Dealing with the distress called cough

Cough is one of the most common distressing problems world over. The affected person feels sick and uncomfortable; cannot talk or sleep properly because of the persistent cough. It is one of the most common problems for which people seek medical aid. Cough is an explosive form of expiration, that is, expelling air from the lungs, the aim of which is to clear the wind pipe and its branches of secretions and foreign bodies. Certain stimuli initiate cough by causing inflammation of the the inner lining of the respiratory passages and the lungs. This occurs as in bacterial or viral infec-tions of the respiratory mucous membranes. It may also be caused by common cold, where secretions from the nose irritate the throat. Gastric reflux with aspiration can also induce cough. Infections of lungs like tuberculosis or pneumonia produce cough by causing inflammation of the respiratory mucosa. Mechanical stimuli producing cough are dust particles in any form. Compression and closure of the air ways induces cough. This may be either from outside as by foreign bodies or tumors or within as in bronchial asthma or collapse of the lungs. Systemic diseases like cardiac and renal failure produce cough due to collection of fluid in lungs. Irritation of the throat by fumes, chemicals, droughts of cold or hot air, can induce cough. Worm infestations like Ascariasis cause cough by producing state of allergy within the body and also by direct invasion of the lungs. In bronchial asthma, cough occurs due to allergy to certain substances. Irrespective of the cause, cough is distressful. It may be dry or associated with expectoration, depending on the site affected and severity of affection. If a blood vessel is eroded due to inflammation, expectoration may be blood mixed. Along with cough, there may be fever, anorexia, among other problems depending on the cause. Severe cough may occur with vomiting, which though harmless, is frightening. This occurs because the centre for both is located adjacent to one another in the brain and stimulation of one excites the other. Very severe cough can lead to rupture of a part of lungs tissue or air way because of the mechanical stress. Diagnosis of cause of cough is usually established clinically. Blood tests, X-ray and sputum examination aid in confirmation of diagnosis. Treatment is always of the cause, if possible as in case of infections. If the infection is mild or is viral no treatment is required and cough subsides spontaneously. In case of asthma or allergic bronchitis one has to avoid the offending substance if possible and use medication as advised. Whatever the cause for cough, drinking plenty of water and some hot water at least two or three times is very useful. Steam inhalation is also helpful in providing relief. Honey is a good natural mucolytic agent (one liquefying phlegm). Therefore one or two small spoons of honey taken in hot water or hot milk are very soothing and one gets relief after taking it. Smokers need to give up smoking if they wish to get rid of, “smoker’s cough”. People engaged in work involving exposure to dust should use protective face masks. Protection from cold weather also helps in preventing cough. Cough should not become a distressful symptom and should be stopped at the earliest with appropriate measures. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital rachna212002@yahoo.co.uk

Health

Dealing with the distress called cough