Cough – symptom complex

Synonyms in a broader sense

Chicks, chestnuts, irritable cough, coughing irritation engl. : to cough

Introduction

Coughing can be a symptom of many different diseases, such as a cold, bronchitis or allergic asthma. This makes coughing one of the most frequent reasons for patients to present themselves to their family doctor. It is particularly important for the doctor to clarify whether the cough is acute, i.e. sudden and only recently; or chronic (> 8 weeks).

A sudden cough without warning symptoms such as high fever, chest pain, shortness of breath or coughing up blood is usually a sign of a simple cold or a reaction to irritation in the throat area, e.g. in allergic asthma. If a cough lasts longer than 8 weeks or if warning symptoms (see above) occur, additional diagnostic measures such as an X-ray or lung function examination must be carried out. This can help to rule out more serious diseases.

Especially in smokers, lung cancer can be hidden behind a dry, long-standing cough. Coughing sometimes occurs suddenly and quickly develops its full extent or begins rather slowly, and may be a precursor of the disease in the form of sore throat. The cough, whatever its cause, is characterized by a pulling sensation in the chest and neck area.

After coughing up, there is a brief improvement before the coughing irritation increases again. In many cases, the cough does not begin until night and while lying down, or worsens at this time of day. The reason is that the ciliated epithelium of the upper airways reduces the workload at late hours and no longer transports foreign substances (mucus etc.)

out of the lungs as quickly. The accumulation of mucus from the bronchial tubes then triggers the coughing sensation. In this way, the body wants to clear the airways as quickly as possible to ensure the exchange of oxygen.

After long periods of coughing, cough-related pain is sometimes added to the symptoms, which further worsens the overall clinical picture. The reason is mechanical overstrain of the respiratory muscles, which are increasingly weakened by the constant coughing. Many patients then try to suppress the coughing stimulus in order to avoid the painful coughing up.

However, the attempt to suppress the cough usually leads to a further increase in the coughing stimulus. After very long periods of coughing or after very hard coughing up, a so-called pneumothorax may develop. This is a detachment of one half of the lung from the thorax.

The consequence is a constriction of the lung and thus a reduced ventilation of this side. A pneumothorax becomes noticeable with shortness of breath and pain. If this leads to a lateral displacement of the internal organs, we speak of a tension pneumothorax, which requires emergency treatment. Cold and dry ambient air increases the urge to cough; moist and warm air tends to weaken it.