{"id":21785,"date":"2019-08-20T10:09:02","date_gmt":"2019-08-20T06:09:02","guid":{"rendered":"http:\/\/www.mauritiustimes.com\/mt\/?p=21785"},"modified":"2019-08-20T10:09:02","modified_gmt":"2019-08-20T06:09:02","slug":"health-check-why-do-i-have-a-cough-and-what-can-i-do-about-it","status":"publish","type":"post","link":"https:\/\/www.mauritiustimes.com\/mt\/health-check-why-do-i-have-a-cough-and-what-can-i-do-about-it\/","title":{"rendered":"Health Check: why do I have a cough and what can I do about it?"},"content":{"rendered":"

\"\"<\/p>\n

\"\"<\/p>\n

Dry, moist, productive, hacking, chesty, whooping, barking, throaty. Which type of cough do you have and why?<\/span><\/h5>\n
\n

Dry, moist, productive, hacking, chesty, whooping, barking, throaty. These are just some of the terms people use to describe their cough.<\/span><\/p>\n

While we\u2019re deep into cold and flu season, it\u2019s one of the most common reasons people see their family doctor.<\/span><\/p>\n

But what is a cough anyway? And what\u2019s the best way to get rid of it?<\/span><\/p>\n

What is a cough?<\/span><\/h4>\n

People can\u00a0cough on purpose or spontaneously in a protective reflex action. The aim is to both protect the airways from material that shouldn\u2019t be there (like dust) or to clear the secretions that come with respiratory diseases, such as the mucus and phlegm that come with colds and flu.<\/span><\/p>\n

Nerve receptors throughout the lungs, and to a lesser extent in the sinuses, diaphragm and oesophagus (food pipe), detect the irritant or mucus. Then, they send messages via the vagus nerve to the brain. The brain, in turn, sends messages back through the motor nerves supplying the diaphragm, chest muscles and vocal cords.<\/span><\/p>\n

This results in a sudden, forceful expulsion of air.<\/span><\/p>\n

Your cough may be a one off. Alternatively, you can have a run of repeated coughs, especially in\u00a0whooping cough, which people describe as a bout, attack or episode.<\/span><\/p>\n

Which type of cough do I have?<\/span><\/h4>\n

There are many different types of cough but no one definition that everyone agrees on. This can be confusing as patients classify their cough in descriptive terms like hacking or chesty, while doctors classify them on how long they last: acute (under three weeks), subacute (three to eight weeks) and chronic cough (more than eight weeks).<\/span><\/p>\n

\"\"<\/span><\/p>\n

Neither of these approaches\u00a0tells us about the cause of the cough.<\/span><\/p>\n

Coughs can also be called wet or dry.\u00a0Officially, you have a wet cough when you produce more than 10mL of phlegm a day.<\/span><\/p>\n

For people with chronic coughs, their cough can further be classified after an x-ray \u2014 either with lung pathology to indicate something like pneumonia or tuberculosis, or without signs of underlying disease (an x-ray negative cough).<\/span><\/p>\n

What caused my cough?<\/span><\/h4>\n

Whether you have a\u00a0wet or dry cough\u00a0may tell you what has caused it.<\/span><\/p>\n

A dry cough\u00a0indicates a non-infectious cough from conditions including\u00a0asthma,\u00a0emphysema,\u00a0oesophageal reflux\u00a0and\u00a0upper airway cough syndrome, previously called post-nasal drip.<\/span><\/p>\n

A wet cough\u00a0is more common in people with sinus and chest infections, including influenza, bronchitis and pneumonia, and serious infections such as\u00a0tuberculosis. A smoker\u2019s cough is usually wet, as the precursor to chronic bronchitis. As it progresses, or when complicated with infection, larger amounts of mucus may be coughed up daily.<\/span><\/p>\n

Then there is a dry cough associated with a cold or flu that turns into a moist cough. People tend to describe this as \u201cchesty\u201d and it makes them worry the infection has moved to their lungs.<\/span><\/p>\n

Yet mostly their lungs are clear of infectious sounds when examined with a stethoscope. Even a small amount of mucus stuck around the vocal cords or back of the throat may produce a moist sounding cough. But this is not necessarily a wet or \u201cproductive\u201d (producing lots of mucus) cough.<\/span><\/p>\n

One study\u00a0showed even doctors struggled to make an accurate diagnosis based only on the sound of the cough. Their diagnosis of the cough was correct only 34% of the time.<\/span><\/p>\n

For people with chronic \u201cunexplained cough\u201d, a common hypothesis is that cough receptors\u00a0become more sensitive\u00a0to irritation the more they are exposed to the irritant. These cough receptors are so sensitive that even\u00a0perfumes, temperature changes, talking and laughing\u00a0may trigger the cough.<\/span><\/p>\n

People with\u00a0upper airway cough syndrome\u00a0may feel mucus secretions moving down the back of the throat, causing them to cough. New evidence suggests the cough\u00a0is caused by\u00a0the increased thickness of the mucus and slowness of that mucus being cleared by cilia (hair like structures in lining cells whose job is to move mucus along).<\/span><\/p>\n

This mechanism keeps the chronic cough going through a feedback loop I call the \u201ccough and mucus\u201d cycle. In other words, the more the throat is irritated by the sticky mucus, the more you cough, but the cough is poor at shifting the mucus. Instead, coughing irritates the throat and fatigues the cilia, and the mucus becomes stickier and harder to shift, stimulating further coughing.<\/span><\/p>\n

When coughing gets too much<\/span><\/h4>\n

Coughing is hard work so no wonder you can feel physically exhausted.\u00a0In one study, people with asthma coughed as many as 1,577 times in one 24-hour period. But for people with a chronic cough, it was up to 3,639 times.<\/span><\/p>\n

The high pressures generated in vigorous coughing\u00a0can cause\u00a0symptoms including chest pains, a hoarse voice, and even rib fractures and\u00a0hernias. Other complications include vomiting, light-headedness, urinary incontinence, headaches and sleep deprivation. Chronic cough may also lead to people becoming embarrassed and avoiding others.<\/span><\/p>\n

Is it true?<\/span><\/h4>\n

People still seemed surprised and worried when a cough persists after a cold and flu despite the fact cough outlasts other symptoms in most cases. When an\u00a0Australian study\u00a0followed 131 healthy adults with an upper respiratory tract infection, 58% had a cough for at least two weeks and 35% for up to three weeks.<\/span><\/p>\n

Then there\u2019s the colour of your mucus. Patients and doctors commonly interpret discoloured mucus, particularly if green, as a sign of bacterial infection. But there\u2019s\u00a0clear evidence\u00a0that the colour alone is not able to differentiate between viral and bacterial infections in otherwise healthy adults.<\/span><\/p>\n

Another study\u00a0found that people with acute cough who coughed up discoloured phlegm were more likely to be prescribed antibiotics, but they did not recover any faster than those not prescribed antibiotics.<\/span><\/p>\n

When and how should I treat my cough?<\/span><\/h4>\n

Due to the multiple causes and types of cough there is not room to cover this question adequately. A safe approach is to diagnose the disease that is causing the cough and treat it appropriately.<\/span><\/p>\n

For chronic dry coughs and coughs that last after acute upper respiratory tract infections, the cough is no longer serving a useful function and treatments can be targeted at breaking the cycle of irritation and further coughing. The evidence for effective treatments is patchy, but cough suppressants, steam inhalation and saline nasal irrigations, as well as prescribed anti-inflammatory sprays may help.<\/span><\/p>\n

A spoonful of honey\u00a0reduces cough\u00a0in children more than placebo and some cough mixtures. It is thought that the soothing effect on the throat is the way this works.<\/span><\/p>\n

\"\"<\/span><\/p>\n

However, there is no good evidence for the effectiveness of commonly used over-the-counter medicine (cough medicine or syrup) to alleviate acute cough, yet they are still sold. Some contain drugs with the\u00a0potential to cause harm\u00a0in children, such as antihistamines, and codeine-like products.<\/span><\/p>\n

Recent expert panel reports\u00a0don\u2019t recommend the use of these cough medicines\u00a0for adults and children with acute cough, until they are shown to be effective.<\/span><\/p>\n

When should I be concerned?<\/span><\/h4>\n

It is fine to try to treat yourself, but if a cough persists or is bothersome, your doctor may be able to suggest or prescribe treatments to reduce your symptoms.<\/span><\/p>\n

If you cough up blood or are becoming more unwell, consult a doctor, who will investigate further.<\/span><\/p>\n

Children who cough up phlegm for more than four weeks\u00a0have been found to benefit\u00a0from medical investigations and antibiotics.<\/span><\/p>\n

\"\"David King<\/span><\/strong>
\n<\/span>Senior Lecturer, <\/span>
\nThe University of Queensland<\/span><\/p>\n

\n

* Published in print edition on 16 August 2019<\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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