Cough is a reflex action of the respiratory tract that is used to clear the upper airways.
Chronic cough lasting for more than 8 weeks is common in the community. The causes may be
- cigarette smoking
- exposure to cigarette smoke
- exposure to environmental pollutants( especially particulates )
Diseases causing chronic cough:
- asthma
- eosinophilic bronchitis
- gastro-oesophageal reflux disease
- postnasal drip syndrome or rhinosinusitis
- chronic obstructive pulmonary disease(commonly called COPD)
- pulmonary fibrosis
- bronchiectasis
Doctors should always work towards a clear diagnosis, considering common and rare illnesses. In some patients, no cause is identified, leading to the diagnosis of idiopathic cough. Chronic cough is often associated with an increased response to tussive agents such as capsaicin. Plastic changes in intrinsic and synaptic excitability in the brainstem, spine, or airway nerves can enhance the cough reflex, and can persist in the absence of the initiating cough event. Structural and inflammatory airway mucosal changes in non-asthmatic chronic cough could represent the cause or the traumatic response to repetitive coughing.
Effective control of cough requires not only controlling the disease causing the cough but also desensitisation of cough pathways
Usually the problems arrises when we cant decide either to use an antitussive or a sedative antihistamine for cough
there may be a different type of cough such as productive or dry which encompass the major types
patients feel non compliant with cough preparations for several reasons such as :
- most of them present with sedation
- in 80% of the cases it gets to a more aggravated state
- it takes a long time to relive the patient.
most general practitioners believe that the sound of cough is the most important thing to diagnose the proper type . because once you get the correct diagnosis . a proper treatment is not far off
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