General information
Coughing is a mechanism of the body that serves to self-cleanse the respiratory tract. It is needed as a cleansing reflex especially when the cleaning of the bronchial tree by the cilia no longer works. In addition, coughing also occurs when the bronchial system is supplied with highly contaminated air or when one swallows.
Causes
Coughing itself is not a disease, but a symptom of almost all bronchial and lung diseases. In addition, coughing can also occur in diseases of the upper respiratory tract, as an undesirable side effect of taking certain medications (for example ACE inhibitors to lower blood pressure) or of reflux of stomach acid. Acute cough is distinguished from chronic cough, i.e. a cough that lasts longer than eight weeks.
A frequent cause of an acute cough is a viral infection of the upper airways (acute bronchitis). The causes of chronic cough are chronic bronchitis (especially in smokers), chronic obstructive bronchitis (COPD), bronchial asthma and chronic inflammation of the nose and sinuses. Due to these multiple causes, coughing is one of the most common complaints, which is why a patient visits the doctor’s office.
Pain when coughing can have many different causes. The most important factor in determining the cause is the localization of the pain. In the further course of this article we will explain which possibilities there are for pain when coughing, depending on the localization of the pain.
Diagnosis
A doctor’s appointment is particularly necessary if the cough persists for a long period (more than three weeks) or if it is accompanied by other symptoms such as shortness of breath, fever or bloody sputum (haemoptysis). During a medical consultation, it is essential to take a medical history (anamnesis). Here, attention should be paid to whether there are other symptoms in addition to the cough, such as pain when coughing or weight loss, whether the person concerned smokes, what occupation he or she has, whether he or she suffers from allergies and whether he or she is taking certain medications that can also cause irritable coughs.
In the further course of the treatment, the affected person should be physically examined. Special attention should be paid to listening to the bronchi and lungs. Depending on the patient’s general condition and the duration of the cough, an x-ray of the lungs (chest x-ray) may then be appropriate.
A blood sample with a subsequent blood test can also help to detect acute inflammation of the lungs. In some cases, an examination of the bronchi with a flexible tube, an endoscope (bronchoscopy), is also indicated. If it is still unclear why pain occurs when coughing, an examination of the organs located in the region of the strongest pain can also be helpful.
