Cough is a reflex that the body produces in an attempt to force out mucus in the respiratory system. This is include mucus produced in the nose, throat, larynx, airways and lungs. Cough is a symptom rather than a diagnosis explained our chronic cough doctor specialist.
Prolonged Cough however can be distressing it can affect your sleep, make you very tired, affects your concentration and even work and academic performance.
In general, cough can be divided into Wet or Dry Cough.
Wet Cough or Productive Cough is caused by excessive mucus produced by the respiratory system. The body produces a cough reflex to expel the mucus orphlegm.
Wet cough is usually associated with runny nose, blocked nose and post nasal drip. This is usually caused by a cold, flu or sinus infection says the chronic cough doctor specialist.
The Duration of wet cough can be Acute if it is less than 3 weeks or Chronic if it lasts more than 8 weeks.
Other causes of a wet cough include pneumonia, chronic obstructive pulmonary disease, atelectasis, acute bronchitis and asthma.
In children and babies, the commonest causes are flu or upper respiratory tract infection.
This cough is caused by a scratchy throat where very little or no mucus is expelled. Infection is also the main cause of dry cough – Laryngitis, pharyngitis, mycoplasma and more recently COVID 19. In addition, acid reflux, allergens, irritants and even medicine like ACE inhibitor for hypertension can produce a dry cough.
INVESTIGATION & TREATMENT
The Chronic Cough Specialist will need to take a careful history and perform certain investigations like nasendoscopy, X Rays or Allergy tests to determine the underlying cause. Based on this finding, your cough can be eliminated or greatly reduce.
Productive or Wet Cough tends to be infective. It is therefore important to obtain a sample of mucus or phlegm to send for culture to determine the nature f the infection. In many cases there may be bacteria that are resistant to the usual antibiotics and hence the prolonged cough. The cultures can also be obtained through a nose or throat swab by the cough doctor specialist.
If there is evidence of sinus or chest infection, then X Ray or CT scans of the sinus and lungs are indicated. This will also help determine the severity of the infection.
In most instances, the antibiotics may need to be taken for up to 3 weeks.
In sinusitis that is causing the chronic cough and antibiotics does not eliminated the infection, sinus surgery may be indicated. The aim of sinus surgery is to restore natural drainage of the sinuses and removed diseased mucosa.
In Dry Cough, the cause tend not to be infective. However a nasal swab should still be done to eliminate the possibility of a low grade infection.
In individuals that may have reflux symptoms, a trial of reflux treatment can be performed. This would involve a liquid based antacid that will also form a barrier to acid reflux in the stomach, a stomach acid suppressant and a medication that promotes the movement of gastric contents into the intestine. This combination usually works if reflux is a cause.
Allergic Rhinitis, Pharyngitis and asthma may also trigger a dry cough. Allergy tests such as skin prick test or blood IgE tests may be necessary to identify the cause.
Delayed Food Allergy is cause that is not widely known. After a patient has gone through all the treatment mention above without improvement, delayed food allergy should be investigated. This food allergy is determined by a intradermal food provocation test that is available at our clinic. The allergic food are usually those we take regularly in our diet such as wheat, soy, malt and egg. By eliminating the food from the list, the cough will decrease or stop altogether.
It is therefore important to seek a cough doctor specialist advice if your cough is persistent and does not go away with the usual mediation or after consulting your regularly family doctor.