Chronic cough

Chronic cough is a cough that lasts for a long time, up to two months or more in adults and one month or more in children. Chronic cough is not a disease, but a symptom of another health problem.

Non stop coughing can cause :

• Poor sleep quality.
• Disrupt the balance of the body.
• Interferes with daily activities.

10%-20% of chronic cough cases experienced by adults are known to be triggered by genetic hypersensivity (atopy) and exposure to cigarette smoke.

Chronic cough types :

• Chronic dry cough ➡ a cough that does not produce mucus and is usually a symptom of a sinus problem or viral infection.
• Chronic wet cough ➡ a cough that produces mucus and indicates a bacterial or fluid infection in the lungs (depending on the color of the mucus).
• Stress cough ➡ a cough that occurs due to spasms of the airways, generally caused by stress or stress. This cough does not produce mucus and is not associated with any infection.
• Barking cough ➡ cough caused by this viral infection. The cause of a sound like a barking dog is swelling of the trachea.
• Whooping cough (pertussis) ➡ a cough that is classified as dangerous and contagious. Causes death in infants < 1 year old. 

Cause.

• Postnasal drip : a condition where there is excess mucus that collects at the back of the throat causing a cough. This condition is called upper respiratory cough syndrome.
• Asthma : occurs in certain seasons (especially winter) or after experiencing an upper respiratory infection.
• Acid reflux disease : acid from the stomach that rises into the esophagus.
• Infections : pneumonia, flu, colds, whooping cough (pertussis).
• Blood pressure drugs : Angiotensin-converting enzyme (ACE inhibitor) inhibitor medication commonly prescribed for patients with high blood pressure or heart failure.
• Chronic bronchitis : chronic inflammation of the respiratory tract that occurs as a result of smoking or exposure to secondhand smoke.
• Inhaling air pollution continuously.
• Aspiration : entry of foreign objects into the respiratory tract, as a result of choking on food or drink.
• Bronchiolitis : respiratory tract infection that causes inflammation and blockage in the bronchioles.
• Bronchiectasis : damage to the respiratory tract.
• Pharyngeal laryngeal reflux : stomach acid that rises to the throat.
• Cystic fibrosis : a disease that causes the mucus in the body to become thick and sticky.
• Nonasthmatic eosinophilic bronchitis: inflammation of the airways in the absence of asthma.
• Sarcodiosis : inflammation of cells in the body (lung cells).
• Lung cancer.
• Cardiovascular conditions : heart failure, pulmonary embolism, inflammation of the main blood vessels (aortic aneurysm).
• Vitamin B deficiency : marked symptoms of sensory neuropathy.

Symptoms.

Symptoms of a chronic cough that are still mild :

• Runny or stuffy nose.
• Fluid flows continuously down the back of the throat (postnasal drip).
• Sore throat.
• Hoarseness.
• Short breath.
• Sour in the mouth.

Symptoms of a chronic cough that are classified as severe :

• Night sweats.
• High fever.
• Weight loss.
• Feel pain in the chest.
• Coughing up blood.

Get to the hospital immediately if the cough doesn't stop for up to 8 weeks or if you have severe symptoms.

Diagnosis.

• Physical examination and medical history.
• X-ray test to detect common causes of cough, such as asthma, acid reflux or postnasal drip.
• CT-Scan to diagnose lung conditions.
• Lung function test to measure how deep the patient can inhale and exhale.
• Advanced asthma test by measuring breath levels before and after inhaling drugs containing methacholine.
• Laboratory test.
• Bronchoscopy to see the condition of the lungs and airways through a monitor.
• Biopsy : takes a small piece of tissue from the respiratory tract for examination in the laboratory.
• Rhinoscopy to check the condition inside the nose.
• Gastric acid test to check the level of acid contained in the patient's esophagus.
• Echocardiography tests are performed if the doctor suspects that there is a problem with the patient's heart.

Treatment.

• Antibiotic drugs to fight bacteria and pneumonia.
• Antihistamines and decongestants to relieve airway inflammation and allergies.
• Glucocorticoids to relieve hormone problems, chronic bronchitis and asthma.
• Bronchodilators for asthma patients to relieve inflammation and blocked airways.
• Cough relievers : dextomethorphan, benzonatate, hydrocodone.
• Gastric acid drugs: usually choose antacids, H2-2 receptor inhibitors or proton pump inhibitors.

Discussions with your doctor before taking angiotensin-converting enzyme inhibitor (ACE inhibitor) or patients < 4 years old to avoid dangerous side effects.

Complications.

• Broken ribs if you cough too hard.
• Dizzy.
• Headache.
• Hard to sleep.
• Syncope.
• Urinary incontinence : excess urine volume.

Prevention.

• Drink warm drinks to thin the mucus that has accumulated in the throat.
• Suck on cough suppressants to relieve throat irritation.
• Don't smoke and avoid smoke.
• Don't eat and drink acid reflux triggers, such as spicy, sour, mint, chocolate and caffeine.
• Nasal irrigation therapy using a saline solution to remove mucus in the respiratory tract.