jobs is a question to answer.

4) Wheezing: When air passages of the body become blocked, constricted, or inflamed, the lungs produce a wheezing  or whistling sound as you breathe. While it can be due to other causes, wheezing is also a lung cancer symptom, which is why it demands your doctor’s attention. If wheezing continues, don’t assume it’s asthma or an allergy. Let your doctor find out what's causing it.

5) Chest Pain: Lung cancer may cause pain in the chest, shoulder, or back area. These aches may not be associated with coughing. Consult a doctor if you notice any type of chest pain, whether it is sharp, dull, constant, or twitching.

6) Hoarse Voice: If there is a noticeable change in your voice that stays for more than 2 weeks, or if someone else points out that your voice sounds hoarse or deeper, get it checked out by your doctor.

7) Loss of  weight: A sudden and unexplained loss of weight can be associated with lung cancer or another type of cancer. Cancer cells use energy in the body. Do not ignore it.

8) Painful Bones: If it gets spread to the bones, lung cancer may produce pain in the back or in other areas of the body. This pain may get worsen at night while resting on the back. Notice your aches and pains, and discuss them with your doctor.

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Alert! Don't Ignore These Signs of Lung Cancer

A cough is probably one of the most common respiratory diseases that people suffer from. In most cases, it is nothing to worry about and can be cured with cough suppressants and salt water gargles. However, coughing of blood is a serious problem. The coughing up of blood that originates from below the level of the larynx is known as hemoptysis. This can vary in terms of severity depending on the amount of blood being expelled. This disease is a common condition, but on an average, less than 5% of hemoptysis cases are life threatening.

Hemoptysis rarely affects children. The symptoms of this condition include:
Sudden onset of a cough with bloody phlegm

Fever
Anorexia and weight loss
Dyspnoea
Paroxysmal nocturnal dyspnoea
Fatigue
Chest pain: Medical attention should be sought in cases where this condition recurs often, if it lasts for longer than a fortnight or if the volume of blood expectorated is more than 30ml per day. The various tools that help in the diagnosis of this condition are:
Chest radiography: This imaging modality helps lateralize bleeding and understand the amount of lung involvement. It is quick, inexpensive and can also help detect other underlying abnormalities.
Bronchoscopy: This involves the insertions of a rigid or flexible endoscope into the bronchial passages to check the airways and determine active bleeding sites.
MDCT: A multidetector CT is a non-invasive imaging tool that provides a comprehensive evaluation of airways, lung parenchyma, and thoracic vessels. It can also be used to uncover potential causes of bleeding such as bronchiectasis, pulmonary infections and lung cancer. In some cases, a multidetector CT angiography may also be used.

Oral antibiotics are usually the first stage of treatment for this condition. Smokers will also be urged to quit cigarettes as this can worsen their condition. Treatment for minor hemoptysis may also include:

Oral hemostatics
Cough suppressants
Anticoagulants
Radiation of laser treatment
Therapeutic bronchoscopy
In its later stages, hemoptysis can be treated with a minimally invasive procedure known as endovascular embolization or with surgery. In some cases, endovascular embolization may also be sued to stabilise the patient before surgery. This procedure reduces the pressure in the hypertrophic arterial blood vessels and decreases the risk of perioperative bleeding.

Hemoptysis is also one of the most common complaints of lung cancer patients. Depending on the stage of cancer and the amount of blood expectorated, treatment in some cases may not be possible. In such cases, a parenteral opioid and fast-acting benzodiazepine may be administered. 

How to Treat Coughing Blood (Hemoptysis) Problem

Coughing during the night can really wreak havoc for your sleep and cause inexplicable discomfort in the throat and chest region. Thankfully, you can manage it by soothing your tickling throat as well as sensitive airways before you go to bed at night. 

Drink herbal tea: A mugful of non-caffeinated tea mixed with a teaspoon of honey before going to bed can help you to a considerable extent. This is because any warm liquid has the power to break down the formation of mucus in the throat region and with a bit of honey, the herbal tea becomes even more powerful.
Try to sleep in an inclining position: Gravity is your greatest enemy while combating night-time cough. When you lie down flat on your back at night, all the mucus and dust particles, which you have swallowed all through the day, would accumulate in the throat area and aggravate it making more cough. But you can easily defy gravitational force by piling up some pillows and prop yourself on them while sleeping. You may also keep a wooden block of 4 inches height under your head, which would keep the acids in the stomach so that they don t come up to irritate your throat.
Make sure you use the steam cautiously: When your airways are dry, it can make you cough harder. Therefore, you may find relief if you take a warm shower or a bath before going to bed. But you have to be sure that you don t have asthma as steam can prove harmful for you.
Check the level of humidity: Humidifiers are known to soothe the problem of persistent coughing when the surrounding air is dry. But too much of moisture during the night can also make you cough. This is because dust mites, mold and other allergens thrive well in the damp air and they could conspire to make your cough even worse. So, pick up a cheap hygrometer from a hardware store and see that the humidity level stays within 40 to 50 percent.
Equip yourself at night: Keep all the things from drops to water to cough syrup or anything that soothes coughing at your bedside so that you can help yourself in case you wake up in the middle of the night and start coughing.
By following these few tips every day, you can manage the night time cough and have a good night s sleep without any interruptions.

Night Time Cough - 5 Tips to Manage it

Have you been coughing for a long time and don't know what to do? Well, here are 5 ways in which you can manage your chronic coughing:
1. Give up Smoking: Give up smoking before life gives up on you. Quitting at any point of time slows down the deterioration of lung function though not reverting to non smoking status.
2. Practice Pursed Lip Breathing: It's a very useful technique. Breathe in with your lips sealed up and breathe out with your lips slightly opened as if you're blowing birthday candles.
3. Wear a Mask when Going Out: Be cautious while going outdoor when there is sudden change in ambient environmental temperature and when pollution is high or pollen are there in the environment. (Actually simple mask do not help too much)
4. Stick to the prescribed inhaled treatment - Rush to doctor if there is increase in breathlessness, cough and/or sputum production which is not controlled by ongoing treatment. That marks exacerbation and may need hospitalisation.
5. Get vaccinated - by annual influenza vaccine and if you are above 65 then an additional single shot of pneumococcal vaccine. This will prevent infectious exacerbation.


Chronic Bronchitis - 5 important tips to manage it

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