A Comprehensive Guide On Chronic Cough Treatment - Latest Updates 2024
A chronic cough, persisting for more than 8 weeks, often perplexes individuals as it may not be directly linked to a specific illness or health issue. Despite its seemingly innocuous nature, a chronic cough can profoundly disrupt one’s quality of life. It arises from various factors, including but not limited to airway irritation, underlying medical conditions, or environmental triggers.
Unlike acute coughs that typically accompany respiratory infections and subside within a few weeks, a chronic cough persists, sometimes with symptoms so severe that they impair daily functioning and sleep patterns. It becomes a persistent companion, affecting social interactions, work productivity, and overall well-being.
Recurrent coughing is a characteristic symptom of many common health conditions. However, a constant cough stands out due to its persistence beyond the typical duration of acute illnesses such as the common cold. In adults, lasting 8 weeks or more, and in children, persisting for 4 weeks or longer, a chronic cough can be either dry or accompanied by persistent coughing with phlegm, signifying underlying respiratory issues.
There are two types that Doctors categorise a chronic cough and they are categorised as:
| Category of Chronic Cough | Definition |
|---|---|
| Refractory Chronic Cough | Refractory chronic cough persists despite attempts at treatment and isn't attributed to another underlying health condition. Despite undergoing multiple treatments, the symptoms remain unabated, posing challenges in management and impacting the individual's quality of life. |
| Symptomatic Chronic Cough | Symptomatic chronic cough arises when coughing symptoms stem from an underlying condition, and these symptoms alleviate upon effective treatment of the root cause. |
Understanding the physiological mechanism behind coughing illuminates its significance in maintaining respiratory health. Coughing serves as the body’s defence mechanism, aiding in the expulsion of irritants, foreign particles, and excess mucus from the airways. By forcefully expelling these substances, the body safeguards the lungs and ensures the optimal functioning of the respiratory system.
However, when coughing becomes chronic, it signifies an underlying imbalance or disturbance in the respiratory tract. This persistent irritation triggers a reflexive cough that persists beyond its usual duration, signalling a need for further investigation and management.
The predominant manifestation of constant cough is, naturally, the persistent cough itself. However, individuals often observe accompanying symptoms, such as:
- A persistent tickle in the throat or frequent throat clearing
- Acid reflux or heartburn
- Occasional fever
- Hoarseness or a sore throat
- Postnasal drip, characterised by the sensation of sinus drainage down the back of the throat
- Runny nose
- Shortness of breath
- Wheezing
Alongside a chronic cough, individuals may also experience more severe symptoms, including:
- Chest pain
- Coughing up blood
- Headaches or dizziness
- Persistent heartburn
- High fever
- Intense coughing leading to rib pain, possibly indicating a fracture from prolonged coughing
- Symptoms disrupting sleep consistently
- Vomiting due to forceful coughing
Numerous potential causes and risk factors contribute to the development of chronic cough:
- Allergies
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Gastroesophageal reflux disease (GERD)
- Environmental exposures to dust or chemical irritants
- Lung cancer
- Postnasal drip
- Respiratory tract infections or related conditions, including whooping cough
- Sinus problems
- Smoking or exposure to secondhand smoke (both active smokers and those exposed to secondhand smoke, including former smokers, face an elevated risk of chronic cough compared to nonsmokers)
Certain blood pressure medications may induce chronic cough as a potential side effect.
In diagnosing a chronic cough, the primary objective is to pinpoint its underlying cause, which may sometimes involve multiple factors. To achieve an accurate diagnosis, your physician will initiate a comprehensive physical examination and delve into your complete medical history. Additionally, lung function tests may be conducted to assess the efficiency of your respiratory system.
Further diagnostic measures may include scoping studies, wherein a camera attached to a long tube is utilised to inspect your oesophagus, upper airway, lungs, or sinuses. This procedure aids in detecting signs of infection or obstruction that could contribute to chronic coughing.
Moreover, imaging tests like X-rays or MRIs may be recommended by your physician to either identify the root cause of your chronic cough or eliminate potential underlying factors.
Chronic cough treatment involves tailoring the treatment to address its underlying cause. For instance, if your chronic cough is a result of certain blood pressure medications, your healthcare provider may recommend switching to an alternative medication. Similarly, if smoking is suspected as the root cause of your chronic cough, your doctor will strongly encourage smoking cessation as part of the chronic cough treatment plan.
Your doctor may prescribe various treatments and medications tailored to alleviate your chronic cough:
- Acid reflux medications
- Antibiotics (if the cough is caused by a bacterial infection)
- Antihistamines (for coughs triggered by allergies)
- Asthma medications (to manage coughs associated with asthma)
- Decongestants (for coughs related to nasal congestion)
- Increased fluid intake to help thin mucus, making it easier to expel
Furthermore, your physician may also suggest the use of a cough suppressant to help control persistent cough with phlegm. It’s important to note, however, that while a cough suppressant can provide temporary relief by mitigating the symptom of coughing, it does not address the root cause of the condition. Therefore, it’s essential to seek guidance from your healthcare provider before embarking on any medication regimen, including over-the-counter options.
In cases where environmental triggers are believed to contribute to your chronic cough, your doctor may recommend implementing lifestyle changes. For instance, if dry air exacerbates your coughing episodes, your physician might advise utilising a humidifier to add moisture to the air, thereby alleviating throat irritation and promoting more comfortable breathing environments. Additionally, your healthcare provider may offer guidance on avoiding other potential triggers, such as allergens or irritants in the home or workplace, to help manage and reduce the frequency of coughing episodes.
In conclusion, dealing with chronic coughing can pose significant challenges and greatly affect daily life. Whether the cough is triggered by allergies, asthma, GERD, or environmental factors, accurate diagnosis and tailored treatment plans are essential. Consulting a healthcare professional for personalised care and guidance, including medication adjustments, lifestyle changes, and symptom management, is crucial in addressing chronic cough effectively and improving overall well-being.