Causes Of Cough

Coughing is a natural reflex reaction of the body to irritation of the airways.

Physiologically speaking, coughing is a natural reflex reaction of the body to irritation of the respiratory tract. Normally, in all people, the respiratory tract is covered with a layer of mucus from the inside, which cleans them, protects them from drying out, infections and other dangers. The quantity and quality of this mucus is strictly controlled by physiological mechanisms (the work of the glands, the peristaltic movements of the bronchi, as well as the work of microscopic cilia on the inner surface of the bronchi and trachea), and "emergency" cleansing of the airways occurs using the cough reflex.

In everyday life, coughing, especially painful and debilitating, often causes serious discomfort. Frequent nocturnal coughing fits when a person is in a horizontal position can lead to sleep deprivation. Coughing fits in public places cause discomfort not only to the coughing person, but also to those around them. The cough itself can also have adverse effects. Frequent persistent cough, especially in the form of prolonged attacks, can contribute to a gradual increase in blood pressure in the pulmonary circulation. A strong cough can provoke mild hemorrhages in the vessels of the eye sclera and in the bronchial vein system. Very intense coughing fits in rare cases can lead to fainting, heart rhythm disturbances, and even seizures.

At the same time, perfectly healthy people can cough after inhaling some irritating substances: smoke, dust, soot, fumes, chemicals, cosmetics, or even too dry or hot air. In this case, coughing is not a reflection of a pathological process, but a healthy way to cleanse the respiratory tract from irritating substances and mucus, in which they settle and accumulate.

Cough as a symptom of a respiratory illness

Cough can be caused by a wide range of diseases that may or may not be associated with pathological processes in the respiratory system (see below), and the cough itself cannot be considered a disease or even a symptom of any particular disease. Rather, a cough is a signal from the body that not everything is well in the respiratory system, that you should pay attention to this, and possibly consult a doctor. For an experienced doctor, the nature and characteristics of the cough in a particular patient, as well as other symptoms that accompany it, can tell a lot.

The most common cough occurs with acute respiratory infections caused by viruses or bacteria. In addition to coughing, with respiratory infections, many other symptoms are observed - runny nose, headaches, fever, etc.

With respiratory infections, coughing can be a symptom of conditions such as:

• Pharyngitis - inflammation of the pharyngeal mucosa. A sore throat in this case is often accompanied by a dry and sometimes painful cough;
• Laryngitis is an inflammation of the larynx. It manifests itself in hoarseness or loss of voice, dry rough "barking" cough, which is accompanied by pain and discomfort in the throat and when swallowing;
• Tracheitis - inflammation of the trachea. Often occurs as a consequence of pharyngitis or laryngitis. It is accompanied by a dry cough, especially at night and in the morning, as well as chest pain;
• Bronchitis - inflammation of the bronchi, often also a consequence of inflammation of the overlying parts of the respiratory tract (tracheitis, laryngitis). Characterized at first is a dry, debilitating, especially at night, cough, which then turns into a wet cough with mucopurulent sputum. During a medical examination, weak dry and / or moist rales are heard in the lungs against the background of hard breathing;
• Pneumonia - pneumonia. Different types of pneumonia are accompanied by different symptoms, including dry or wet cough, sudden fever, weakness, headache, chest pain when coughing. With "typical" pneumonia, there is a wet cough with purulent sputum;
• In preschool children, a cough can appear with prolonged rhinitis and inflammation of the adenoids. In this case, a superficial cough without wheezing is possible, which is caused by mucus flowing from the nasopharynx along the back of the pharynx or larynx.

Other possible causes of cough:

• Allergic reactions, including those associated with bronchial asthma or hay fever. Allergic cough can be the initial manifestation of bronchial asthma, so it is important to find the allergen that triggers the cough and get rid of it.
• Diseases and disorders of the esophagus, such as gastroesophageal reflux
• Helminth infections.
• The ingestion of foreign bodies in the respiratory tract, especially in children.
• Side effects of drugs aimed at treating another disease. These include, for example, some drugs for the treatment of hypertension.
• Pathology of the heart, stagnation of blood in the pulmonary circulation.
• Chronic wet cough is seen in smokers, chronic obstructive pulmonary disease (COPD) and other chronic respiratory diseases. Under unfavorable conditions and improper treatment, acute tracheitis and bronchitis can also acquire a chronic form. So, in European countries, eosinophilic bronchitis accounts for 7 to 20% of all diseases with cough.
• The characteristic paroxysmal cough can be a symptom of whooping cough.
• Cough can be a manifestation of diseases such as lung cancer or tuberculosis.
• In terms of duration, cough is divided into acute (lasting less than 3 weeks), subacute (from 3 to 8 weeks) and chronic (more than 8 weeks). If the cough persists for several weeks, you need to see a doctor and find out its origin.

Links:
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4. PE Gibson et al., Mechanism of Cough. Curr Opin Allergy Clin Immunol 2014 14: 55-61.