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Cough

Cough

 
 
 
 
 

Overview

Coughing is a natural reflex that helps clear the airways of irritants such as mucus, dust, or foreign particles. However, there are various types of coughs, each with different causes and characteristics. Coughs can be classified as productive (wet) or non-productive (dry), as well as more specific types like paroxysmal and croup coughs. Understanding the type of cough and its underlying cause is essential for appropriate treatment, as coughing can range from a mild, self-limiting issue to a symptom of a more serious condition.

Symptoms and Causes

1. Wet / Productive Cough

A wet or productive cough is characterized by the presence of mucus, which is often expelled through coughing. Postnasal drip, where mucus drains down the throat, commonly triggers this type of cough. If mucus reaches the lungs, it can lead to more severe conditions like pneumonia.

Conditions that cause wet coughs:

  • Flu
  • Pneumonia
  • Chronic Obstructive Pulmonary Disease (COPD), including emphysema and chronic bronchitis
  • Acute bronchitis
  • Asthma
  • Bronchiectasis, a condition where mucus accumulates in small pouches in the lungs and cannot be fully cleared.

2. Dry / Non-Productive Cough

A dry or non-productive cough does not involve mucus production. It can be more difficult to control and often occurs in long, irritating fits. This type of cough typically results from inflammation or irritation in the respiratory tract.

Possible causes:

  • Upper respiratory tract infections
  • Laryngitis, croup, tonsillitis, sinusitis
  • Asthma and allergies
  • Gastroesophageal reflux disease (GERD)
  • ACE inhibitors (blood pressure medications like enalapril and lisinopril, which cause coughing in about 20% of users)
  • Exposure to irritants like smoke, dust, or chemicals.

3. Paroxysmal Cough

Paroxysmal coughing refers to sudden, violent coughing fits that are often uncontrollable. These episodes can be exhausting and painful, and may lead to vomiting or difficulty breathing.

Causes

  • Pertussis (whooping cough): A bacterial infection that causes intense coughing fits followed by a "whooping" sound when the person inhales.
  • Other causes: Asthma, COPD, pneumonia, tuberculosis, and choking.

4. Croup Cough

Croup is a viral infection that primarily affects children under the age of 5. It leads to swelling in the airway, making breathing difficult.

Symptoms

  • A distinct "barking" cough
  • Raspy voice and squeaky breathing sounds
  • Struggling to breathe or rapid breathing
  • High-pitched noises during inhalation due to airway narrowing.

Diagnosis

Diagnosing the cause of a cough involves a thorough examination of symptoms, medical history, and possible environmental or lifestyle factors. A doctor may ask several questions to determine the type of cough and identify the underlying condition.

Key questions include:

  • Does anything come up when you cough? (e.g., mucus, blood)
  • If mucus is present, what color is it? (clear, yellow, green, or brown)
  • What is the consistency of the mucus?
  • How long have you had the cough? (acute vs. chronic)
  • Did any specific event trigger the cough?
  • Do you have any known allergies?
  • Do you smoke or take any medications?
  • Have you had any past respiratory infections?

Based on these answers, the doctor may conduct further tests, such as chest X-rays, blood tests, or sputum analysis, to pinpoint the cause of the cough.

Treatments

Treatment for a cough depends on its type and underlying cause. Some common approaches include:

For Wet/Productive Coughs:

  • Expectorants to help thin mucus, making it easier to expel.
  • Hydration and steam inhalation to loosen mucus.
  • Antibiotics if the cough is caused by bacterial infections like pneumonia.

For Dry/Non-Productive Coughs:

  • Cough suppressants to control the cough reflex.
  • Anti-inflammatory medications for reducing airway irritation.
  • Avoiding triggers like allergens or irritants.

For Paroxysmal Coughs:

  • Treatment for the underlying cause, such as antibiotics for whooping cough.
  • Bronchodilators for asthma-induced coughing fits.

For Croup Cough:

  • Humidifiers and cool-mist vaporizers to soothe the airway.
  • In severe cases, corticosteroids may be prescribed to reduce swelling in the airways.

In all cases, addressing any underlying conditions such as asthma, GERD, or chronic infections is key to preventing future coughing episodes.

Locations

Treatments are available at the following locations:

Cromwell Hospital

164-178 Cromwell Rd,
London SW5 0TU

One Welbeck

1 Welbeck Street, Marylebone
London, W1G 0AR

London Bridge Hospital

27 Tooley St,
London SE1 2PR

Chelsea Oupatients Centre

280 King's Rd,
London SW3 5AW

Chelsea & Westminster Hospital

369 Fulham Rd,
London SW10 9NH

Sloane Hospital

125 Albemarle Rd,
Beckenham BR3 5HS

Lister Hospital

Chelsea Bridge Rd,
London SW1W 8RH

Royal Brompton Hospital

Sydney Street, London
SW3 6NP

The London Clinic main hospital

20 Devonshire Place
London W1G 6BW

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