Cough (acute, chronic, persistent)

Cough (acute, chronic, persistent)cough Description, Causes and Risk Factors: Types of cough: Aneurysmal, brassy, habit, privet, reflex, weaver's, and whooping. Cough is an important reflex defense mechanism for clearing the airways of inhaled noxious stimuli. The reflex begins with stimulation of the cough receptors by viruses, aeroallergens and chemicals. There are two distinct types of afferent fibres, namely: the rapidly adapting irritant receptors (RARs) and the capsaicin-sensitive unmyelinated bronchial C-fibres. The former type of fibres is sensitive to mechanical and/or chemical stimuli. They are present throughout the respiratory tract down to the respiratory bronchioles, especially the posterior wall of the trachea, carina and branching points of large airways. They are also present in the external auditory canals and tympanic membrane, pleura and pericardium, where they tend to respond to only mechanical stimuli. The bronchial C-fibres are neuropeptide-containing nerve fibres that are sensitive to chemical stimulation rather than mechanical stimulation. Stimulation of these fibres causes bronchial smooth muscle contraction, vasodilatation, plasma extravasation and mucus secretion. However, the exact role of C-fibres in the human cough reflex is still unclear. The most common causes of an acute cough include:
  • The common cold.
  • Acute sinusitis.
  • Pertussis (whooping cough).
  • COPD (chronic obstructive pulmonary disease) exacerbations.
  • Allergic rhinitis.
  • Non-allergic rhinitis.
Chronic cough, defined as coughing for more than four weeks, is a common childhood complaint. Causes of chronic C:
  • Asthma: It may be the only symptoms of asthma or allergy. It may be accompanied by the typical of breath and wheezing. Asthma is inflammation of the air passages, which causes swelling of the lining of the airway, mucus production, and "twitchiness" of the muscle surrounding them. This inflammation can be caused, or made worse by, many factors; including activities, allergies, environment, season, and stress.
  • Cigarette-related: A "cigarette cough" indicates that your smoking has already damaged your Breathing passages. You may also be so used to your cigarette cough that you do not even notice it and cannot tell if a change has occurred. Continued smoking results in inflammation and increased production of mucus. Eventually, destruction of the lung (emphysema) occurs. Both chronic bronchitis and emphysema can cause chronic disease.
  • Infections: Just like a cold can cause a coupe lf weeks of coughing, chronic infections can cause a chronic thing. Of greatest concern if TB (tuberculosis), either a new infection or recurrent of an old infection, can cause chronic cough.
  • Allergies or Post nasal drip: Inflammation of the nasal passages or sinuses produces secretions in the nose. Some of this mucus may drip down into the back of the throat and vocal cords and causing chronic disease. The type of cough can often be a 'tickle' or more of a need to clear your throat.
  • Acid Reflux: Acid coming up from the stomach can cause cough by irritating the throat, vocal cord or airways. Acid reflux also cause heartburn, but some people may not feel any heartburn and only have the cough.
  • Medicines: Certain blood pressure medications can also cause the disease.
Causes of persistent cough: A persistent C is defined as a cough that persists for a period of eight weeks or longer. The cough may be dry, or you may cough up mucous. This is in contrast to an "acute" cough that lasts less than 8 weeks, such as those that occur with the common cold. The 3 most common causes include:
  1. Postnasal drip from hay fever (allergic rhinitis), sinus infections, nasal polyps, or other conditions.
  2. Asthma.
  3. Acid reflux.
Less common causes include
  • Smoking.
  • Infection.
  • Eosinophilic bronchitis.
  • Lung diseases such as emphysema, bronchiectasis, and sarcoidosis.
  • Fungal infections such as coccidiomycosis, histoplasmosis and tuberculosis.
  • Inhaling a foreign object.
  • Heart failure.
Diagnosis:
  • A careful history and physical exam.
  • Blood tests to look for signs of infection.
  • A chest x-ray to look for infection of any evidence of a tumor.
  • A CT scan of your chest or CT scan of your sinuses to look for signs of infection or a tumor.
  • Allergy testing.
  • Pulmonary function tests to screen for lung conditions such as asthma and emphysema.
  • Esophageal pH testing to test for the presence of acid reflux as a possible cause of a persistent cough.
  • Bronchoscopy to check for foreign bodies or evaluate your airways for a tumor.
  • Laryngoscopy to examine your throat and voice box.
Treatment: The treatment will depend upon the underlying cause, as well as the degree in which your cough is interfering with your day to day activities. For acute coughing from a virus, you DO NOT need antibiotic treatment. The infection will generally clear on its own within one week. For chronic C, the most important step you can take is to quit smoking. If caught early enough, you can reverse the damage to your lungs. Other important steps include:
  • Limit your exposure to pollutants and other lung irritants.
  • Get a flu vaccine each year and a pneumococcal vaccine one time.
  • Attend a respiratory training program that includes physical activity and breathing exercises.
  • Your doctor will usually prescribe inhaled medicines for chronic Cough. These drugs, which include bronchodilators like albuterol and ipratropium, open your constricted airways and aid in the clearance of mucus. An oral bronchodilator called theophylline and steroids (either inhaled or by mouth) are often necessary as well. If you have an active infection, your doctor will put you on antibiotics and sometimes recommend regular antibiotic treatment to prevent infection.
Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  

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