The cough that won’t go away

If you have been cough­ing for a while it is im­por­tant to try and fig­ure out why. That is be­cause a cough in it­self is not a dis­ease, but a symp­tom of some­thing else go­ing on in your body.

The Manica Post - - Health - Dr Zuze Mat­ters of Health

COUGH­ING is how the lungs clear them­selves of ir­ri­tants like fluid and mu­cus and is clas­si­fied as acute or chronic de­pend­ing on whether or not it lasts more than four weeks. Be­low are a few sit­u­a­tions that will give you a nag­ging cough that may last a long time.

Bron­chi­tis: If you just get an acute cough with­out any ob­vi­ous flu or cold symp­toms (like a tick­ling throat or nasal con­ges­tion), then you might have acute bron­chi­tis. This usu­ally causes a wet pro­duc­tive cough with coloured mu­cus or spu­tum.

Most acute bron­chi­tis is caused by viruses and an­tibi­otics won’t help. Dark brown or blood­stained spu­tum maybe signs of a bac­te­rial in­fec­tion though. Cough caused by bron­chi­tis usu­ally lasts for about 18 days.

Pneu­mo­nia: This is a po­ten­tially se­ri­ous con­di­tion that will re­quire an­tibi­otics.

Symp­toms in­clude a pro­duc­tive cough (of­ten with dis­coloured or blood­stained spu­tum), fever, chest pain, fa­tigue and short­ness of breath.

Some­times you can pick up pneu­mo­nia the same way you catch a cold but it can also fol­low vi­ral in­fec­tions.

Drugs: A class of anti-hy­per­ten­sive drugs called ACE in­hibitors can give you a dry cough which may come in fits.

Drugs in this class in­clude cap­to­pril and enalapril which a lot of peo­ple here are on. You can de­velop this cough even if you have been on th­ese drugs for years with­out any prob­lems.

If you are taken off th­ese med­i­ca­tions, it can take up to four weeks for the cough to dis­ap­pear.

Post nasal drip: This is when drainage from your si­nuses flows down the back of your throat in­stead of com­ing out through the nose.

When the drip gets to your throat, it ir­ri­tates it, which trig­gers a cough. With post nasal drip you will usu­ally feel worse at night be­cause ly­ing on your back helps si­nuses drain more eas­ily.

The cough from post nasal drip is usu­ally wet sound­ing and maybe pro­duc­tive of mu­cus like stuff. This cough is treated with an­ti­his­tamines which dry out the drainage.

Gas­troe­sophageal re­flux dis­ease: This typ­i­cally causes heart­burn and stom­ach pain but is also a com­mon cause of chronic cough.

The acid from your stom­ach trav­els to your voice box where it ir­ri­tates and causes a dry sound­ing cough. Peo­ple with re­flux will of­ten no­tice an in­crease in cough af­ter eat­ing a heavy meal. It’s also worse at night and early morn­ings since ly­ing down al­lows acid to move more read­ily to your throat.

Lim­it­ing or avoid­ing al­co­hol, caf­feine, late night eat­ing, spicy foods and some pain med­i­ca­tion can help re­lieve this con­di­tion and the as­so­ci­ated cough.

Asthma: This is a com­mon cause of chronic cough.

Symp­toms in­clude wheez­ing, short­ness of breath and a dry cough. You won’t nec­es­sar­ily have all th­ese symp­toms.

In chil­dren, asthma might some­times just present as short­ness of breath on ex­er­tion. There are mul­ti­ple treat­ments for asthma which mostly work by open­ing up your lung pas­sages and de­creas­ing mu­cus se­cre­tions in there.

Chronic ob­struc­tive pul­monary dis­ease (COPD): This is a pro­gres­sive dis­ease that makes it harder and harder to breathe due to in­jury to the air­ways usu­ally caused by long term cig­a­rette smok­ing or ex­po­sure to oc­cu­pa­tional ir­ri­tants like smoke or dust.

There are two types of COPD: Chronic bron­chi­tis and em­phy­sema. In chronic bron­chi­tis, the lin­ing of your air­ways is con­stantly in­flamed. This re­sults in a chronic pro­duc­tive cough.

Em­phy­sema grad­u­ally dam­ages the air sacs in your lungs, re­duc­ing the amount of oxy­gen that gets to your blood.

This can cause dry cough, wheez­ing, and short­ness of breath. There is no cure for this dis­ease though med­i­ca­tion can help re­duce the sever­ity of the symp­toms.

Lung cancer: This causes a chronic cough as­so­ci­ated with other signs of cancer like weight loss, cough­ing up blood, fa­tigue and chest pain.

If you have been treated sev­eral times for pneu­mo­nia with no im­prove­ment, lung cancer may need to be ex­cluded.

Lung cancer is much more com­mon in smok­ers and for­mer smok­ers. Ul­ti­mately, if you are wor­ried about a chronic cough you need to visit your doc­tor and get checked out.

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