Cough

Cough

A young boy coughing due to pertussis causing
whooping cough.
Coughing

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The sound of a person coughing.
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Classification and external resources
pronunciation (help·info) Latin:
Pronunciation
tussis
Specialty
Infectious disease
ICD-10
R05
ICD-9-CM 786.2
DiseasesDB 17149
MedlinePlus 003072
eMedicine ENT/1048560
MeSH
D003371
[edit on Wikidata]

usually accompanied by a distinctive sound. a forced exhalation against a closed glottis. lung tumors. irregular coughing is caused by a respiratory tract infection but can also be triggered by choking. Treatment should target the cause.[1] asthma. Cough suppressants such as codeine or dextromethorphan are frequently prescribed. Most of the time. especially if the cough is productive.A cough is a sudden and often repetitively occurring reflex which helps to clear the large breathing passages from secretions.4 Air pollution o 2. Frequent coughing usually indicates the presence of a disease.3 Gastroesophageal reflux o 2. heart failure and medications such as ACE inhibitors. smoking cessation or discontinuing ACE inhibitors.7 Psychogenic cough o 2.[2] Contents  1 Classification  2 Differential diagnosis o 2.1 Infections o 2.5 Foreign body o 2.9 Other  3 Pathophysiology  4 Diagnostic approach  5 Treatment . and a violent release of air from the lungs following opening of the glottis. post-nasal drip. Many viruses and bacteria benefit evolutionarily by causing the host to cough. As it is a natural protective reflex.[1] Coughing is either voluntary or involuntary.6 Angiotensin-converting enzyme inhibitor o 2. but have been demonstrated to have little effect. chronic bronchitis. The cough reflex consists of three phases: an inhalation. gastroesophageal reflux disease. which helps to spread the disease to new hosts. smoking. suppressing the cough reflex might have damaging effects. air pollution.8 Neurogenic cough o 2. for example.2 Reactive airway disease o 2. Other treatment options may target airway inflammation or may promote mucus expectoration. foreign particles and microbes. irritants.

[3] Infections A cough can be the result of a respiratory tract infection such as the common cold. pertussis. and timing. and a tickle in the throat. Symptoms may include a tightness in the chest. and chronic when lasting longer than eight weeks. or tuberculosis.e.[3] A barky cough is part of the common presentation of croup. acute bronchitis. This cough may often persist for weeks after an illness.[3] In adults with a chronic cough. the person may be left with a postinfectious cough.[5] Differential diagnosis A cough in children may be either a normal physiological reflex or due to an underlying cause. acute coughs. a cough longer than 8 weeks.[3] The causes of chronic cough are similar in children with the addition of bacterial bronchitis. quality. asthma.[6] In people with a normal chest X-ray. This typically is a dry.[3] The most common cause of an acute or subacute cough is a viral respiratory tract infection. non-productive cough that produces no phlegm. pneumonia. eosinophilic bronchitis. Treatment consists of any anti-inflammatory medicine (such as ipratropium) [7] to . 6 Complications  7 Epidemiology  8 Other animals  9 References  10 External links Classification A cough can be classified by its duration.[3] The duration can be either acute (of sudden onset) if it is present less than three weeks.[3] In healthy children it may be normal in the absence of any disease to cough ten times a day. While these have not been found to be diagnostically useful in adults.[3] A number of characteristic coughs exist. tuberculosis is a rare finding. which in turn produces more coughing. coughs shorter than 3 weeks. are due to the common cold.[4] while a staccato cough has been classically described with chlamydia pneumonia. character. and gastroesophageal reflux disease. After a respiratory tract infection has cleared. In the vast majority of cases. The repetition of coughing produces inflammation which produces discomfort. more than 90% of cases are due to post-nasal drip. i. It may occur only at night (then called nocturnal cough). they are of use in children.[3] A cough can be non-productive (dry) or productive (when sputum is coughed up). subacute if it is present between three and eight weeks. or just during the day. The cause of the cough may be inflammation similar to that observed in repetitive stress disorders such as carpal tunnel syndrome. i. Pertussis is increasingly being recognised as a cause of troublesome coughing in adults. during both night and day.e.[7] Postinfectious cough typically does not respond to conventional cough treatments.

Chronic bronchitis is defined clinically as a persistent cough that produces sputum (phlegm) and mucus.[citation needed] Inflammation may increase sensitivity to other existing issues such as allergies. abundant eosinophils in the sputum. sour taste in the mouth. but with normal airway function and responsiveness. shortness of breath. and a tight feeling in their chest. A bronchodilator. People who exercise outdoors on hot. for example. increase their exposure to pollutants in the air. Coughing may be the only symptom the person has from their asthma. Cough can also worsen in an acute exacerbation of chronic obstructive pulmonary disease. and a cough suppressant to reduce frequency of the cough until inflammation clears. Eosinophilic bronchitis is also characterized by eosinophils in the sputum. Treatment of the asthma should make the cough go away. Individual reactions to air pollutants depend on the type of pollutant a person is exposed to. Sometimes GERD can complicate respiratory ailments related to cough. irritant gases.[3] This occurs when acidic contents of the stomach come back up into the esophagus. An esophageal pH monitor can confirm the diagnosis of GERD. which helps open up the airways. Chronic bronchitis is often the cause of "smoker's cough". without airway hyperresponsiveness or an atopic background. Two related conditions are atopic cough and eosinophilic bronchitis. particulate matter. May also be caused by pneumoconiosis and long-term fume inhalation. Air pollution Coughing may be caused by air pollution including tobacco smoke. and treatment of other causes of coughs (such as use of an air purifier or allergy medicines) may help speed recovery. May be treated by quitting smoking. This condition responds to treatment with corticosteroids.[3] The human health effects of poor air quality are far reaching.[citation needed] Reactive airway disease When coughing is the only complaint of a person who meets the criteria for asthma (bronchial hyperresponsiveness and reversibility). although. Depending on how severe the asthma is. but principally affect the body's respiratory system and the cardiovascular system. gastroesophageal reflux disease should be considered. Asthma is a common cause of chronic cough in adults and children. for at least three months in two consecutive years. this is termed cough-variant asthma. The treatment involves anti-acid medications and lifestyle changes with surgery indicated in cases not manageable with conservative measures. Coughing helps clear those secretions out. secretion of mucus into the airway. .treat the inflammation. or a feeling of acid reflux in the chest. may also help treat this type of cough. more than half of the people with cough from GERD don’t have any other symptoms. or asthma symptoms may also include wheezing. Atopic cough occurs in individuals with a family history of atopy (an allergic condition). The tobacco smoke causes inflammation. such as asthma or bronchitis. the degree of exposure. Gastroesophageal reflux In people with unexplained cough. Symptoms usually associated with GERD include heartburn. smoggy days. and difficulty clearing that mucus out of the airways. it can be treated with bronchodilators (medicine which causes the airways to open up) or inhaled steroids. and dampness in a home. the individual's health status and genetics.

and high blood pressure. Through irritation of the nerve. In 10-25%[citation needed] of the people who take it. and might explain why workers in factories with these vegetables can develop a cough.Foreign body A foreign body can sometimes be suspected. Such medicines for hypertension are very common in use such as ramipril and quinapril.[11] Other causes of nocturnal cough include asthma. as the heart does not compensate for the increased volume shift to the pulmonary circulation. Nocturnal cough is associated with heart failure. heart disease. Rarely. Angiotensin-converting enzyme inhibitor Angiotensin-converting enzyme inhibitors are drugs used in diabetics. capsaicin is widely used to determine the cough threshold and as a tussive stimulant in clinical research of cough suppressants. Cessation of ACE Inhibitor use is the only way to stop the cough.[10] Treatment for neurogenic cough may include the use of certain neuralgia medications.[9] Psychogenic cough is thought to be more common in children than in adults. sutures left behind inside the airway branches can cause coughing.[9] Neurogenic cough Some cases of chronic cough may be attributed to a sensory neuropathic disorder. interstitial lung diseases and sarcoidosis. Capsaicin is what makes chili peppers spicy. other illnesses have to be ruled out before a firm diagnosis of psychogenic cough is made. in turn causing pulmonary edema and resultant cough. Other Cough may also be caused by conditions affecting the lung tissue such as bronchiectasis. A cough can be triggered by dryness from mouth breathing or recurrent aspiration of food into the windpipe in people with swallowing difficulties. Psychogenic coughing is different from habit coughing and tic coughing. for example) can also cause cough.[12] Another cause of cough occurring preferentially in supine position is recurrent aspiration. for example if the cough started suddenly when the patient was eating.[11] Given its irritant nature to mammal tissues. However. post-nasal drip and gastroesophageal reflux disease (GERD). A possible scenario: psychogenic cough develops in a child who has a chronically ill brother or sister. although it should be distinguished from throat-clearing in this disorder. "habit cough" or "tic cough" may be the cause in the absence of a physical problem. diseases of the external auditory canal (wax. it can cause them to have a cough as a side effect. pulmonary infarction and aortic aneurysm.[8] Psychogenic cough A psychogenic cough. There are cases of "cough of unknown origin" who had resolution with stopping the drug. emotional and psychological problems are suspected. . cystic fibrosis. Coughing may occur in tic disorders such as Tourette syndrome. Cardiovascular diseases associated with cough are heart failure. In these instances. Coughing can also be triggered by benign or malignant lung tumors or mediastinal masses.

[3] Further workup may include labs. namely the myelinated rapidly adapting receptors. or become a maladaptive displacement behavior. x-rays. A cough is a protective reflex in healthy individuals which is influenced by psychological factors. such as coughing before giving a speech.[13] According to the American Academy of Pediatrics the use of cough medicine to relieve cough symptoms is supported by little evidence and thus not recommended for treating cough symptoms in children.[14] It appeared similar to . Pathophysiology Coughing is viewed as a public health issue. Coughing is not always involuntary.Coughing may also be used for social reasons. and nonmyelinated C-fibers with endings in the lungs. and spirometry. In children half of cases go away without treatment in 10 days and 90% in 25 days. Diagnostic approach The determination of the cause of a cough usually begins by determining if it is specific or nonspecific in nature. Coughing can be used to attract attention. and can be used in social situations. coughing may become one of many displacement behaviors and/or defense mechanisms.[3] There is tentative evidence that the use of honey is better than no treatment or diphenhydramine in decreasing coughing. However it is not certain that the stimulation of nonmyelinated C-fibers leads to cough with a reflex as it's meant in physiology (with its own five components): this stimulation may cause mast cells degranulation (through an asso-assonic reflex) and edema which may work as a stimulus for rapidly adapting receptors. In such environments.[3] The cough reflex is initiated by stimulation of two different classes of afferent nerves.[3] Treatment The treatment of a cough in children is based on the underlying cause.[3] A specific cough is one associated with other symptoms and further workup is dependent on these symptoms while a non specific cough occurs without other signs and symptoms. It is believed that the frequency of such coughing increases in environments vulnerable to psychological tension and social conflict. release internal psychological tension.

  Goldsobel AB.   Pavord ID. acute cough is due to acute viral upper respiratory tract infection (URTI). Paediatr Child Health 12 (6): 473–477.. Am Fam Physician 73 (8): 1411–6. PMID 18424325.   Dicpinigaitis PV. Chipps BE (March 2010). cough-induced vomiting. PMID 18424326.[3] Complications The complications of coughing can be classified as either acute or chronic. Cough 5: 11.   Postinfectious cough: ACCP evidence-based clinical practice guidelines. tic cough. Johnson DW (July 2007). Goolsby MJ. PMID 20176183.129. PMID 16669564.   Miller KE (April 2006). coughing defecation and in women with a prolapsed uterus. Cardiologist: "Cases of Cough of unknown origin. Chang AB (January 2006). PMC 2802352. data on file. Epidemiology A cough is the most common reason for visiting a primary care physician in the United States.   Kostas Koliopoulos. the common cold.1016/j. PMID 16428707. cough urination. Lancet 371 (9621): 1364–74. In the vast majority of cases. due to use of ACE medication for hypertension".174S.1378/chest.004. pathogenesis. "Diagnosis and treatment of Chlamydia trachomatis infection". . Spector SL. "Habit cough.2009. doi:10.1186/17459974-5-11.e1. PMID 19030411.[15] References 1.jpeds. "Management of chronic cough".1_suppl.e. doi:10. Pavord ID (April 2008). PMID 20015366. Rogg GI. "Prevalence. Pediatr. PMC 2528757. "Cough in the pediatric population". insomnia. subconjunctival hemorrhage or "red eye". and causes of chronic cough". Chung KF (April 2008). Winther B (2009).dextromethorphan.[14] A trial of antibiotics or inhaled corticosteroids may be tried in children with a chronic cough in an attempt to treat protracted bacterial bronchitis or asthma respectively. Retrieved 2010-07-09. Lancet 371 (9621): 1375–84. fatigue fractures of lower ribs and costochondritis. J. Chest 129 (1 Suppl): 174S–179S. Glomb WB. i. "Acute cough: a diagnostic and therapeutic challenge".1016/S0140-6736(08)60596-6. Acute complications include cough syncope (fainting spells due to decreased blood flow to the brain when coughs are prolonged and forceful). "Croup in the paediatric emergency department".12. doi:10. doi:10. Preveza.  Chung KF.[3] Other animals Marine mammals such as dolphins cannot cough.   Bjornson CL. 2010   Irwin RS. Chronic complications are common and include abdominal or pelvic hernias. doi:10. Colice GL. Greece. 156 (3): 352–358. rupture of blebs causing spontaneous pneumothorax (although this still remains to be proven). and psychogenic cough in adult and pediatric populations: ACCP evidence-based clinical practice guidelines".1016/S0140-6736(08)60595-4.

TARGET Programme. doi:10.   NCBI » Bookshelf » Clinical Methods » The Pulmonary System » Cough and Sputum Production By Sattar Farzan. Boston: Butterworths. doi:10. "Honey for acute cough in children.) 347: f7027. EE (Mar 14.  http://vet. C. W Dallas Hall.  Gibson PG.pub3. DI. Extracted from the book Clinical Methods. "Duration of symptoms of respiratory tract infections in children: systematic review. and J Willis Hurst. MM. PS. Meremikwu. Buckley. and Laboratory Examinations. Ryan NM (August 2011). Udoh.2011. PMID 22419319. Heneghan. BMJ (Clinical research ed. Hay.sagepub.html National Lung Health Education Program > C. Physical. The Cochrane database of systematic reviews 3: CD007094. Oyo-Ita.org/books/pul_Pre/chronic-cough. 3rd edition The History. MD. M. 1990.cd007094. Team (Dec 11. PMID 24335668.com/content/6/3/257.1517/14656566. Expert Opinion on Pharmacotherapy 12 (11): 1745–1755. MD. 2013). A. ISBN 0-9671809-2-9   Thompson. TA.". Chronic Cough] The Snowdrift Pulmonary Foundation. Vodicka.   Oduwole. doi:10.full. PMID 21524236. Blair. ISBN 0-409-90077-X   http://www. MD.1136/bmj.pdf .". 2000.576249.nlhep. 2012). O. "Cough pharmacotherapy: current and future status".1002/14651858. Edited by H Kenneth Walker. AD. Inc.f7027. PMC 3898587.