A cough is not necessarily to be worried about always. It is the natural response of our body to throw out harmful particles which somehow managed to enter our respiratory tract. There is sticky mucus situated in the pathway to lungs which plays a major role in trapping harmful particles. Coughing once or twice is generally a natural phenomenon but if it s persistent it is called the chronic cough, and there is a reason to worry.

Is your cough chronic?
An acute cough aggravates within a very short span of time, maybe 2-3 days. There are situations when coughing doesn t hinder your day to day activities and are easily neglected. Sometimes these infrequent bouts of a cough can persist for long and continue for more than 2 months, which has been characterized as a chronic cough.

A chronic cough is sometimes found associated with blocked or running nose. Persons suffering from a chronic cough feel very exhaustive and suffer from a headache, dizziness along with excessive sweating. Under such situations, you must consult a pulmonologist.

Know the causes of a chronic cough
There are several causes for persistent coughing, and the following are the common causes of a chronic cough and medication is taken in consultation with a trained medical practitioner only.

Infections: Bacterial or viral infection in lungs can be one of the causes of a chronic cough. Tuberculosis is one of them which initiates as a chronic cough and is later characterized by emitting blood after cough bouts.
Drug Interactions: Antihypertensive drugs have been found to be responsible for a chronic cough in some people. Hypersensitivity to the prescribed drugs is found to responsible for the cough bouts, and change in medication takes care of the issue.
Asthma: It s a situation characterized by blockages in the bronchi which disallows the normal air flow during inhalation and exhalation. Due to inadequate oxygen, brain assumes that there is a blockage which needs to be expelled and coughing pattern starts. However, asthma has to be treated, and the bronchi have to be brought back to normal with the help of medication by an expert medical practitioner.
COPD: The most common cause of a chronic cough nowadays is COPD, better known as Chronic Obstructive Pulmonary Disease. This is one of the progressive diseases which means it deteriorates with time. Active smokers are the biggest victims of it. Persons exposed to high degree of pollution or similar occupational hazards are also at high risk. Exposure to these pollutants causes inflammatory responses in lungs resulting in the tapering of the airways and destruction of lung tissues. These can be measured by lung function tests. In asthma, the narrow airways can be broadened by external medication, but in case of COPD, it s not possible.
To conclude, chronic cough is a preventable disease by reducing the exposure to risk factors as mentioned above. Quitting smoking, improving the indoor air quality with the use of solar cooking and moving on battery run vehicles can prevent COPD from further worsening. You can also undergo pulmonary rehabilitation program which is being counseled and coordinated by many physicians to benefit the individual suffering from the issue.

Chronic Cough - Why It Happens?

Cold and cough is caused by a viral infection, which can last for about two to four weeks. The symptoms include stuffy or a runny nose, coughing and sore throat. Many times, the infection may raise body temperature and the child may suffer from fever. Our body s immune system naturally fights with such infections. Depending on the type of cough and the symptoms, the virus can stay active in the body for about 4 to 6 weeks. It is quite painful to see the child suffering from cold and cough. The symptoms of this infection are worse during the first two days.

The child will experience pain and irritation in the throat with difficulty in swallowing, frequent coughing with mucous, breathing difficulty and high fever. Most parents rush to over the counter drugs for cold and cough to ease of their child s agony. However, most drugs/ cough syrups available over the counter only provide temporary relief. Medical evidence suggests that antibiotics do not kill viruses, thus, it is not advisable to treat cold and cough with antibiotics unless accompanied by another infection. So, what do parents do? Well, there is a lot that can be done.

Let s first understand the type of a cough your child might be suffering from:



Dry cough: Generally occurs due to infection in upper respiratory tract, cold or influenza. Children with asthma and allergies are also prone to this type of cough as dry cough is triggered by smoke or dust.
Croup Cough: A harsh barking and dry cough with swelling beneath vocal cords.
Wet Cough: Most commonly caused by cold. This is an infection of the lower respiratory tract characterised by mucous secretions.
Whooping cough: Characterised by fast coughing, breathing difficulties and a whooping sound while breathing.
Apart from this, If coughing starts suddenly along with choking, the child may have inhaled a foreign body. Immediate help may be required. For babies less than 12 months of age, cold cough followed by breathing difficulties may indicate bronchiolitis and require a paediatric attention. A normal cold and cough generally subside with two to four weeks. However, it is important to understand when to consult a doctor.

Chest pain or breathing problems
Cough lasting for more than 6 weeks.
A yellow, green or brown mucous indicating another infection.
Swollen glands, persistent high fever, rashes.
Body getting pale and symptoms getting worse.
Temperature higher than 38 degrees in the case of infants.
Precautions and diet that should be taken care of

Increase Intake of fluids especially hot liquids
Never stop breastfeeding the baby
Vapour rub applied on chest and back is an effective remedy
Inhaling steam provides relief to a sore throat and nose
Intake of crushed tulsi leaves with honey or hot turmeric milk is soothing and very helpful
There is little we can do to prevent viral infections. However, proper care and caution can ensure a smooth recovery.

Cold and Cough in Children - Precautions that Parents Must Take

Fever in children is a very common phenomenon, but still parents absolutely dread it. It can completely break your heart to suddenly see a happy, healthy child not getting up from the bed. Your first instinct when that thermometer crosses that dreaded 100 degrees F is to rush to the doctor for an immediate cure. That is probably the best remedy as a doctor can often catch additional signs of any disease that you may miss out on. Beyond that, here is how you can understand about fever in children better and how you can help. Technically, your child has fever when the body temperature crosses 100.4 degrees F.
 
Some children manage to stay active even then, but slowly get bogged down with muscle pain or other accompanying symptoms like cold, diarrhea, vomiting etc.
 
Causes: Fever is normally caused by the body's reaction to fighting an infection. (That is why most doctors say it's a sign of a robust immune system). When the body's natural defense system is stimulated, the core inner temperature rises, thereby making it harder for the bacteria and viruses that caused the infection to survive. Most fever subside on their own but that's a tough thing to accept as a parent who only wants to see their child up and running as soon as possible.
 
What you can do: Keep an eye on that temperature obviously. You need to find a doctor the moment the fever crosses the threshold temperature (101+ for less than three months olds, 102+ for 3-6 month olds and over 102 for older children). You should also see a doctor if there are accompanying symptoms or if you've given a dose of Paracetamol but the fever shows no sign of subsiding. It might happen at midnight and beyond, when no regular pediatrician is unavailable. So it is best to find out which hospital has an emergency center capable of handling such eventualities near your home.
 
Fever medications: It is super important for parents to know that fever medications must be given in the correct dose at the right times based on a child's weight, age, and overall health. An overdose can lead you straight to the emergency room. Don't mix a cold/cough medication that also has a fever medication in it.
 
Home remedies: Encourage your child to drink as much fluids as possible to prevent dehydration. Some doctors advise complete body sponging to bring down the temperature and this can be done as long as it doesn't cool the body too suddenly (there are contradictory notes on this practice, so do consult you doctor before your do this).
 
As parent, it is important you equip yourself with the right knowledge before you provide treatment to your child. 

Parenting Tips for Fever in Children

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?


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.

Click on Consult Privately to ask me a private question on this topic or a related one.

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Alert! Don't Ignore These Signs of Lung Cancer

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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