Cough

Coughs are sudden and explosive movements, which remove particles and excess mucus from the airways. Coughing is a protective response, which prevents foreign material from entering and damaging the lungs. Coughs are a common symptom of respiratory illnesses.

Coughs may be acute (lasting less than 3 weeks) or chronic (lasting longer than 3 weeks). Coughs fall broadly into two categories: productive (mucus producing) and non-productive (dry).

Dry Coughs are usually caused by a viral illness. The cough is triggered by a tickling sensation in the throat. The upper airways may be inflamed and a postnasal drip may be present. A viral Cough usually resolves within 2-3 weeks.

Productive Coughs usually indicate a bacterial infection, or allergic reaction. When the airways are irritated, excess mucus is produced to trap foreign particles. Coughing then helps the body to remove this extra mucus from the airways. Non-infected mucus, produced during allergic reactions, appears white or clear. Mucus with a green or yellow colour is a sign of infection. Streaks of blood in the mucus may be a sign of mild trauma due to violent coughing. Heart failure may cause a cough with frothy pink mucus, while bright red mucus is a sign of fresh bleeding in the upper airways. If any blood appears in the mucus, your Doctor should be consulted. Productive Coughs are also referred to as 'chesty' coughs, with the related symptoms of 'chestiness' and 'congestion'.

CAUSE
INFECTION
An acute cough is usually caused by a viral infection such as the common cold and is commonly associated with a sore throat. A dry cough can be early symptom of pneumonia along with fever, coloured mucus and breathlessness. Tuberculosis may present as a chesty cough and is more likely to occur in high-risk people such as the elderly, alcoholics, those with a suppressed immune system. Initial symptoms of whooping cough are similar to the common cold. The cough then develops a characteristic 'whooping' sound.

POST-NASAL DRIP (PND) often develops in people as a result of allergies or the common cold. Nasal secretions entering and irritating the lining of the throat cause the PND cough.

ASTHMA may present as a chronic cough with wheezing, breathlessness or tightness of the chest.

GASTRIC REFLUX occurs when acidic stomach contents move upwards into the oesophagus. This can cause a burning sensation in the chest and a chronic cough may develop. A cough caused by reflux is usually worse at night or on bending and straining.

BRONCHITIS refers to inflammation of the bronchial tree (the breathing tubes within the lungs). Chronic bronchitis is characterized by a long-term, productive cough.

BRONCHIECTASIS is an abnormal enlargement of the main airways (bronchi) that carry air into the lungs. This condition can cause a chronic, chesty cough with large amounts of coloured, foul-smelling mucus.

MEDICATIONS such as ACE inhibitors causes a dry cough in 15% of people. The cough usually resolves within weeks of withdrawal of the drug.

PSYCHOGENIC COUGH, habit or nervous cough usually present as a barking or honking sound or as a repeated dry cough. This type of cough usually begins as part of a viral infection and continues voluntarily due to the attention the person receives or as a result of anxiety. Symptoms are absent during sleep with this type of cough.

HEART FAILURE may cause a type of cough. Left-ventricular heart failure may produce the symptom of a night-time cough, therefore it is important to seek medical advice for any type of unexplained or persistent coughing.

TREATMENT OPTIONS
As with all conditions your Doctor should be consulted. Your Doctor will diagnose and treat this condition. A specific diagnosis by your Doctor can usually be made with a thorough history, physical examination and simple laboratory investigations. Your Doctor might suggest a chest X-ray and other tests to diagnose the cause of the cough.

DIET HINTS
• Try to avoid all foods that aggravate the cough reflex. Food allergies or intolerances may promote coughing.
• Dry foods e.g., biscuits or crispbread and spicy or very sweet foods may promote coughing, while liquids tend to have a soothing action.
• Foods high in vitamins A, C, E and zinc may help the body to combat any infections, which may be present. Citrus fruits as well as red, orange and yellow fruits and vegetables are high in these vitamins.
• Garlic and onions should be eaten regularly to help shift mucus out of the lungs and help combat infections. Garlic has natural antibiotic properties, which is thought to be useful in combating infections.
• Try to drink plenty of fruit and vegetable juices at room temperature. These may help expel mucus and sooth the throat. Ginger, added to juices and cooking, is an effective herb for coughing.

VITAMINS/MINERALS/HERBS
• Vitamin A may enhance immune function.
• Vitamin C may enhance immune function and may assist chronic bronchitis via its anti allergy actions
• Zinc may assist in boosting the immune system.
• Garlic may be useful due to its antibacterial properties.
• Liquorice herb can be effective to reduce coughing, enhance immune function and sooth the respiratory tract. Note: Caution should be used with people suffering from high blood pressure.
• Echinacea herb can assist as has antiviral and antibacterial actions.
• Cherry bark has an expectorant action, which may reduce coughing.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Suppressants are effective in relieving a dry cough. Common ingredients in cough suppressants include pholcodine, codeine and dextromethorphan. It is important that a cough suppressant is not used for a productive cough as this can worsen the condition.
2. Demulcents such as lemon, glycerin, honey and eucalyptus are soothing and have few side effects. They are particularly suitable for children due to their pleasant flavour.
3. Expectorants are used to treat productive coughs. They help loosen the mucus to make it more easily coughed up. The active ingredient is called guaiphenesin.
4. Sympathomimetics are used when a combination of suppressants and expectorants is desired. They may cause sleeplessness and are not suitable for children, or patients taking certain medications.
5. Smoking is a common cause of coughing. It causes extreme irritation to the airways and increases the risk of infections. Ask your Pharmacist about the range of products available to help you stop smoking.
6. A steam vaporiser can help by humidifying the air and reducing irritation to the upper airways.