What Causes Chronic Coughing
Smoking is a leading cause. Sooner or later, most cigarette smokers develop a chronic “smoker’s cough.” Chemical irritation is responsible but the same noxious chemicals that cause the simple smoker’s cough can lead to far more serious conditions, such as bronchitis, emphysema, pneumonia, and lung cancer. The chronic cough is always a cause of concern for smokers.
A lingering cough is also a worry for nonsmokers. Fortunately, benign problems are responsible for most chronic coughs in nonsmokers. Benign or not, persistent coughing can cause worry, embarrassment, exhaustion, and more. That’s why chronic coughs should be diagnosed and treated before they linger too long.
Dozens of conditions can cause a recurrent, lingering cough, but the lion’s share are caused by just five: postnasal drip, asthma, gastroesophageal reflux disease , chronic bronchitis, and treatment with ACE inhibitors, used for high blood pressure. Many people have several of these conditions, but in nonsmokers, the first three, singly or in combination, account for nearly all chronic coughs. The major causes of long-term coughing are listed below.
What Is An Asthma Cough
An asthma cough is commonly known as cough variant asthma. In fact, it surprises many people to learn that cough variant asthma is also a type of asthma which is only marked by the presence of a dry and nonproductive cough. Most types of asthma have the patient suffering from some kind of breathing problem, typically shortness of breath and wheezing. However, in an asthma cough, the individual presents with no traditional asthma symptoms and therefore, this condition often fails to be diagnosed correctly.
In spite of the fact that an asthma cough does not have any of the traditional asthma symptoms, it does have an impact on the body. This includes:
- An asthma cough increases your risk of catching other allergic conditions
- It increases the bodys sensitivity to allergens, particularly the sensitivity of the airways
- An asthma cough can cause swelling and narrowing of the airways, thus causing disruption in air flow
Cough variant asthma is often also known as a chronic cough because doctors use this term to refer to a cough that lasts for over 6 to 8 weeks. If you have an asthma cough, you will be coughing either during the day or during the night. In particular, nighttime asthma cough is considered to be worse, as it often causes disturbed sleep. Asthma a cough also becomes worse with exercise. This condition is then referred to as exercise-induced asthma. Dust, strong perfumes, cold air, or any allergy-triggering factors can increase asthma coughing.
Persistent Cough Common Causes And Cures
What’s that nagging cough, and what can you do to cure it? Cough for a minute or two, and you may think something has “gone down the wrong pipe.” Cough for a day or two, and you may think you’ve picked up a cold or the flu. After a week, bronchitis or allergies may come to mind. But after three or four weeks, your mind starts to race, and the worry begins to mount.
For many people, chronic coughing raises the specter of cancer. But is cancer really a common cause of a cough that lingers? And if it’s not, what is and what can you do to quiet a nagging cough?
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What Is The Asthma Cough Reflex
Nerves line your airways. Cough receptors are in your upper airways. This includes your larynx and pharynx. These nerves respond to certain irritants. When this happens, they send signals to your cough receptors. This induces a cough reflex.2-4
These irritants may include things you inhale. Examples include respiratory viruses or microscopic particles. They may also include things within your own body. These include nasal drainage and even asthma.
Your cough receptors receive the signal. They, in turn, send signals to the cough center of your brain. Its in your brainstem. It sends signals to the muscles of respiration. Inspiratory muscles contract, thereby causing you to take a deep breath. Expiratory muscles contract, thereby causing you to forcibly exhale. The force here is quite powerful. It can reach up to 300 mmHg.2-4
The goal is to force out foreign particles. Some of these particles may be balled up in sputum. So, this sputum is brought to the back of your throat. It can then be swallowed to be dissolved in stomach juices. It can also be spit-up.
There Are Various Reasons Why You Could Be Experiencing A Cough Or Sore Throat
Post-nasal drip will also irritate your esophagus and occurs because of sinusitis or the more chronic allergic rhinitis also known as Hay Fever. Post-nasal drip occurs when your sinuses become clogged, hence the term plugged up. Usually, youll experience additional symptoms, such as nasal congestion, sneezing and a runny or itchy nose, similar to symptoms we notice when our are acting up.
Even food allergies can cause a sore throat. Generally, youll notice almost instant swelling and enlarging of the throat, which can quickly advance to anaphylaxis. This is a much more serious allergic reaction than an irritated throat. Often allergy medications , such as Benadryl, can have side effects such as a dry, scratchy throat, along with dry mouth. Consult a doctor before taking any medication and monitor your reactions to these types of allergy medicines.
For those with more serious allergies, symptoms can last an entire season, especially in the springtime. The flu and common cold will generally only have symptoms for a week to two weeks. If it is allergies, you will most likely also experience:
- tiredness
- itchy, watery eyes
- post-nasal drip
Its important if you are experiencing these symptoms to get tested by your local allergist. Rather than treating the symptoms, its best to find and treat the cause.
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Learn How To Manage Symptoms
The good news is that todays treatments for and allergies mainly medication and inhalers are very effective.
Theyre relatively easy to use and have minimal side effects, Dr. Purcell says. When symptoms are more severe or do not respond to other measures, allergy shots is very effective.
One option that should not be on the table is letting allergic asthma ruin your quality of life. The goal is to manage your condition so that it never limits the activities you love because they trigger an allergic reaction, he says.
Working with your doctor will help you find a treatment plan that works for you.
Cough: What Can Cause Acute And Chronic Cough
A cough is an impulse action to clear the airways of mucus and irritants, as smoke or dust. It is rarely a sign of something serious.
A dry cough means it is sickly and does not produce any thick mucus . A chesty cough means a thick mucus is produced to aid clear the airways.
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Diganosis And Management Of Specific Cough Syndromes
4.4.1 Cough variant asthma and eosinophilic bronchitis
Definition
An isolated cough in a patient without objective evidence of asthmathat is, variable airflow obstruction and evidence of eosinophilic inflammation. In cough variant asthma bronchial hyperresponsiveness is present, whereas in eosinophilic bronchitis it is absent.
These syndromes are a common cause of isolated cough, accounting for around 30% of cough referrals to cough clinics., Clinical indicators of cough variant asthma include cough occurring nocturnally, after exercise, or after allergen exposure, although how reliable these features are is unclear. Some studies have highlighted overdiagnosis of cough variant asthma in children.
Diagnosis of cough variant asthma
Recommendations
Current methodology for measurement of airway hyperresponsiveness is well standardised and widely accepted. A negative test excludes asthma but does not rule out a steroid responsive cough.
This requires the demonstration of variable airflow obstruction and/or airway hyperresponsiveness. In patients with normal or near normal spirometric values , tests of airway responsiveness are more sensitive and specific than bronchodilator reversibility studies and PEF records.,
Asthma syndromes and cough
Key points
Management
Recommendation
4.4.2 Gastrooesophageal reflux disease
Background
Does antireflux therapy improve cough associated with GORD?
Recommendations
What is the role of antireflux surgery?
Recommendation
Definition
Similar To Asthma Treatment Of Cva Consists Of A Combination Of Drugs Including:
- Antihistamines/Allergy medication
- Inhaled corticosteroids or anti-inflammatory drugs that ease and prevent swelling in the airways
- A beta antagonist to prevent future asthma attacks.
- An antiasthmatic regimen of inhaled bronchodilators relaxes the muscles that tighten around the airways, leading them to open. They can act short-term or long-term depending on the severity of asthma
- preventive oral medications Doctors often supplement inhalers with oral pills called leukotriene modifiers that relieve asthma symptoms for 24 hours
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Upper Airway Cough Syndrome
The term UACS, previously referred to as postnasal drip syndrome, was coined in the 2006 American College of Chest Physicians guideline 4 in recognition of the fact that multiple etiologies, including chronic rhinosinusitis, allergic rhinitis, and nonallergic rhinitis, were difficult to differentiate solely by clinical presentation. UACS is the most common cause of chronic cough.10 Rhinorrhea, nasal stuffiness, sneezing, itching, and postnasal drainage suggest the diagnosis, but their absence does not rule out UACS.11 Physical findings may include swollen turbinates and direct visualization of postnasal drainage and cobblestoning of the posterior pharynx. If a specific cause is identified, therapy should be started otherwise, initial treatment includes a decongestant combined with a first-generation antihistamine. Intranasal corticosteroids, saline nasal rinses, nasal anticholinergics, and antihistamines are also reasonable options.10 Clinical improvement should occur within days to weeks, and up to two months. If chronic rhinosinusitis is suspected, sinus computed tomography or flexible nasolaryngoscopy should be performed. Sinus radiography is not recommended because of limited sensitivity.12
Diagnosis Of Chronic Variant Asthma
Diagnosis of CVA can be quite challenging as it is usually characterized by a chronic cough. Chronic cough lasts more than four weeks in children and more than eight weeks in adults.
Therefore, one should always consult a doctor if they are experiencing an unexplained persistent cough, though it is wise to keep track of your cough and share the details with your doctor to avoid misdiagnosis.
A spirometry test is used by a healthcare professional to diagnose asthma. This test assesses how well your lungs work. If symptoms and test results are negative for asthma, the next step is a methacholine challenge test.
Ideally, when a person with asthma inhales methacholine, it triggers coughing and bronchial spasms. Therefore, a person with asthma will be more sensitive to methacholine than a healthy person causing lung function to drop during the test.
If a doctor strongly suspects CVA, they may skip the methacholine test and prescribe asthma treatments. Since CVA responds well to asthma treatment, a healthcare provider will be likely to diagnose CVA.You can also get some insights on how to know if you have asthma on our blog.
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Is It Asthma Or Copd
If you have a chronic cough or wheeze and are often short of breath, it could be asthma. Or it could be COPD. Or both. Heres how to find out whats causing your symptoms.
Asthma and chronic obstructive pulmonary disease, or COPD, share many symptoms and even certain treatments, but understanding the differences between the two conditions is the key to taking control of the health of your lungs.
COPD is an umbrella term for a group of lung diseases including chronic bronchitis and emphysema diseases that block airflow as you exhale and make it progressively harder to breathe.
Asthma is also chronic, marked by an inflammation and narrowing of the airways. Both conditions could cause trouble breathing. So whats the answer?
Tips To Prevent Asthma Attacks
Consistency in taking your medication is essential. Therefore, to make progress, you must make sure to take daily medications, and use your inhaler. Moreover, if you have coughing attacks, taking strong, short-acting medications is vital.
Often try to avoid known allergens or irritants that trigger your asthma such as, Dust, some insects, pollen, smoke, cold air, some exercises, etc. Especially, avoid smoking as it will trigger coughs and other respiratory illnesses
Uncontrolled asthma may have long-term consequences, thereby impacting your health. It is, therefore, necessary to seek medical attention as soon as you feel the symptoms.
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Options For Refractory Cough
Patients with unexplained chronic cough after evaluation and treatment of common causes should be referred to a pulmonologist or otolaryngologist.4,5 Neuromodulators have shown some benefit in randomized trials based on the hypothesis that refractory chronic cough may be due to hypersensitivity of the cough reflex caused by peripheral and central mechanisms .3638 Therapies included gabapentin , which improved symptoms within four weeks pregabalin in conjunction with speech therapy, which showed greater improvement vs. placebo with speech therapy and speech and language therapy alone.3941
What Can You Do
Drink warm lemon and honey this is a tried and tested cough remedy for good reason as the warm liquid helps to soothe the throat and rid it of irritation.
Help out your immune system the immune system is put under a great deal of strain when its busy fighting off allergens so its a good idea to help it out as best you can. You may want to take some Echinaforce Echinacea Drops for example, which support the immune system.
Stay hydrated water helps to wash out any allergens that are lurking in the throat and which are therefore causing a cough. However, it also stops your throat from getting dry and irritated which would worsen a cough.
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Diagnostic Tests For Chronic Cough
Your physician may order a variety of diagnostic tests to identify the underlying ailment. These include imaging and lung function tests.
Pulmonary function tests look at how your lungs are functioning and can identify lung conditions. During a spirometry test, the doctor measures how much air your lungs can hold and how hard you can exhale.
Imaging tests, such as x-rays and CT scans, are used to inspect your lungs, throat, and overall respiratory system. These help the doctor diagnose lung diseases, sinus infections, pneumonia, and even signs of cancer.
Measurement And Monitoring Of Cough
Key points
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Accurate measurement of cough helps determine cough severity, assess treatment efficacy, and may provide diagnostic information.
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Ambulatory cough recording currently offers most promise in the objective assessment of cough, although further technical refinement is required if it is to be broadly accessible to physicians.
A number of methods to measure cough frequency, intensity and severity have been described. Visual analogue scales and selfreport cough diary cards have been used but do not consistently correlate with objective methods such as ambulatory cough monitoring. The use of a series of different ambulatory cough recording monitors has been reported in both adult, and paediatric,, literature. Although some technical limitations currently exist, they offer the best objective means of recording cough. Differences in the characteristics of the cough sound and flow pattern between asthma, bronchitis, and interstitial fibrosis have been reported. Recently, analysis of overnight cough recording determined differences in character and intensity of cough sounds between patients with cystic fibrosis and those with cryptogenic fibrosing alveolitis. These observations open the diagnostic possibilities for cough monitoring.
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Why Do I Keep Coughing Even Though Im Not Sick
Even if you are not currently sick, there are many conditions that can cause of a lingering cough. Besides infection, most coughs are the result of postnasal drip, asthma, acid reflux, or blood pressure medication. A physician can use your medical history and diagnostic tests to pinpoint the reason behind your cough.
Need And Purpose Of Bts Recommendations On The Management Of Cough
The American College of Chest Physicians and the European Respiratory Society , have each endorsed their own set of guidelines on the management of cough however, criticism of their content and breadth suggest the need for further concise recommendations. The British Thoracic Society guidelines cover not only chronic cough but also acute cough and the organisational issues of cough clinics. International differences in delivery of respiratory health care and management strategies support the notion that such guidelines would be desirable. The British Thoracic Society Standards of Care Committee agreed to the development of a Working Group tasked with the job of producing a set of guidelines for the management of cough with the following key objectives:
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To produce guidelines that are relevant to the clinical management of cough in both primary and secondary care.
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To produce a critical review of the available literature.
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To highlight cough as a clinical and research area of considerable importance.
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To encourage extended cooperation between clinicians, scientists, and the pharmaceutical industry with the core aim of developing effective cough therapies.
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Can Allergies Cause A Cough
Yes, and you can blame it on your immune system. When your body mistakes a substance like pollen or mold as a harmful invader, it sets off an intense response to try and flush it out, according to the American Academy of Allergy, Asthma & Immunology . During this process, your cells release histamine and other chemicals, which triggers an allergic reaction. Cue the cold-like symptoms, including a sore throat, runny or stuffy nose, sneezing, and coughing.
Allergy coughs are typically caused by swelling or irritation of the airways, the AAAI says. And, if you develop post-nasal dripwhen the mucus hanging out in your sinuses trickles down the back of your throatthat can also cause a cough, Dr. Bassett says.
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Can My Chronic Cough Be A Sign Of Asthma
While classic asthma has tell-tale wheezing and chest tightness, a chronic cough variant of asthma usually presents only with cough. Its cause is not well understood, but CVA is clinically considered a variant type of asthma, a phase at the start of asthma pathogenesis, or a precursor of classic asthma.
A study recommends healthcare providers consider asthma a potential cause in patients with chronic cough. This is because asthma is a common condition frequently associated with cough.
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