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 a longer period of time more than 4 weeks in children and 8 weeks or more in adults 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:
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 a 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 or PPI 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 airflow. 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 a chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers. Cough hygiene should be learnt and practised to prevent the spread of infections.
If you find yourself suffering from coughing spells accompanied by breathlessness and phlegm, you may have bronchitis. Bronchitis is a respiratory disease that causes inflammation of the bronchial tubes. This narrows the airway and does not allow sufficient oxygen to reach the lungs. There are two types of bronchitis; acute bronchitis that lasts for 1-3 weeks and chronic bronchitis that persists for 3 months to 2 years.
Causes of acute bronchitis
Acute bronchitis is usually a result of viral, lung infections. It can also be caused by bacterial infections and exposure to irritants such as tobacco smoke, dust, vapours and particulate matter in the air.
Causes of chronic bronchitis
Repeated attacks of acute bronchitis can weaken the bronchial passage with time and lead to the development of chronic bronchitis. This condition can also be caused by prolonged exposure to dust, pollution and industrial fumes. This puts coal miners, grain handlers and metal workers at a high risk of suffering from this disease. Smoking cigarettes can also irritate the bronchial tubes and contribute to the development of this condition. Chronic bronchitis worsens when a person is exposed to high levels of sulphur dioxide and other such air pollutants for prolonged time periods. Some of the symptoms of bronchitis are:
If these symptoms last for over a week or begin to interfere with your regular lifestyle, you should seek medical attention as soon as possible. Self-medicating with an over the counter cough suppressant is counterproductive in the case of bronchitis as a cough is the only way for phlegm and mucus to be expelled from the body. Conventional treatment for bronchitis includes
Along with this, your doctor may also prescribe cough medicines and a bronchial inhalator. In cases of chronic bronchitis, oral or inhaled steroids may also be needed. Your doctor may also suggest a flu vaccine as bronchitis make your lungs vulnerable to further infections. If you smoke, your doctor will also urge you to quit as cigarette smoke can aggravate your symptoms.
In cases of severe chronic bronchitis where the bronchial tube’s ability to pass oxygen is compromised, oxygen therapy may be needed. In such cases, you may need to have an oxygen tank on hand to be used continuously or as required.
A cough is a reflex action to clear the throat from mucus and the external irritants such as the dust particles, smoke, microbes, and fluids etc. In short, the cough is a quick eviction of air from the lungs, which passes through the mouth. It is a common reflex that helps remove the obstruction of breathing and does not need immediate medical attention at the initial stage. However, if a cough lasts longer, it may possibly a sign of the serious disease as well.
A cough can be divided into two parts viz. an Acute Cough and Chronic Cough. Coughs that last not more than 2 to 3 weeks are called Acute Cough while Chronic Coughs last longer than 3 weeks and can be dangerous for health. These kinds of coughs are known as Persistent Coughs as well.
Causes of Acute Coughs (Short-Term Coughs)
A quite common infection that causes the Acute Coughs is called the Upper Respiratory Tract Infection, which is also known as the URI or URTI. This infection affects the throat, trachea and sinuses, which triggers flu, common cold, and Laryngitis.
Another reason that causes Acute Coughs is called the Lower Respiratory Tract Infection (LRTI), which affects the lungs and lower airways. This infection causes Pneumonia and Bronchitis. Besides, Acute Coughs can cause Hay Fever as well.
Causes of Chronic or Persistent Coughs (Long-Term Coughs)
There can be a number of reasons that cause Chronic Coughs such as smoking, Asthma, Bronchitis, post-nasal drip, Gastro-Oesophageal Reflux Disease (GORD) or Gastro-Esophageal Reflux Disease (GERD) etc.
A cough caused by the smoking is often called the ‘Smoker’s Cough’. It usually lasts longer and may lead to loads of complications in the respiratory system of the body including the Chronic Obstructive Pulmonary Disease (COPD), which obstructs the lung and creates several breathing problems and poor airflow for a long-term.
Bronchitis is a type of inflammation that damages the bronchial tubes, which carries the air to the lungs. It produces thick mucus that can further result in bronchial tubes to be swelled and/ or blocked.
4. Post-Nasal Drip:
The body produces mucus, a thick, wet and stingy fluid substance, on a regular basis to help gets rid of the external dust particles and virus. Usually, it is not noticeable and drips down the throat from the back of the nose. However, when the body produces an excessive amount of mucus, it comes out of the nostrils and mouth and causes running nose.
5. Gastro-Oesophageal Reflux Disease (GORD) or Gastro-Esophageal Reflux Disease (GERD):
The Acute Coughs often cause stomach acid to leak up into the tube that joints mouth and stomach, which is called oesophagus/ esophageal or gullet. The tube is also known as the food pipe. GORD usually leads to the heartburn and affects the taste buds as well.
Types of Coughs
Coughs can further be divided into four distinct categories namely Croup Coughs, Dry Coughs, Wet Coughs and Whooping Coughs. Let us know about these four types of coughs first.
1. Croup Coughs:
Croup is an infection that is caused by the viruses and bacteria, and affects the Larynx, also called the voice box, trachea, known as the windpipe and the bronchial tubes that supply air to the lungs. Croup Coughs are usually contagious, especially at the initial stages. It irritates the Upper Respiratory Tract and makes it swelled that causes complications while breathing.
2. Dry Coughs:
Dry Coughs are often caused by several factors such as the infection in the nose and throat, allergies air pollution, change in the temperature, dry atmosphere and acid reflux etc. It produces very less or no mucus during the infection and is also known as the Tickly Coughs and Non-Productive Coughs.
3. Wet Coughs:
Wet Coughs are also known as the Chesty Coughs and Productive Coughs. This type of coughs produces a large amount of mucus and phlegm, which is stored in the Lower Respiratory Tract due to the infection and/ or asthma. Wet Cough occurs to remove the additional mucus through the nostrils and mouth.
4. Whooping Coughs:
Whooping Coughs are also known as the Pertussis. This type of coughs is caused by the bacterial infection into the Upper Respiratory Tract and is highly contagious. Some of the symptoms the Whooping Coughs cause include the running nose, fever, nasal blockage, watery eyes, and extreme fatigue in some cases.
Cough Symptoms and Signs-
- Sore throat
- Excessive production of the mucus and phlegm
- Blocked nasal
- Running nose
- Post-nasal drips
- Unpleasant and sore taste
These are the common symptoms, in case of multiple symptoms, ask your doctor to consult the patient.
Complications of Cough
While Acute Cough is a protective function that removes the blockage in the airways and fights the external bacteria and germs, Chronic Cough can sometimes be quite dangerous and can lead to many other serious diseases. Some of the common and major complications that cough causes include:
1. Fainting and Dizziness
The severe coughs sometimes cause fainting and dizziness and are often known as the Cough Syncope. It affects the sensory organs and reduces the blood flow to the brain while coughing, which can lead to major damages. Usually, Asthma, Gastro-Oesophageal Reflux Disease (GORD), Chronic Obstructive Pulmonary Disease (COPD), Whooping Coughs, and some kinds of heart diseases cause fainting during the coughs.
Insomnia is a sleep disorder, which is among the common complications caused by the coughs. Regular production of mucus makes the body release it through the coughs and makes it difficult to sleep at nights. The post-nasal drips and symptoms of GERD are the two main causes that increase the chances of having insomnia.
3. Abdominal Hernia-
Chronic Coughs often cause throat infection, which can spread throughout the body and can affect other parts as well; and can lead to tearing the abdominal wall. This condition is however quite rare. Usually, the abdominal hernia caused by other infections or diseases is hard to identify, however, the hernia caused by the coughs are easily identified.
4. Fractured Ribs-
As per the article published by the World Journal of Emergency Surgery in 2006, fractured ribs caused by the Chronic Coughs are among the quite common complications occurred by the coughs. It mainly occurs in the old adults and has an effect on women for the most part. Chronic Coughs majorly affect the middle ribs and increased the chances of attacking the people having low bone density.
The severe Persistent Coughs affect the gas exchange in the lungs and blocks the necessary amount of oxygen required by the body tissues. This condition is called the Hypoxia. Hypoxia caused by the Persistent Coughs commonly attacks infants and babies as compared to the adults. Furthermore, Whooping Coughs develop the bacteria in the body that cause the Pneumonia, which may increase the risks of getting Brain Hypoxia.
Other Complications of Cough
- Physical exhaustion
- Cough-induced urine leakage
- Hoarse voice
- Muscle uneasiness
- Small blood vessel injury
- Inflammation in the throat tissues
How to Prevent Coughing?
- Avoid the extreme change in the temperature, such as the sudden exposure to the Sun or moving to the air-conditioned rooms from the heat outside.
- Avoid taking warm bath late at nights or early in the morning.
- Avoid consuming pickles and fried foods as sour food items increase the chances of getting a cough
- Avoid extremely cold food items, especially the cold drinks and ice creams
- Keep the hands and body clean to get rid of the germs
- Keep the house clean and make sure bathroom and kitchen are hygienic and germ-free
- Avoid getting in touch with dust
- Keep the rooms ventilated with filtered air-conditioning system
- Keep the body hydrated and consume enough water or any other beverages
- Avoid being in contact with infected people. Many types of coughs are contagious and transmit the bacteria very quickly.
- Have proper sleep
- Avoid consuming alcohol and smoking
The doctor starts the diagnosis procedure with examining the throat and test out if the infection persists. Further analysis includes listening to the sound of coughs and enquiring about the symptoms the patient is having. If the patient has a bacterial infection that causes coughs, the doctor will recommend some oral antibiotics.
Generally, there is no need to have intense treatment for mild and Acute Coughs as it usually does not harm the body severely at the initial stages. Such mild coughs can be treated at some by consuming fluids and keeping the body hydrated. Taking painkillers such as Paracetamol or Ibuprofen will also work. However, if the coughs persist for weeks and becoming rigorous day by day, a medical care is required immediately.
Home Remedies for Cough-
1.Treatment of Cough by Honey-
Honey is being used to cure the coughs since the centuries now and is considered as one of the most effective remedies for coughs. Having honey with warm tea, warm lemon water or even with the grape juice helps soothe a sore throat. Drinking honey alone is also quite effective as it coats the throat and lessens the irritation caused by the infection.
(Note: Do not give honey to infants and babies under the age of one year as it contains the bacterium called Clostridium Botulinum, which may increase the risks of infant botulism).
2. Treatment of Cough by Herbal Tea-
Drinking a couple of cups tea helps tame coughs as fluids soothe the throat and reduces the infection. One of the best parts of having tea is one can experiment the drink with several herbs and spices such as ginger, cardamom, cinnamon, honey, and clove etc. Further, adding turmeric, marshmallow root, or liquorice root is a scientifically proven treatment to cure coughs.
3. Treatment of Cough by Steam Inhalation-
One of the great ways to treat Chronic Coughs includes inhaling the steam. It helps reduce the amount of mucus and phlegm stored in the lungs and helps hydrate the airways, thus, providing relief in a cough and cold. Using eucalyptus oil while inhaling steam proves to be quite helpful in reducing the mucus.
4. Treatment of Cough by Warm Water-
Water, as always, is the best remedy to cure both Acute and Chronic Coughs. While gargling with salted water helps cure the swollen throat tissues, adding lemon, honey and eucalyptus leaves in the warm water helps reduce the soreness in the throat.
5. Treatment of Cough by Peppermint Leaves-
Peppermint has the menthol possessions that reduce the congestion produced by the mucus and helps soothe the throat from infection. Peppermint’s antibacterial properties help relax the muscles that cause fever and sore throat. Drinking peppermint tea with honey is also a proven remedy that is often used to cure Wet Cough.
(Note: Avoid giving peppermint to infants as it can cause burning mouth and tongue.)
6. Treatment of Cough by Lemon-
Lemon is also an effective remedy to calm the soaring throat caused by the infection. Lemon has the Antioxidants and Vitamin C that helps stimulate saliva and reduce the throat irritation. Cut a lemon in half and sprinkle black pepper and salt on it. Squeeze it in the mouth and slurp it to get an instant relief. Drinking lemon juice with added honey in it is also quite helpful to cure coughs.
7. Treatment of Cough by Garlic
Garlic possesses antibacterial and antimicrobial properties that help restore the Upper Respiratory Tract from throat infections. Boil a cup of water and add garlic, two to three cloves and one teaspoon honey and mix in properly. Wait for 5 to 10 minutes and let it cool to a room temperature. Once its temperature gets down, drink it.
8. Treatment of Cough by Almonds
Almond is believed to have the nutritional properties that help relieve bronchial problems. Soak few almonds in the water at night and make a smooth paste of it in the morning. Add teaspoon butter or sip it with the orange juice. Repeat this activity for a couple of days to remove the symptoms of coughs.