Calming a nagging cough

by Karen Bowen

With winter nearly upon us, we are entering the season of snow, ice, and coughs. Although coughing is not particularly pleasant, it is an effective, protective reflex that helps maintain our health by pushing harmful germs, dust, and mucus out of our lungs.

Most coughs are just an inconvenience which ends after a few days. However, some coughs can extend for months, or even years. A cough that lasts eight weeks or more is called a chronic cough.

A chronic cough is more than just an annoyance. By continually interrupting your sleep, it can lead to exhaustion, impaired concentration, and reduced work safety.
A chronic cough will often be accompanied by these other symptoms: a runny/stuffy nose; hoarse voice; sore throat; frequent need to clear your throat; wheezing; heartburn; vomiting; stress incontinence; fainting; lightheadedness; excessive sweating; and/or headaches.

As well, some less common, but more severe, symptoms include: broken ribs ( from extreme coughing fits); coughing up blood; night sweats; shortness of breath; fever (high and/or prolonged); chest pain; and unexplained weight loss.

If your chronic cough includes these more severe symptoms, see your doctor immediately. To treat chronic cough, it is necessary to first identify the underlying medical issues. Once the underlying cause is treated, chronic cough usually disappears.

The following (alone or in combination) are the most common causes: smoking is the leading cause. In addition, postnasal drip, in which sinuses produce excessive mucus, which drips down the back of your throat, triggering the cough reflex.

Infections can also be a cause. After the other symptoms of upper respiratory infections (flu, pneumonia, and a cold) are resolved, a cough may persist. Asthma can be a cause if you have exposure to seasonal allergens, chemicals, fragrances or extreme cold air may trigger coughing. COPDs (chronic bronchitis, emphysema) results when ongoing inflammation of your bronchial tubes triggers a cough that produces blood in the sputum.

GERD (gastro esophageal reflux disease) consists of irritating stomach acid flowing up from your stomach into your esophagus, which can trigger chronic coughing.
ACE inhibitors can also be a cause. One side-effect of medications commonly prescribed for high blood pressure and heart failure is chronic cough.

Less common causes include: aspiration of food; bronchiectasis (damaged airways); bronchiolitis (infection of the bronchioles); cystic fibrosis; lung cancer; non-asthmatic eosinophilic bronchitis (airway inflammation not caused by asthma); sarcoidosis (abnormal inflammatory cells in different parts of your body, most commonly the lungs); whooping cough; and/or heart failure.

To reduce your cough on your own, try using an over-the-counter cough suppressant that contains dextromethorphan (such as Mucinex or Robitussin) to relax the cough reflex. Suck a cough drop or hard candy and/or pack a thermos of fluids, particularly warm liquids (broth, tea, or juice) to drink and soothe your irritated throat.

Between trips: breathe moisturized air, using a kettle, humidifier or steamy shower to reduce irritation; perform nasal irrigations to help flush away excessive secretions; avoid tobacco smoke (first- and second-hand), and other air-born pollutants.

If your chronic cough persists, consult your doctor, who will prescribe an appropriate treatment plan after identifying your particular underlying causes. If an ACE inhibitor medication is the cause, an alternative prescription that doesn’t trigger coughing as a side-effect may be substituted. If allergies or postnasal drip is diagnosed, antihistamines, glucocorticoids and decongestants may be prescribed.

For asthma, inhaled asthma drugs (glucocorticoids and bronchodilators) will reduce inflammation and open your airways. For COPDs, bronchodilators and inhaled steroids will improve your airflow. For a bacterial infection, antibiotics may be recommended. For GERD, medications that block acid production may be offered.

Very rarely, surgery may be required.

If your doctor prescribes a cough suppressant such as benzonate (Tessalon Perles, or Zonatuss), be sure to read the label to ensure it can be used safely while driving.

Some cough medicines contain the narcotic codeine or hydrocodone, which may also cause dizziness, drowsiness and blurred vision.

Quiet your nagging, chronic cough, and enjoy the holiday season.

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