A cough is considered to be a normal, though nagging, part of having the flu or cold. Usually, it runs its course of a few days and vanishes after generous doses of honey and ginger. But there are times when a cough does not respond to home remedies and may need medical attention.
If the cough persists for a prolonged period [even after the cold has subsided], it can lead to pain in the throat, neck and back, as well as nausea.
A cough that lasts for less than three weeks is most often caused by infections, such as pneumonia, or due to exposure to pollutants or allergens. It will subside once exposure to the pollutant is stopped or if the infection is treated with antibiotics.
A cough that persists for more than three weeks is termed as chronic and may be due to asthma, allergic rhinitis, sinus infection, oesophageal reflux. In case of a chronic cough, you must seek medical attention. Along with fatigue caused by sleep interruptions, it could also lead to chest pain, stomach pain, worsening of hernias and urinary incontinence.
When should you worry?
Chronic cough: Smoking is one of the main causes of a chronic cough, lending it the name ‘smoker’s cough’. However, even non-smokers are susceptible; the most probable causes in this case being post-nasal discharge, chronic bronchitis and acid reflux from the stomach. If the cough lasts for more than three weeks and produces thick sputum, appropriate blood tests and a chest X-ray are necessary to diagnose tuberculosis. Usually, if it is a case of TB, other symptoms such as evening fever, weight loss and fatigue will also be observed.
Cough with breathlessness: This could be due to asthma, and can be ruled out with the help of lung function tests. In case these tests are inconclusive, another way to diagnose if the cough is due to asthma would be to check if you respond to anti-asthma medications.
Cough with blood: This could be due to throat or lung cancer. In less serious instances it could be because of irritation of the lining of the air passages. With every bout of cough the lining of the airways get ruptured and causes some bleeding. At times blood from a stomach ulcer may be coughed up and may cause confusion about the source of bleeding.
Chronic cough in the elderly could be due to disorder called gastro oesophageal reflux disease [GERD], in which the acid from the stomach travels up leading to irritation of the upper oesophagus, pharynx and larynx causing cough.
After effects of a chronic cough:
- Pain in the ribs: In those with brittle bones or osteoporosis it may even lead to fractures in the ribs.
- Loss of sleep: In cough that gets worse on lying down sleep may get disturbed because any attempt to recline can result in a bout of coughing.
- Headache: Cough associated with cold or sinusitis may cause a throbbing headache especially in the temples and forehead. Excessive coughing may also cause pain in the neck.
- Urinary incontinence: This is more common in women. Coughing causes an increase in the abdominal pressure and this causes some urine to leak out.
- Exhaustion: Severe coughing can be tiring.
- Inability to focus on work.
- Worsening of hernia: Continuous and severe cough can cause or worsen hernias in those with weak abdominal muscles.
In case of chronic cough, visit your doctor, diagnose the cause and get it treated accordingly. Neglecting or self medication in this case can be dangerous.
Over the counter remedies
Not all cough syrups are the same. For productive coughs there are expectorants that loosen the sputum and make it easier to cough it up. For dry coughs there are cough suppressants that can suppress the cough reflex and provide some relief. Make sure you take the right one for your kind of cough.
Cough syrups also contain antihistamines that cause drowsiness. So you may want to avoid having them during the day. Although not as effective, medicated lozenges containing menthol, eucalyptus oil, honey, or ginger are also helpful.
This was first published in the September 2012 issue of Complete Wellbeing.
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