Cough is one of the most common, distressing problems, world over. It is one of the most common problems for which people seek medical aid.
Cough is an explosive form of expiration i.e. expelling air from the lungs, the aim of which is to clear the wind pipe and its branches of secretions and foreign bodies.
Certain stimuli initiate cough by causing inflammation of the inner lining of the respiratory passages and the lungs. This occurs as in bacterial or viral infections of the respiratory mucous membranes, i.e. inner lining.
It may also be caused by common cold, where secretions from the nose irritate the throat. Acid reflux from the food pipe or stomach can induce cough due to irritation of the throat.
Infections of lungs like T.B. or pneumonia produce cough by causing inflammation of the respiratory mucosa.
Mechanical stimuli producing cough are dust particles in any form. Cough induced by exposure to smoke is a common experience.
It can be due to active as well as passive smoking. Similarly, irritation of the throat by fumes of chemicals, droughts of cold or hot air, can induce cough.
Compression and closure of the air ways induce cough. This may be either from outside as by foreign bodies or tumors or from within as in bronchial asthma or collapse of the lungs.
Systemic diseases like cardiac and renal failure produce cough due to collection of fluid in lungs.
Worm infestations like Ascariasis cause cough by producing state of allergy within the body and also by direct invasion of the lungs.
In allergic bronchitis or bronchial asthma, cough occurs due to allergy to certain substances. The allergy can be due to substances present in the atmosphere or something consumed as food or drink or something applied over the body.
Irrespective of the cause, cough is distressful. It may be dry or associated with expectoration, depending on the site affected and severity of affection.
If a blood vessel is eroded due to inflammation, expectoration may be blood mixed. Along with cough, there may be fever, loss of appetite, e.t.c., problems depending on the cause.
At times, cough may occur with vomiting, which though harmless, is frightening. This occurs because the centre for both is located adjacent to one another in the brain and stimulation of one excites the other.
Very severe cough can lead to rupture of a part of lungs tissue or air way because of the mechanical stress.
Diagnosis of cause of cough is usually established clinically. Blood tests, X-ray and sputum examination aid in confirmation of diagnosis.
Treatment is always of the cause, if possible as in case of infections. If the infection is mild or is viral no treatment is required and cough subsides spontaneously.
In case of asthma or allergic bronchitis one has to avoid the offending substance if possible and use medication as advised.
Whatever the cause for cough, drinking plenty of water and some hot water at least 2 or 3 times is very useful. Steam inhalation is also helpful in providing relief. Honey is a good natural mucolytic agent (one liquefying phlegm).
Therefore one or two small spoons of honey taken in hot water or hot milk are very soothing and one gets relief after taking it.
Smokers need to give up smoking if they wish to get rid of, “smoker’s cough”. People engaged in work involving exposure to dust should use protective face masks.
Protection from cold weather also helps in preventing cough. Cough should not become a distressful symptom and should be stopped at the earliest with appropriate measures.
Dr. Rachna Pande, former internist, Ruhengeri Hospital. E-mail: firstname.lastname@example.org
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