WHY DO YOU COUGH?
Most of us think that winter weather brings on coughing.
There are many different causes of both acute cough (4 weeks or less)
& chronic cough (8 weeks or more) that can happen all year round.
A cough by itself is not a disease
it’s a symptom of something else going on in your body.
Coughs are a protective mechanism that lungs use to evacuate things that
are irigating it like fluid, mucus or any king of airway irritant.
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Asthma, Post-Nasal Drip & GERD make up
the three most common causes of chronic cough.
ASTHMA
(Chronic Cough)
- With asthma, the tubes carrying air to your lungs constrict
- This often causes things like wheezing & shortness of breath
- It can also spark a dry cough
- There’s a type of asthma called cough-predominant asthma, in which coughing would be the only symptom
- It's more likely, though, you’ll also have some of the more common symptoms that you
didn't realize 'shout' asthma like not running rat without being short of breath - Asthma is typically diagnosed through breathing tests or lung function test
- If tests come back normal, your doctor may take it a step further & test the hyperreactivity of your airways, to see if that’s causing your cough
- The condition is often treated with a drug called Albuterol or an inhaled steroid
POST-NASAL DRIP
(Chronic Cough)
- Post-nasal drip is when drainage from your sinuses flow down the back of your throat instead
of coming out through the nose - When the drip hits your voice box, it irritates it, which triggers a cough
- You can tell you’re having post-nasal drip because you'll notice the thick, salty stuff rolling
back down your throat but you may not think that's connected to your cough - Post-nasal drip can irritate your throat & make it sore
- You’ll probably feel worse at night because reclining on your back helps your sinuses drain more easily
- You might wake up coughing & gagging or wake up in the morning with a sick, unsettled stomach from the drainage making its way down in there
- Coughs from post-nasal drip are often wet-sounding & you may actually hack some yellow
stuff up which is similar to the snot you blow out of your nose - Post-nasal drip is generally diagnosed clinicall & sometimes CT scans of the sinuses are done
- reatment is anti-histamines, which dry out the drainage
Gastroesophageal Reflux Disease (GERD)
(Chronic Cough)
- Most people don't even know they have the disease, since it can present with just a cough instead of the more typical signs like heartburn or sour stomach
- In GERD, the acids from your stomach travel up to your esophagus where they reach your
voice box - When the acids hit that level, they burn the bottom of your voice box & trigger a reflex for
a dry-sounding cough - People with GERD will often notice an increase in cough after eating a heavy meal
- It’s usually also worse at night or first thing in the morning, since lying down allows the acid to move more readily up your esophagus
- Your doctor can look for GERD with a test that measures the amount of acid in your
esophagus - The doctor may also use a scope, a flexible tube equipped with a camera that’s snaked
down your nose to the back of your throat - If your doctor suspects GERD, you need to limit or avoid
1. Alcohol
2. Caffeine
3. Late-night eating
4. Spicy or fatty foods
Your doc may also prescribe an acid reflux medication like Zantac or Prilosec
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BRONCHITIS
(Acute Cough)
- The common cold can cause a bit of a dry, tickling cough in addition to other symptoms like runny nose, sore throat, or congestion BUT if a cough is your predominant symptom, you
might have acute bronchitis - Acute bronchitis usually causes a wet, productive cough & it’s common to hack up some
colored sputum, or mucus, with it BUT color isn’t a surefire way to determine if you’re dealing with something viral or bacteria - When you cough up dark brown or blood sputum, there's a concern that it might be an infection BUT that doesn’t mean it’s not viral
- The majority of cases of acute bronchitis are viral which means antibiotics won’t help at all so
if your doctor wants to prescribe antibiotics, ask for a sputum culture first - According to researchers from the University of Georgia, acute coughs caused by bronchitis
& other bugs last an average of 18 days.
PNEUMONIA
(Acute Cough)
- A productive acute cough that often has discolored or even bloody sputum is a sign of pneumonia, a potentially serious illness that is treated with antibiotics
- The cough may not be the first symptom to pop up because sometimes, the infection in the lungs can be so dense that you’ll need a few days of antibiotics to work on the bugs before
the cough comes through - You might also have a fever, overall fatigue, body weakness, discomfort, shortness of
breath, & chills - You can pick up pneumonia without warning just like a common cold
- You can also develop a secondary bacterial pneumonia after a viral illness
1. This might be the case if you’ve been dealing with run-of-the-mill cold symptoms for a few
days
2. An you suddenly begin feeling much worse. - If you have a high fever, develop chest pain, or experience other pneumonia symptoms,
you need to see your doctor.
1. The doctor will probably order a chest X-ray
2. Pneumonia often shows up as a hazy, irregular area in your lungs
ACE INHIBITORS
(Chronic Cough)
- ACE inhibitors are a class of medication used to treat high blood pressure by relaxing your blood vessels & increasing blood flow
- When they’re broken down in your body, they increase the amount of a substance called bradykinin, which can trigger a dry hacking cough reflex that are like whooping cough
- If this happens, your doctor will probably take you off the ACE inhibitors &start you on a
different class of BP meds like ARBs - It can take 3 or 4 weeks for an ACE-inhibitor cough to dissipate after discontinuing the meds
COPD
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(Chronic Cough)
- COPD is a serious cause of chronic cough
- COPD is a progressive disease that makes it harder & harder to breathe due to injury to the airways, usually caused by
1. Long-term cigarette smoking
2. Exposure to occupational irritants like smoke or dust - Types of COPD - Chronic
1. In chronic bronchitis, the lining of your airways is constantly inflamed.a
2. This results in a chronic productive cough
Types of COPD - Emphysema
1. Emphysema gradually damages the air sacs in your lungs, reducing the amount of oxygen
that hits your blood
2. This can cause dry cough, wheezing, and shortness of breath - COPD is treated similar to asthma
1. With long-term inhaled steroids and bronchodilators like Albuterol
2. These meds can help manage symptoms, but there is no cure for the disease so
if you're still smoking STOP!
LUNG CANCER
(Chronic Cough)
- It’s pretty rare to have an isolated cough as the only symptom to herald a lung cancer
- It's unlikely that you have Lung Cancer if you're coughing for more than 8 weeks with no
other symptoms - You would have develop weight loss, coughing up blood, fatigue & chest pain
- If that sounds like you, make an appointment with your dotor right away
- Your doctor will probably order a chest X-ray to see if there are any masses or tumor
- It’s also possible that lung cancer can be mistaken for pneumonia on a chest X-ray even
though they usually look quite different - So if you’ve been diagnosed with pneumonia & haven’t responded to multiple courses of antibiotics, you may want to get the chest x-ray repeated to make sure it really is pneumonia
- It’s also a good idea to get a follow up X-ray 6 to 8 weeks after treatment
- Non-smokers can get lung cancer, but like COPD, it’s much more common in current
smokers & former smokers
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