Here’s everything you want to know about chronic cough

Chronic cough is a significant public health burden, with prevalence ranging from 9% to 33% worldwide. A chronic cough is a cough that lasts eight weeks or more in adults, or four weeks in children.

Chronic cough is associated with impaired quality of life, more than just discomfort. It can interrupt your sleep and wear you out.

Terms to describe chronic cough

When diagnosing a cough, there are three lengths: “Acute cough” is one that lasts less than three weeks. “Subacute cough” is one that lasts three to eight weeks and “chronic cough” lasts longer than eight weeks.
Intractable cough is cough that has not been controlled after several specific tests and treatments as well as after trying various over-the-counter treatments from your health care provider.

Types of chronic cough

“Symptomatic” chronic cough is caused by an underlying disease and can be treated once the disease is diagnosed.

Chronic “refractory” cough is cough that persists despite treatment based on recommendations.

Risk factors

About half of patients with chronic cough have no known cause. In light of this evidence, chronic cough has been described as a distinct clinical syndrome, i.e. cough hypersensitivity syndrome.

Smoking: Foreign substances in tobacco smoke can cause a “smoker’s cough” – the result of the airways constantly trying to get rid of chemicals. Heavy smokers often develop chronic bronchitis after age 40. Exposure to secondhand smoke can also increase a person’s risk. The smoke can irritate the airways and lead to chronic coughing and lung damage.

Exposure to chemicals in the air, such as working in a factory or laboratory, can also lead to long-term coughing.

Asthma and/or Allergies: Allergies can lead to swollen airways, post-nasal drip and resulting cough. Poorly controlled asthma is another risk factor for chronic cough. In some people, asthma presents primarily as a cough (without the characteristic labored breathing).

Home or work irritants: Exposure to dust, pollen, pet dander, chemicals, industrial pollution, and other irritants can increase the risk of chronic coughs.

Chronic lung disease: Conditions such as emphysema and chronic bronchitis cause persistent irritation and inflammation of the airways, leading to chronic cough.

Gender: Women have a more sensitive cough reflex, which increases their risk of developing a chronic cough.
Obesity: A link between obesity and chronic respiratory disease is increasingly recognized. Obesity can also increase the risk of gastroesophageal reflux, which could lead to chronic cough.

Angiotensin converting enzyme (ACE) inhibitors are drugs that help relax veins and arteries to lower blood pressure. ACE inhibitors prevent an enzyme in the body from producing angiotensin II, a substance that narrows blood vessels. This narrowing can cause high blood pressure and forces the heart to work harder. Angiotensin II also releases hormones that increase blood pressure. Taking ACE inhibitors is an important risk factor for coughing. About 20% of people who take ACE inhibitors develop a cough.

Gestational age, underlying medical conditions, previous wheezing, and daycare attendance are risk factors for chronic cough in young children.

Fortunately, chronic cough usually goes away once the underlying problem is treated.

Prevalence

The prevalence of chronic cough differs by age, gender, and geographic location. It is more common in women and in the elderly population. There are geographical differences in the prevalence of chronic cough with an estimated prevalence of 18.1% in Oceania, 12.7% in Europe, 11.0% in America, 4.4% in Asia and 2.3% in Africa.

Causes of Chronic Cough

Coughing is an essential defense mechanism. However, chronic cough is an important cause of morbidity. Previously, chronic cough was considered a consequence of various diseases, such as asthma/eosinophilic bronchitis, rhinitis and gastroesophageal acid reflux. Recent evidence, however, suggests that chronic cough is a clinical syndrome with a distinct intrinsic pathophysiology characterized by neuronal hypersensitivity.

Various factors can cause a chronic cough. Sometimes more than one factor can be responsible. Some of the more common causes of chronic cough include: asthma, a type of asthma known as cough variant asthma, chronic bronchitis, gastroesophageal reflux disease.

Persistent sequelae of infection. If a person has had a serious infection, such as pneumonia or the flu, they may still experience lingering effects, including a chronic cough. Even if most of their symptoms have disappeared, the airways may remain inflamed for some time.

Postnasal drip, also known as upper respiratory tract cough syndrome, postnasal drip is the result of mucus leaking from the back of the throat. This irritates the throat and triggers a cough reflex.

Less common causes of chronic cough include: aspiration, bronchiectasis, excessive mucus production, bronchiolitis, cystic fibrosis, heart disease or heart failure, and lung cancer.

Complications

A cough can be problematic if it interferes with a person’s daily life. When you can’t sleep due to constant coughing, any aspect of your health that depends on the recovery aspects of sleep can suffer. Additionally, you may be at risk of accidents or injury because you are less alert and slow to react to situations.

Headache

The tension created in your body when you cough can cause headaches. Soft tissues, including muscles, blood vessels, and nerves, can all be involved when a cough causes headaches.

Dizziness

The constant jerky movements of a chronic cough can upset the balance of the inner ear organs. Although these effects are usually not serious, they can also cause nausea and vomiting.

Fainting

Your cough can interfere with blood circulation enough to cause brief periods of fainting, more commonly known as fainting, especially if you have a severe coughing fit.

Subconjunctival hemorrhage

The membrane that covers the whites of your eyes is filled with tiny blood vessels. A chronic cough may be enough to rupture some of them, creating minor bleeding that makes your eyes look bloody.

Urinary incontinence

Spasms of the abdominal muscles during coughing can lead to contractions of the muscles controlling the bladder. Women sometimes have problems with urinary incontinence after menopause or pregnancy, so chronic coughing can make it worse.

Fractured ribs

The chest contractions associated with a chronic cough can be strong enough to break or crack the bones in your rib cage.

Hernia

Cough strain can contribute to inguinal or femoral hernias, when an internal organ protrudes through a muscular wall.

Prevention tips

Stop smoking or don’t start smoking, as it is the most common cause of chronic cough. If you are regularly near second-hand smoke, you can reduce the danger by staying away from the smoker and finding a smoke-free area, making sure guests in your home know they can’t smoke indoors, and by not letting passengers smoke in your car – even with the window down.

Avoid contact with anyone you know who may have bronchitis or pneumonia.

Eat fruits and foods that contain fiber. Research suggests that a combination of fiber and flavonoids found in fruit can prevent chronic cough.

Avoiding foods that can trigger acid reflux is one of the best ways to manage this condition and reduce the accompanying cough. Foods and beverages that most commonly trigger acid reflux include: alcohol, caffeine, chocolate, citrus fruits, fried and fatty foods, garlic and onions, mint, spices and spicy foods , tomatoes and tomato products.

Drink plenty of water (at least eight glasses a day). Gargle with warm salt water to help loosen any mucus. Inhale steam. Avoid inhaling dust, smoke or other pollutants as much as possible. Use extra pillows at night to support your head and upper body.

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