Cough Causes and Remedies

Symptoms

Coughing is a physiologic defense response used to clear foreign bodies, microorganisms, and mucus from the respiratory tract. An acute cough lasts up to three weeks and a subacute cough lasts up to eight weeks. After eight weeks, it is referred to as a chronic cough (Irwin et al., 2000). A distinction is also made between a cough that produces mucus (productive cough) and a dry, irritating cough (nonproductive cough). Coughing can lead to complications such as sleep disturbances, headaches, and rib fracture, and also poses a psychosocial problem because of the noise and limits quality of life.

Causes

The most common cause of an acute cough is an infectious disease. This is usually a cold or flu. Asthma is an obstructive airway disease that also manifests as shortness of breath, tightness, and wheezing. Chronic obstructive pulmonary disease (COPD) is most often caused by tobacco smoking and manifests as a chronic cough accompanied by mucus production, sputum, shortness of breath, chest tightness, breath sounds, lack of energy, and sleep disturbances. Allergies, such as hay fever or an allergy to cats, can trigger an allergic cough. Many drugs can cause cough as an adverse effect. The best-known example is ACE inhibitors, which are prescribed to treat high blood pressure and other cardiovascular diseases. Finally, acid regurgitation (gastroesophageal reflux, GERD) can also cause coughing. Other causes (selection):

  • Nervous tic (psychogenic cough).
  • Foreign body aspiration
  • Sinusitis (Postnasal Drip)
  • Bronchitis, bronchiolitis
  • Cystic fibrosis
  • Heart disease
  • Lung cancer
  • Heart failure, pulmonary embolism
  • Irritants, e.g. dust, smoke
  • Other infectious diseases: Pneumonia, tuberculosis, childhood diseases.

Diagnosis

Diagnosis is made by medical treatment based on patient interview, patient history, physical examination, symptoms, laboratory methods, pulmonary function test (spirometry) and imaging techniques.

Nonpharmacologic treatment

  • Cough drops, sage lozenges.
  • Drink plenty of fluids, cough teas
  • Warm compresses, e.g. potato compresses
  • Inhalations
  • Smoking cessation

Drug treatment

Drug treatment depends on the cause. For example, inhaled glucocorticoids and bronchodilators, rather than antitussives, are prescribed for asthma. Acid regurgitation is often treated with proton pump inhibitors, which stop gastric acid secretion. Antitussives:

  • Are cough-irritant drugs used for symptomatic treatment of an unproductive irritable cough. The best-known active ingredients include codeine (e.g., Resyl plus), dextrometorphan (e.g., Bexin, Pulmofor), and butamirate (e.g., NeoCitran cough suppressant). When dispensing, it is important to remember that antitussives can cause adverse effects and are sometimes susceptible to drug-drug interactions. Due to its cleansing function, coughing should not usually be systematically suppressed on a permanent basis. Antitussives are therefore often administered once daily before bedtime.

Expectorants:

Herbal medicines:

Cold balms:

  • Contain essential oils in a greasy base and are rubbed on the chest. They should not be used on infants and young children, depending on their composition.

Antibiotics:

  • Are indicated only if the cough is due to a bacterial infection. Antibiotics are not required for a common cold cough.

Antihistamines:

  • Such as loratadine (Claritine, generic) and cetirizine (Zyrtec, generic) should be administered only if there is an underlying allergic cause. First-generation antihistamines are included in many cold medications. The reason for their use is primarily that they inhibit secretion.