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

Whooping Cough (another name for Pertussis) can be termed as an infection to the respiratory system caused by the bacterium Bordetella Pertussis (B. pertussis). It generally affects infants (below one year of age) and who have not yet been immunized; also kids between 11 to 18 years of age whose immunity graphs are on a downward spiral.

What are the Signs and Symptoms?
Initially, whooping cough produces signs and symptoms that may just seem to overlap with those exhibited during the average cough and cold; mild coughing, sneezing, runny nose, low fever, etc. These persist for about a week or two and then slowly, there is the onset of the dry, irritating cough which again turns to prolonged coughing spells. The child s face may seem flushed with a purple hue. The child may also vomit or make the distinctive whooping sound at the end of one such spell. Breathing difficulty can be another issue.

What is the Diagnosis?
The doctor performs an initial check-up followed by tests of mucus sample from the nose or throat. The mucus is checked for the presence of the Bordetella pertussis bacteria. To make a more thorough diagnosis, a blood test is also advisable.

What is the Treatment?
Hospitalisation might be required in case of acute distress. Respiratory support may also be provided if required. If there is intense dehydration, intravenous (IV) fluids may also be administered. As this disease is on account of a bacterial infection, antibiotics will be needed. But these will just treat the immediate effects and the cough cannot be completely done away with.
What can be the Possible Complications?

The possible immediate complications include:

Brain Damage
Pneumonia
Convulsion
Haemorrhaging in the brain
What can be the Prevention?
Vaccination is needed in order to prevent whooping cough. The vaccines are advised to be administered at the age of two months, four months and six months respectively. The 1st booster dose is to be given at 16 to 18 months age and 2nd booster dose is given on 5 year completion of age. An optional booster may be given at 10 year age.

Whooping Cough in Kids - How It Can Be Treated?


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 a sign that there is something wrong with the throat. Be it an infection or a sore throat or food stuck in the windpipe, a cough can start. While it may sometimes disappear, sometimes, it may just refuse to go. This not just is bothersome to you to allow to continue work, it also irritates the others in the surrounding and attracts attention. Everybody looks at you annoyed and gives a look which says  why don t you do something about it?  Well, they mean well, and there are definitely things that can help manage a nagging cough. Find out for yourself!

Salt water gargling: Mix about a teaspoon of water in a glass of warm water and gargle your mouth for about 1 minute. It helps soothe the throat and reduce the cough. It can also clear the bacteria along the throat, providing relief from the cough. If there is phlegm lodged in the throat, it gets easily expelled too.
Honey: This viscous liquid coats the inflamed and irritated mucous membranes along the throat and provides instant relief. It is also known for its antibacterial nature and has good enzymes from the bees, which are known for providing instant relief to both children and adults. The sweet taste makes it further appealing. Adding ground black pepper powder to it further improves the effect, as it clears congestion.
Steam: Cough is often the result of an irritated and inflamed throat mucosa. Inhaling steam is one of the best ways to soothe this mucosa and provide relief. It reduces mucosal inflammation and removes phlegm. Adding a few drops of essential oils like eucalyptus or tea tree oil further improves the effect. These have antibacterial and antiviral properties and so enhance the relief. With boiled water in a vessel, bend over it and cover your head to ensure the steam is inhaled. Be careful to avoid burns, as steam can burn. This can be repeated 4 to 5 times daily until you get sufficient relief.
Ginger and Mint: Another wonder substance is the ginger. To a cup of warm water, add honey, few slices of ginger, and some dried peppermint. This helps by acting as an expectorant and reduces irritation in the throat, which produces cough.
Cough drops or lozenges: If you are in a public space and cannot do the above, try cough drops. Sucking on them can soothe the throat and the constant swallowing of saliva helps relieve the irritation in the throat.
Nasal irrigation: This helps relieve the postnasal congestion and dripping, which often leads to nagging coughs.
These are some simple, effective ways to reduce constant coughing.

Nagging Cough - 6 Quick Ways You Can Manage It!

Coughing of blood is a serious problem in comparison to normal coghing. 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.

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.

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
What should you follow in following situations?

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 determines 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.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Coughing Up Blood: Know The Causes Of It! 

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