All About Coughs

By Canada Cloud Health | Published Thursday 18 February 2021

Cough is a symptom that is experienced by everyone. Cough is actually an essential protective and defensive action by the body to remove mucus, noxious substances and infections from the larynx, trachea and larger airways. 

Coughing is the most efficient mechanism for clearing the upper airways, and is essential innate inbuilt defense mechanism.

Absence of the coughing is harmful and may cause problems, and sometimes may be fatal.

Cough may be the first sign of disease of the airways or lungs (Upper Respiratory Tract Infection). If cough is persistent then it may be a potential disease for clinician to identify based on duration of coughing.  

What causes a cough?

Nearly all conditions affecting the respiratory tract and some extrapulmonary conditions may cause cough. Clinicians will decide the cause of cough and accordingly treatment will be prescribed.  

Cough may be persistent in incurable diseases such as in terminal lung cancer, when other chronic symptoms are also present such as dyspnea and pain. 

Cough may be the most prominent symptom complained of by patients with chronic respiratory disease such as asthma, cystic fibrosis and Chronic obstructive pulmonary disease (COPD).

Excessive persistent cough may be due to chronic non-malignant disease with or without excessive mucus production. 

The effect of persistent cough itself may be harmful and deleterious to the patient. Chronic cough causes difficulty in breathing, and adversely affects social activities and sleep. This in turn degrades the quality of life of patient and also causes social embarrassment. In addition, cough also causes urinary incontinence, muscle ache, bodyache, insomnia and fatigue.

Exposure to pollutants or environmental irritants are the potential factors that trigger coughing.  

Types of cough

Coughing is also the commonest symptom for which medical advice is sought. Cough may be divided into 

    • Defined, acute, self-limiting cough: Lasting <3weeks.
    • Subacute cough: 3–8 weeks’ duration.
    • Chronic persistent cough: >8 weeks’ duration

The majority of consultations with acute cough are due to viral respiratory tract infections. Viruses like influenza, parainfluenza, rhinovirus, adenovirus, respiratory syncytial virus and the respiratory corona virus cause coughing.

Respiratory syncytial virus is the single most common cause of cough in infancy. Infection occurs as epidemics, usually between the winter and early summer. Each outbreak lasts between 2 and 3 months and can involve as many as half of all families with children.  

The three common causes of chronic cough- Asthma, Gastroesophageal reflux disorder (GERD), rhinitis and post nasal drip cough.
Cough is also classified as Dry cough, Wet cough and Whooping cough.

    • Dry cough- Dry cough is common symptom of respiratory illnesses. It is also called as non-productive cough. There is very little or no mucous in the throat. Throat is sore and rough and person may have itching.  It can be because of asthma, or GERD or lung cancer. Many times, cough subsides within few days.

    • Wet cough- There is increased mucus secretion and patient coughs up phlegm. It is also called as productive cough or chesty cough. Wet cough may be because of bronchiectasis, pneumonia, COPD or some infection.

    • Whooping cough- It is also called as Pertussis, and is a contagious bacterial infection caused by Bordetella pertussis.

When to see a doctor

Cough is one of the most common symptoms for which patients go to clinic. Coughing can be so severe as to induce vomiting, incontinence and syncope, and affects quality of life.
Cough, when frequently accompanies the common cold and is usually self-limiting, causing little problem. In this circumstance, many individuals self-medicate, with ‘over-the-counter’ antitussive preparations. 

Patient should seek medical advice if:

    • Frequent episodes of fever
    • The cough is getting severe and chronic
    • Feeling of swelling or lump in the throat causing difficulty in swallowing 
    • Prolonged cough with weight loss
    • Change in voice and difficulty in speaking
    • Cough with blood in sputum 
    • Difficulty in breathing and pain in chest
    • Chronic cough and disturbed sleep.


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