Cough
Cough | |
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A young boy coughing due to pertussis. | |
Pronunciation |
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A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.[1]
Frequent coughing usually indicates the presence of a disease. Many
Treatment should target the cause; for example,
Presentation
Complications
The complications of coughing can be classified as either
Differential diagnosis
A cough in children may be either a normal physiological reflex or due to an underlying cause.[5] In healthy children it may be normal in the absence of any disease to cough ten times a day.[5] The most common cause of an acute or subacute cough is a viral respiratory tract infection.[5] A healthy adult also coughs 18.8 times a day on average, but in the population with respiratory disease the geometric mean frequency is 275 times a day.[6] In adults with a chronic cough, i.e. a cough longer than 8 weeks, more than 90% of cases are due to post-nasal drip, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease.[5] The causes of chronic cough are similar in children with the addition of bacterial bronchitis.[5]
Infections
A cough can be the result of a
After a respiratory tract infection has cleared, the person may be left with a
Reactive airway disease
When coughing is the only complaint of a person who meets the criteria for asthma (
Asthma is a common cause of chronic cough in adults and children. Coughing may be the only symptom the person has from their asthma, or asthma symptoms may also include wheezing, shortness of breath, and a tight feeling in their chest. Depending on how severe the asthma is, it can be treated with bronchodilators (medicine which causes the airways to open up) or inhaled steroids. Treatment of the asthma should make the cough go away.
Gastroesophageal reflux
In people with unexplained cough,
Air pollution
Coughing may be caused by air pollution including tobacco smoke, particulate matter, irritant gases, and dampness in a home.[5] The human health effects of poor air quality are far reaching, but principally affect the body's respiratory system and the cardiovascular system. Individual reactions to air pollutants depend on the type of pollutant a person is exposed to, the degree of exposure, the individual's health status and genetics. People who exercise outdoors on hot, smoggy days, for example, increase their exposure to pollutants in the air.
Foreign body
A
Drug-induced cough
Drugs used for treatments other than coughs, such as ACE inhibitors which are often used to treat high blood pressure, can sometimes cause cough as a side effect, and stopping their use will stop the cough.[14] Beta blockers similarly cause cough as an adverse event. [2]
Tic cough
A
Neurogenic cough
Some cases of chronic cough may be attributed to a sensory neuropathic disorder.[16] Treatment for neurogenic cough may include the use of certain neuralgia medications. Coughing may occur in tic disorders such as Tourette syndrome, although it should be distinguished from throat-clearing in this disorder.
Other
Cough may also be caused by conditions affecting the lung tissue such as
Given its irritant nature to mammal tissues, capsaicin is widely used to determine the cough threshold and as a tussive stimulant in clinical research of cough suppressants. Capsaicin is what makes chili peppers spicy, and might explain why workers in factories with these fruits can develop a cough.
Coughing may also be used for social reasons, and as such is not always involuntary. A voluntary cough, often written as "ahem", can be used to attract attention or express displeasure, as a form of
Airway clearance
Coughing, and huffing are important ways of removing mucus as sputum in many conditions such as cystic fibrosis, and chronic bronchitis.
Pathophysiology
A cough is a protective
Diagnostic approach
The type of cough may help in the diagnosis. For instance, an inspiratory "whooping" sound on coughing almost doubles the likelihood that the illness is
Blood may occur in small amounts with severe cough of many causes, but larger amounts suggests bronchitis, bronchiectasis, tuberculosis, or primary lung cancer.[22]
Further
Classification
A cough can be classified by its duration, character, quality, and timing.
A number of characteristic coughs exist. While these have not been found to be diagnostically useful in adults, they are of use in children.[5] A barky cough is part of the common presentation of croup.[23] A staccato cough has been classically described with neonatal chlamydial pneumonia.[24]
Treatment
This section is missing information about treatment in adults.(December 2018) |
The treatment of a cough in children is based on the underlying cause. In children half of cases go away without treatment in 10 days and 90% in 25 days.[25]
According to the
Because coughing can spread disease through infectious aerosol droplets, it is recommended to cover one's mouth and nose with the forearm, the inside of the elbow, a tissue or a handkerchief while coughing.[28]
Epidemiology
A cough is the most common reason for visiting a primary care physician in the United States.[5]
Other animals
Marine mammals such as
In other domestic animals,
Deer can cough similarly to humans as a result of respiratory tract infections, such as parasitic bronchitis caused by a species of Dictyocaulus.[32]
References
- ^ S2CID 7810980.
- ^ a b Guidelines, Therapeutic (2021). Cough. Therapeutic Guidelines Ltd.
- S2CID 30806409.
- ^ "Cystocele (Prolapsed Bladder) | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2017-12-02.
- ^ PMID 20176183.
- PMID 23277523.
- PMID 20015366.
In the vast majority of cases, acute cough is due to acute viral upper respiratory tract infection (URTI), i.e., the common cold.
- ^ PMID 16428703.
- ^ "Cystic fibrosis - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-05-24.
- ^ "UpToDate". www.uptodate.com. Retrieved 2022-05-24.
- PMID 22081767.
- ^ "Cough". Mayo Clinic. Retrieved 2022-03-27.
- ^ "Why You Cough". WebMD. Retrieved 2022-03-27.
- PMID 16428706.
- PMID 16428707.
- S2CID 24560981.
- ^ ISBN 0-409-90077-X
- ISBN 0-9671809-2-9
- ^ "ahem". Onomatopoeia List. August 10, 2013. Archived from the original on April 4, 2023. Retrieved April 11, 2022.
- ISBN 9789027221797. Retrieved 25 July 2019.
- PMID 27279650.
- Merck Manuals. Retrieved 2017-04-07. Last full review/revision July 2016
- PMID 19030411.
- PMID 16669564.
- PMID 24335668.
- ^ PMID 29633783.
- PMID 14974067.
- ^ "Coughing and Sneezing". US Centers for Disease Control and Prevention. 2020-04-24. Retrieved 2020-09-14.
- S2CID 26842976.
- ^ a b "Is It Normal for Cats To Cough?". Pet Health Network. Retrieved 2018-04-23.
- ^ "Coughing in horses explained". Your Horse Magazine. Archived from the original on 2020-07-28. Retrieved 2018-04-23.
- S2CID 25720548.
As of this edit, this article uses content from "Acute cough: a diagnostic and therapeutic challenge", which is licensed in a way that permits reuse under the
Further reading
- Carroll, Thomas L., ed. (2019). Chronic Cough. Plural Publishing. LCCN 2018055141.