Cough 101 or Why Won’t that Cough Go Away?

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That question about the cough haunts us and usually takes us three  months to answer. I’ll tell you why.

It is that time of year when we, and everyone we meet has some stage of the cold, cough and ‘flu. This is considered normal and depending on what stage we’re at, some of us go to the doctor for relief, while some of us try and manage with natural remedies for the cough. If we’re lucky the cough gradually goes away. If we’re not, we go through a course of antibiotics, especially when there’s an infection going.

So just when you think you have gotten over the fever and your body is beginning to feel like your own – and you really feel much better, it can be so annoying to continue coughing. Persistent coughs that do not go away can be caused by more than a cold. It could be bronchitis, sinusitis, allergies or even pneumonia. But for most people, the nagging cough can stay for three weeks or more even after the symptoms of cold are gone.

 

Here’s a quick Cough 101

Coughing is a reflex action that we cannot control, whether it is an irritation in the throat or a smoker’s cough. Unfortunately, this cannot be ignored. Depending on the symptoms, it can be a temporary annoyance or signal something more serious.

First, let’s look at how long the cough has been around and if it signals a more serious issue

Listening carefully to that cough can help you understand it better and take action.

If you’ve been coughing just a few hours

A cough is a result of an irritation in the nerves of the respiratory tract. Common triggers are:

• perfume
• bug spray
• inhaling chili powder
• gulping water and having it go the wrong way (or my way!)
• dust
• pet dander
• mucus
• stomach acid

A cough begins with a short breath. Then the larynx or voicebox closes followed by a contraction of the stomach and chest muscles. This builds up pressure so that air from the lungs can be released when the voicebox opens again. Then we let go – and the rush of air through the airways clears the lungs. Coughing is necessary, because anything that gets into the lower respiratory tract could carry bacteria, which means an infection in the airways or pneumonia – a lung infection.

So if it is a minor irritation, the cough is a protective mechanism to expel the offending particle.

If you’ve been coughing less than a month

The cold is invariably the primary cause here with an acute cough that lasts about three weeks. Colds stay a week or ten days. But the cough that comes with it can hang on a lot longer, to as much as a month. The airways become inflamed and sensitive during the infection and take a while to recover. So if the cough is purely related to the cold, it will probably clear up without further intervention.

What about coughs that hang on more than two months?

Some coughs can stay a month or even two, like unwanted guests. They may clear up during this time, or be an indication of an more serious problem. Once you cross the eight week mark, the cough is labeled chronic. Chronic cough may be an indication of asthma, COPD or chronic obstructive pulmonary disease which can develop into chronic bronchitis or emphysema. This is more likely in smokers. A chronic cough can also be due to GERD or gastroesophageal reflux disease where the contents of the stomach back up into the esophagus.

The good news? Chronic coughs can be diagnosed and treated.

When is the cough triggered?

Seasonal coughs

It could be certain times of the year during seasonal allergies that can affect the airways and make you cough. It can be due to cold weather. Where I live, during the winter months, we have a lot of pollen in the air and this means everyone has an allergic cough which often doesn’t go away even when the season changes.

Cough triggered by medication

For those on blood pressure medication, a chronic cough develops. This can start immediately or after months of starting the treatment. The throat becomes raw. Often, changing the medication can make the cough disappear.

Coughing before you speak

Some people habitually clear their throat just before they speak and this can develop into a voluntary cough – a habit.

Involuntary coughs

This is perhaps the most common and could signal a more serious condition.

News update: If you thought your nose was the only organ that has the sense of smell – check this out: Odor guards in lungs can make us cough!

The newly discovered class of cells expressing olfactory receptors in human airways, called pulmonary neuroendocrine cells, or PNECs, were found by a team led by Yehuda Ben-Shahar, PhD, assistant professor of biology, in Arts & Sciences, and of medicine at Washington University in St. Louis who says, ““We forget that our body plan is a tube within a tube so our lungs and our gut are open to the external environment. Although they’re inside us, they’re actually part of our external layer. So they constantly suffer environmental insults.”

Dry cough or wet cough?

Your doc will usually ask if the cough is wet (productive) or dry (non-productive).

• Dry cough usually follows a cold. It can come as a series of short coughs or hacking noisy ones. Smoker’s cough are generally dry and so are asthma related coughs.
• If you cough up a light mucus, it is probably your body’s way of keeping your nose and air passages clean. During a cold or flu, there is a colorless or pale mucus. There could be a lot of it, which we usually blow out through the nose, cough it up or simply swallow it (yeah, ewwww! but swallowing it is quite okay!)
• Too much mucus with the cough coul dsignal chronic bronchitis, a lung problem.
• If the phlegm is greenish, it is a bacterial infection – stay at home until you get better and not spread the infection.
• Colored phlegm can also mean pneumonia and it can make you very sick. The lungs fill with fluid to fight the offending substance. Pneumonia usually comes after a bacterial, fungal or viral infection. The pneumonia vaccine is effective for those over 65 years to ease the symptoms if pneumonia develops.
• The mucus that comes with chronic bronchitis or emphysema looks greenish brown. If the symptoms become worse, the mucus gets thicker making it tougher to cough – this usually happens as the airways become narrow.
• Red stuff that comes up with the cough can be traces of blood. See a doctor right away as it is associated with COPD, pneumonia, TB or even lung cancer. If the mucus is frothy and pinkish it can be fluid accumulation in the lung’s air sacs – this means the emergency room right away.

After figuring out  if it is just a cough or a more serious issue, how long the cough’s been around, and when it usually appears, the next thing to know is what it sounds like.

• A loud hacking chronic raspy cough regardless of whether it is dry or wet needs immediate medical attention
• A wheezy cough that’s usually worse at night could be asthma. We were worried for years when my son was little as he has a tendency to wheeze. The kid gets no ice cream. Can you imagine?
• A whooping cough or pertussis is painful and contagious and it is very important to ensure vaccination against this.

Is it only a cough or are there more symptoms

For example, asthma is identified by the cough alone. There may be wheezing, a constriction in the chest accompanied by breathlessness. The shortness of breath with the cough is a big sign of COPD and this happens especially with over-exertion from climbing stairs or exercise. When my Mom seemed to be coughing almost all the time, she continued to be energetic. During diagnosis six months later, the doctors informed us that it is possible for patients to lose half their lung function before it is found out.

Most of the time, COPD is triggered by smoking, pollution and breathing various other odors.

If there is a fever with the cough along with profuse sweating at night, a viral infection could be the cause. This can range from just a cold, pneumonia or TB. If it is TB, there’s also weight loss. Of the wrong kind.

What if it is a trickling cough where there’s mucus at the back of the throat?  Called a post nasal drip, the sinuses produce a lot of mucus, making the person want to snort to clear the nose. The mucus constantly irritates the back of the throat and the effort to clear it creates the cough. Bad breath is a given along with a sore throat and nausea. Often this can be treated with medication.

Cough that brings a heaviness in the chest, especially for those suffering from GERD  can be really painful, with a feeling of always having something stuck in the throat.

What to do?

Usually, a thorough examination with diagnostic tests helps identify the problem, along with:

• A lung examination for signs of asthma and other issues
• Stomach examination for GERD
• Check sinuses for post nasal drip
• Lung function tests or spirometry to check the functioning of the lungs
• Chest X-rays
• CT Scans
• Endoscopy

As we can see, cough can be caused by more than one condition.

A cough that wont go away is major cause for concern. It is important to figure out  if it is just a cough or a more serious issue, how long the cough has been around, when it usually appears, and what it sounds like. Based on the answers, immediate medical attention may be required followed by the diagnostic tests listed.

But wait, is it possible to get some relief, preferably from natural remedies for cough?

Yes! Here are some natural remedies for cough that work:

A humidifier
When my mother suffered from tuberculosis and had a hacking cough that literally seemed to drain her life away, we were advised to get a humidifier. This moisturizes the air and soothes the inflamed respiratory track tissues. There is a variety of humidifiers available and you can check to see what suits your budget. Don’t forget to read the fine print.

Avoid dairy
Dairy products tend to increase mucus formation and this is something we really do not want when we’re trying to lose the phlegm. Errgh!

Drink up!
Water is your best friend. It helps your body function better and strengthens your immune system. While hot water seems like a good idea, cool water is a better idea because it also soothes the swelling.

Honey
I have at least two bottles of honey on my kitchen shelf. We use it to sweeten, soothe ailments and mix with medicine. In fact,  is is one of our go-to remedies for a variety of health issues. Raw honey is best. It has anti-viral and anti-bacterial properties and you can add it in your tea and lemon juice, too. It is an effective ingredient in remedies for colds and coughs.

Some ways to use it to relieve your cough are:

• add a spoon of honey to half a glass of warm water to soothe and relieve phlegm
• a spoon of honey at bed time can ease respiratory tract infections
• a spoon of honey + basil leaves + a spoon of lemon juice = tastes great and relieves cough and cold
• sweeten your tea

More natural remedies
Our all time favorite remedies for cough and cold are ginger and garlic. I am always fascinated by how most of our medicines are on the kitchen shelf. Here’s how you can use this to your advantage:

• chew on ginger or garlic.
• boil ginger in water and make tea, drink thrice a day
• boil garlic pearls in water and drink this thrice a day
• chop some onion, add some honey to it and heat it over a low flame. Once it is warm, take a spoon of it in your mouth and hold it. For an hour or so, do not drink anything.
• eat a spoonful of raw honey with garlic
• raw honey with a pinch of white or black pepper powder a few times a day
• boil a glass of milk, add half a teaspoon of turmeric and have it before bedtime.
• applying eucalyptus oil on the chest, back and soles of the feet helps control cough

If your cough persists even after a week of home remedies, please do consult a doctor.

Stay healthy!

 

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