Cough

Cough Overview

A cough is the body’s way of responding when something irritates the throat or airways. An irritant (mucus, germs or dust) stimulates nerves that send a message to the brain. The brain then tells muscles in your chest and abdomen to push air out of your lungs to force out the irritant resulting in cough.

A cough,  is a voluntary or involuntary act that clears the throat and breathing passage of foreign particles, microbes, irritants, fluids, and mucus. It is a rapid expulsion of air from the lungs through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. This response is almost instantaneous and very effective.

As a protective reflex, coughing can be repetitive with the following three phases: an inhalation, a forced exhalation against a closed glottis, and a sudden release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound. Coughing can be done deliberately or as part of a reflex. Although coughing can be a sign of a serious illness, more often, it will clear up on its own without the need for medical attention.

Frequent coughing usually indicates the presence of a disease. Many viruses and bacteria benefit from evolutionary perspective, by causing the host to cough, which helps to spread the disease to new hosts. Most of the time, irregular coughing is caused by a respiratory tract infection but can also be triggered by asthma, air pollution, choking, smoking, lung disease.

Coughing is your body’s way of getting rid of an irritant, when something irritates your throat or airway, your nervous system sends an alert to your brain. Your brain responds by telling the muscles in your chest and abdomen to contract and expel a burst of air.

A cough is an important defensive reflex that helps protect the body from irritants like:

• Mucus
• Smoke
• Allergens  in the air, such as dust, mold, and pollen

Coughing is a symptom of many illnesses and conditions. Sometimes, the characteristics of the cough can give a clue to its cause. An occasional cough is normal and healthy. A cough that persists for several weeks or one that brings up discolored or bloody mucus may indicate a condition that needs medical attention.

At times, coughing can be very forceful, prolonged, vigorous coughing can irritate the lungs and cause even more coughing. It is also exhausting and can cause sleeplessness, dizziness or fainting, headaches, urinary incontinence, vomiting, and even broken ribs.

Following are some of the key points of Cough:

• Some germs use coughing to spread to new hosts.
• There is a wide array of potential causes of coughs.
• Some types of cough only occur at night time.
• If the cough is difficult to diagnose, a chest X-ray may be necessary for diagnosis.
• Home remedies can soothe the majority of coughs.

If someone is coughing a lot, it can be a sign of a disease, many coughs are caused by infections and diseases, like the common cold, but there are also non-infectious causes.

Following are the three phases of cough:

1. Inhalation (breathing in).
2. Increased pressure in the throat and lungs with the vocal cords closed.
3. Sudden release of air when the vocal cords open, giving a cough its characteristic sound.

Types of Cough

There are many types of coughs, the characteristics, duration, and severity of a cough may indicate the cause. Coughing is a symptom of many illnesses and could be caused by a variety of conditions.

Following are types of cough:

• Wet Cough
• Dry Cough
• Paroxysmal Cough
• Group Cough

Wet Cough

A wet cough is also called a productive cough, is a cough that typically brings up mucus. A cold or the flu usually causes wet coughs, it can come on slowly or quickly and mucus and may be accompanied by other symptoms, such as:

• Runny nose
• Postnasal drip
• Fatigue

Wet coughs feels wet because the body is pushing mucus out of the respiratory system, which includes the:

• Throat
• Nose
• Airways
• Lungs

If you have a wet cough, you may feel like there’s something stuck or dripping at the back of your throat or in your chest, some of the coughs will bring mucus into the mouth. Wet coughs can be acute and last less than 3 weeks or chronic and last longer than 8 weeks in adults or 4 weeks in children. The duration of a cough may be a big clue as to its cause. Coughs in babies, toddlers, and children that last less than 3 weeks are most of the times caused by a cold or the flu.

Conditions that can cause a wet cough include:

• A Cold or the flu
• Pneumonia
• Lung diseases such as;
• Chronic Obstructive Pulmonary Disease (COPD) including emphysema and chronic bronchitis
• Acute bronchitis
• Asthma

Dry Cough

A dry cough is a cough that doesn’t bring up mucus. It may feel like you have a tickle in the back of your throat triggering your cough reflex, giving you hacking coughs. Dry coughs are often difficult to manage and may present in long fits. Dry coughs occur because there’s inflammation or irritation in the respiratory tract, but there’s no excess mucus to cough up. Dry coughs are often caused by upper respiratory infections, such as a cold or the flu. In both children and adults, it’s common for dry coughs to linger for several weeks after a cold or the flu has passed.

Other possible causes of dry cough include:

• Laryngitis
• Sore throat 
• Croup Infection
• Tonsillitis
• Sinusitis
• Asthma
• Allergies 
• Gastroesophageal Reflux Disease (GERD) 
• Medications, such as ACE inhibitors
• Exposure to irritants such as air pollution, dust, or smoke

Paroxysmal Cough

A paroxysmal cough is a cough with intermittent attacks of violent, uncontrollable coughing. A paroxysmal cough feels exhausting and painful. People struggle to get a breath and may vomit.

Pertussis also known as whooping cough, is a bacterial infection that causes violent coughing fits. During whooping cough attacks, the lungs release all the air they have, causing people to inhale violently with a “whoop” sound. Babies have a higher risk of contracting whooping cough and face more serious complications from it. For them, whooping cough may be life threatening, the best way to avoid contracting pertussis is by getting vaccinated.

Whooping cough frequently causes paroxysmal coughs, other possible causes of a bad coughing fit include:

• Asthma
• COPD
• Pneumonia
• Tuberculosis
• Choking

Croup Cough

Croup is a viral infection that typically affects children ages 5 and younger. Croup causes the upper airway to become irritated and swollen. Young children already have narrower airways. When swelling further narrows the airway, it becomes difficult to breathe. Croup causes a characteristic “barking” cough that sounds like a seal. Swelling in and around the voice box also causes a raspy voice and squeaky breathing noises. In severe cases, children become pale or bluish.

Croup can be dangerous for both children and parents, children may:

• Struggle for breath
• Make high-pitched noises during inhalation
• Breathe very rapidly

Causes of Cough

While an occasional cough is normal, a cough that persists may be a sign of a medical problem. A cough is considered “acute” if it lasts less than three weeks. It is considered “chronic” if it lasts longer than eight weeks (four weeks in children).

Some causes of coughs include:

Common causes of acute cough

• Common Cold
• Influenza (Flu)
• Inhaling an irritant such as dust, smoke, chemicals or some other foreign body
• Pneumonia
• Whopping cough

Common causes of chronic cough

• Allergies
• Asthma (more common in children)
• Bronchitis
• Gastroesophageal Reflux Disease (GERD)
• Postnasal drip

Other causes of cough

• Acute Sinusitis (nasal and sinus Infections)
• Bronchiectasis (a chronic ling condition in which abnormal widening of bronchial tubes inhibits mucus clearing)
• Bronchiolitis (more common in young children)
• Choking
• Chronic Sinusitis
• COPD (exacerbation, worsening of symptoms)
• Coronavirus (COVID-19) SARS-CoV-2
• Croup Infection
• Cystic Fibrosis
• Emphysema
• Heart Failure
• Laryngitis
• Lung Cancer
• ACE (angiotensin converting enzyme) Inhibitors
• Neuromuscular diseases that weaken the coordination of upper airway and swallowing muscles
• Pulmonary Embolism (blood clot in an artery in the lung)
• Respiratory Syncytial Virus (RSV) in young children
• Sarcoidosis (collections of inflammatory cells in the body)
• Tuberculosis