Causes and risk factors
The most common cause of chronic cough is an upper respiratory tract infection such as common cold and flu. Low-grade chronic bronchitis, postnasal drips, asthma , allergies, lung infections such as pneumonia or acute bronchitis, chronic obstructive pulmonary disease [emphysema or chronic bronchitis], sinusitis , lung disease such as bronchiectasis, interstitial lung disease lead to chronic cough. It can also be caused due to Gastroesophageal reflux disease [GERD]. Cigarette smoking, exposure to second hand smoke, exposure to air pollutants predispose to chronic cough. Tumours in the lung can be one of the causes of chronic cough. Certain drugs have risk of developing this condition such as ACE inhibitors. Sarcoidosis, cystic fibrosis, aspiration are some of the rare causes.
Clinical presentation
Chronic cough is a cough that lasts for more than 4 weeks in children and more than 8 weeks in adults. A nasal discharge, frequent need to clear the throat, hoarseness of voice and mucoid or mucopurulent secretions in the posterior pharynx are associated with chronic cough. Accompanying symptoms include, wheezing, heartburn. Chronic cough especially coming up during night results in sleeplessness. In severe cases there can be haemoptysis [spitting up of blood]
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. A chest X ray is done. In case of productive cough, sputum examination is required. Spirometry, Allergy testing, Bronchoscopy is recommended. Pulmonary function test may be advised. Imaging techniques such as CT scan of chest is done for further evaluation.
Treatment
The treatment will depend upon the cause, severity and the type of the cough. Drug induced cough require cessation of drugs. Medical treatment involves anti histaminics, antibiotics, inhaled corticosteroids, cough suppressants. Antacids are prescribed to treat acid reflux. Avoiding exposure to smoke, pollution and similar trigger factors will also help in managing chronic cough.
Other Modes of treatment
The other modes of treatment can also be effective in treating chronic cough. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating chronic cough.
