A cough is a reflex mechanism to expel any irritant like mucous, dust or foreign object from the airways. A cough can be the symptom of an underlying illness, which causes inflammation and narrowing of the airways.
TYPES OF COUGH
- Acute: develops suddenly, and last for 2-3 weeks
- Subacute : last more than 3 weeks but less than 8 weeks
- Chronic: last more than 8 weeks. Long lasting cough may also be called as persistent cough
- Refractory: its chronic cough that hasn’t responded to any treatment.
CAUSES
Cough can be caused by a number of conditions including allergies, infections, inhalation of fumes or foreign object. The duration of the cough and associated symptoms helps the physician to identify the cause.
Allergens or irritants
- Dust
- Smoke
- Pollen
- Strong smells (cleaning products, perfumes, solutions/chemicals)
- Animal dander
- Mold/ fungus
- Medications like ACE Inhibitor (use to treat medical condition like high blood pressure)
Medical illnesses
- Allergies
- Common cold, flu and other viral infections
- Chest infections
- Asthma, COPD, Lung fibrosis
- Bronchitis
- Pertussis
- Heart failure
- GERD (acid reflux)
- Post nasal drip
- Some throat related disorders involving vocal cord.
MANAGEMENT
Investigation:
As cough in itself is not a disease, its presence leads to series of investigation to identify the cause. A detailed history and physical examination help formulate a differential diagnosis. Subsequently, a series of investigations are done to reach a diagnosis.
In blood tests a CBC, CRP, ESR, IGE, and environmental allergy panel. There can be more tests depending on the likely suspicion of the cause.
Radiological tests include a Chest Xray, High resolution CT scan, CT scan of paranasal sinuses, and CT scan with contrast. More advanced investigation can be ordered as per your physician.
For the diagnosis of asthma and COPD, lung function test is performed.
Treatment:
Once the cause is identified, the treatment includes symptomatic relief like cough syrups. Lozenges and targeted medications, like oral antihistamines, antibiotics, oral/ iv steroids, nasal sprays and decongestants, bronchodilators including nebulizer and inhalers, acid suppression,