That annoying and persistent cough (Part 1)

Q: I’ve had a cough for over 3 months. I took three different antibiotics and every cough mixture in the pharmacy, but it persists. What could be causing it and how do I get rid of it?

Introduction

A: You have a chronic cough which is a cough lasting for 8 weeks or more (in an adult). This type of cough often impacts your overall quality of life, primarily by interrupting sleep and leaving you drained.

The causes of such a cough are varied, however, some of the most common culprits are cigarette smoking, acid reflux, a postnasal drip and asthma. Most cases resolve once the cause is identified and appropriately treated.

Frequently associated symptoms and signs.

A chronic cough can occur with other signs and symptoms, which may include:

• Blocked nostrils
• A nasal discharge
• Constant clearing of the throat
• Hoarseness
• Shortness of breath, tightness of the chest and wheezing
• The cough may be worse at night
• Burning in the central chest or acid in the throat – especially on lying dow

Causes:

It is not unusual for all of us to cough occasionally. The cough reflex is there to clear secretions, germs and irritants from our airways, and by extension, to reduce the chances of upper and lower respiratory tract infections.

On the other hand, persistent coughs should be followed up, for it is often caused by an underlying medical problem. While in most instances the underlying cause is not life threatening, however, on some occasions the primary trigger can be serious.

Some of the more common causes of a chronic cough include:

• A postnasal drip originating from the back of the nose and or sinuses.
• An asthma flare may present primarily as a cough. This is often made worse by dust, chemical irritants, and cold air. This cough can be worse at night.
• Acid reflux is often the reason behind many a chronic cough. Unfortunately, the coughing often worsens acid reflux.
• A post infection cough may persist long after the original infection has resolved. Indolent infections of the lung with tuberculosis (TB), mycobacterium or fungal organisms can present as a chronic cough.
• Chronic bronchitis and emphysema (Chronic Obstructive Pulmonary Disease – COPD) may develop in current and former smokers. One of the primary symptoms of COPD is a chronic cough.
• Angiotensin Converting Enzyme (ACE)- Inhibitors used to treat high blood pressure and heart failure may cause a chronic cough in up to 20% of their users.
• Heart failure can cause a build up of fluid in the lungs, often resulting in coughing and wheezing.

Less common causes: Sarcoidosis, cystic fibrosis, lung cancer, ear wax, bronchiectasis, and aspiration
Some complications of an untreated chronic cough include:

• Insomnia
• Excessive tiredness
• Nausea/ Vomiting
• Headaches
• Dizziness
• Excessive sweating
• Urinary incontinence (especially in women)
• Subconjunctival bleeding (minor bleeding over the white/ sclera of the eye)
• Fainting
• Fractured ribs
• Hernias.

Next week Friday June 17 in Part 2 we will cover how the causes of “That Annoying and Persistent Cough” are identified and how it can be treated.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.