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Chronic cough
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Chronic cough
In clinical guidelines chronic cough is defined as a cough lasting more than 8 weeks in adults and more than 4 weeks in children. Some consensus statements suggest that a chronic cough must persist upwards of three months or more to be considered chronic. The prevalence of chronic cough is about 10% although the prevalence may differ depending on definition and geographic area. Chronic cough is a common symptom in several different respiratory diseases like COPD or pulmonary fibrosis but in non-smokers with a normal chest x-ray chronic cough are often associated with asthma, rhinosinusitis, and gastroesophageal reflux disease or could have no specific cause known (idiopathic). Generally, a cough, for example after an upper respiratory tract infection, lasts around one to two weeks; however, chronic cough can persist for an extended period of time, several years in some cases. The current theory about the cause of chronic cough, independent of associated condition, is that it is caused by a hypersensitivity in the cough sensory nerves, called cough hypersensitivity syndrome. There are a number of treatments available, depending on the associated disease but the clinical management of the patients remains a challenge. Risk factors include exposure to cigarette smoke, and exposure to pollution, especially particulates.
Common symptoms present in chronic cough is allotussia, a cough triggered by innocuous stimuli such as perfumes or talking and hypertussia, an increased sensitivity to known tussive triggers like smoke or fumes. Laryngeal paraesthesia, irritation, tickle or lump in the throat, is also common. Other symptoms includes frequent throat clearing and sore throat, hoarseness, wheezing or shortness of breath. If the chronic cough is associated with rhinosinusitis or reflux, symptoms may also include a runny or stuffy nose, a feeling of liquid running down the back of the throat (postnasal drip), heartburn or sour taste in a person's mouth, and in rare cases coughing blood. Most patients with chronic cough have hypersensitivity of the cough reflex, such as the Arnold's nerve reflex.
Long-term coughing and constant irritation of the upper airway can be problematic for individuals who have chronic cough. Due to the consistent coughing, this can interfere with an individual's daily life. This interference can thus cause additional problems such as affecting a person's ability to ensure a consistent sleep, daytime fatigue, difficulty concentrating at work or school, headache, and dizziness. Other more severe but rare complications include fainting, urinary incontinence, and broken ribs, caused by excessive coughing.
Possible causes, alone or in conjunction, that produce the chronic cough include the following.
Life style related factors, some health conditions or diseases, and environmental exposures can put people at risk for developing a chronic cough. Life-style risk factors include smoking cigarettes that the individual smokes themselves or breathes from second-hand exposure. Long-term exposure to smoke can irritate airways and lead to chronic cough and in severe cases lung damage. Other risk factors include exposure to polluted air. Individuals who work in factories or laboratories that deal with chemicals have a chance of developing chronic cough from long-term exposure.
Coughing is a mechanism of the body that is essential to the normal physiological function of clearing the throat, which involves a reflex of the afferent sensory limb, central processing centre of the brain, and the efferent limb. With the body components involved, sensory receptors are also used. These receptors include rapidly adapting receptors which respond to mechanical stimuli, slowly adapting receptors, and nociceptors which respond to chemical stimuli such as hormones in the body. To start the reflex, the afferent impulses are transmitted to the medulla of the brain; this stimulus is then interpreted. The efferent impulses are then triggered by the medulla, causing the signal to travel down the larynx and bronchial tree. This then triggers a cascade of events that involve the intercostal muscles, abdominal wall, diaphragm and pelvic floor, which together create the reflex known as coughing.
There are three main types of chronic cough.[dubious – discuss]
Typical evaluation of chronic cough begins with diagnosing the person's lifestyle choices, such as smoking, environmental exposure or medication. From this doctors can opt to use chest radiography if the patient does not smoke, takes any angiotensin-converting enzyme inhibitor, or still has a persistent cough after the period of medication.
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Chronic cough AI simulator
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Chronic cough
In clinical guidelines chronic cough is defined as a cough lasting more than 8 weeks in adults and more than 4 weeks in children. Some consensus statements suggest that a chronic cough must persist upwards of three months or more to be considered chronic. The prevalence of chronic cough is about 10% although the prevalence may differ depending on definition and geographic area. Chronic cough is a common symptom in several different respiratory diseases like COPD or pulmonary fibrosis but in non-smokers with a normal chest x-ray chronic cough are often associated with asthma, rhinosinusitis, and gastroesophageal reflux disease or could have no specific cause known (idiopathic). Generally, a cough, for example after an upper respiratory tract infection, lasts around one to two weeks; however, chronic cough can persist for an extended period of time, several years in some cases. The current theory about the cause of chronic cough, independent of associated condition, is that it is caused by a hypersensitivity in the cough sensory nerves, called cough hypersensitivity syndrome. There are a number of treatments available, depending on the associated disease but the clinical management of the patients remains a challenge. Risk factors include exposure to cigarette smoke, and exposure to pollution, especially particulates.
Common symptoms present in chronic cough is allotussia, a cough triggered by innocuous stimuli such as perfumes or talking and hypertussia, an increased sensitivity to known tussive triggers like smoke or fumes. Laryngeal paraesthesia, irritation, tickle or lump in the throat, is also common. Other symptoms includes frequent throat clearing and sore throat, hoarseness, wheezing or shortness of breath. If the chronic cough is associated with rhinosinusitis or reflux, symptoms may also include a runny or stuffy nose, a feeling of liquid running down the back of the throat (postnasal drip), heartburn or sour taste in a person's mouth, and in rare cases coughing blood. Most patients with chronic cough have hypersensitivity of the cough reflex, such as the Arnold's nerve reflex.
Long-term coughing and constant irritation of the upper airway can be problematic for individuals who have chronic cough. Due to the consistent coughing, this can interfere with an individual's daily life. This interference can thus cause additional problems such as affecting a person's ability to ensure a consistent sleep, daytime fatigue, difficulty concentrating at work or school, headache, and dizziness. Other more severe but rare complications include fainting, urinary incontinence, and broken ribs, caused by excessive coughing.
Possible causes, alone or in conjunction, that produce the chronic cough include the following.
Life style related factors, some health conditions or diseases, and environmental exposures can put people at risk for developing a chronic cough. Life-style risk factors include smoking cigarettes that the individual smokes themselves or breathes from second-hand exposure. Long-term exposure to smoke can irritate airways and lead to chronic cough and in severe cases lung damage. Other risk factors include exposure to polluted air. Individuals who work in factories or laboratories that deal with chemicals have a chance of developing chronic cough from long-term exposure.
Coughing is a mechanism of the body that is essential to the normal physiological function of clearing the throat, which involves a reflex of the afferent sensory limb, central processing centre of the brain, and the efferent limb. With the body components involved, sensory receptors are also used. These receptors include rapidly adapting receptors which respond to mechanical stimuli, slowly adapting receptors, and nociceptors which respond to chemical stimuli such as hormones in the body. To start the reflex, the afferent impulses are transmitted to the medulla of the brain; this stimulus is then interpreted. The efferent impulses are then triggered by the medulla, causing the signal to travel down the larynx and bronchial tree. This then triggers a cascade of events that involve the intercostal muscles, abdominal wall, diaphragm and pelvic floor, which together create the reflex known as coughing.
There are three main types of chronic cough.[dubious – discuss]
Typical evaluation of chronic cough begins with diagnosing the person's lifestyle choices, such as smoking, environmental exposure or medication. From this doctors can opt to use chest radiography if the patient does not smoke, takes any angiotensin-converting enzyme inhibitor, or still has a persistent cough after the period of medication.