Chronic Cough Definition: A health condition characterized by either a long lasting cough or a recurring cough lasting more than a month.
More than 12 million pediatric doctor visits are due to coughs every year. Most coughs last a few days due to common colds. It is frustrating if a cough is present for weeks and results in several sleepless nights for both children and parents.
Coughing is an important protective mechanism of the lungs. Coughing helps guard against aspiration and assists in the removal of secretions from the airways. Chronic cough results when cough receptors are constantly triggered by various stimuli. Cough receptors are located in the nose, sinuses, larynx, pharynx airways, ear canal and diaphragm (trachea bronchi, pleura, pericardium diaphragm.)
Chronic Cough Causes
Chronic cough can be caused by a variety of conditions such as:
- Cough variant asthma-Chronic cough may be the sole manifestation of asthma. It is the most common cause of chronic cough in children. Cough occurs day and night, precipitated by excessive cold air, common cold or flu.
- Viral or bacterial pneumonia can produce chronic cough.
- Sinusitis, which presents as post-nasal drip, yellow or greenish mucous, facial pain, foul odor of breath, and sore throat, can be a cause for chronic cough.
- CIGARETTE SMOKING- There is a direct association between chronic cough and cigarette smoking. In general, the rate of cough increases with the number of cigarettes smoked. Also, there is a clear association of chronic cough and passive smoking. Children who have parents that smoke in the home have more respiratory diseases. Even if you smoke only in one room, the smoke spreads through the house.
- Habit cough, also known as psychogenic cough. This type of cough is characterized by a single dry, repetitive cough. Habit cough typically occurs only during the day and disappears during sleep. It may be precipitated by anxiety.
- Other causes, like cystic fibrosis, congenital malformations, foreign body and aspiration, can cause chronic cough in children.
- Gastro-Esophageal Reflux.
- Vocal Cord dysfunction.
- Medications: ACE inhibitors for high blood pressure (i.e. Capoten, Vasotec, Prinivil, etc.) may cause chronic cough
Chronic Cough Treatments
Recognizing specific cause, and elimination or treatment of the cause, could result in improvement of chronic cough.
Chronic cough treatment aims to eliminate the underlying cause. Most of the time, each type of treatment is tried separately, one after another, instead of all at the same time. Seeing which one works best helps to figure out the underlying cause. Here are some examples of treatment choices for different causes of cough.
- Postnasal drip — A cough related to postnasal drip may improve with the use of a decongestant, nasal or oral antihistamine, nasal glucocorticoid or a nasal spray that contains ipratropium. The best chronic cough treatment (or combination of treatments) depends upon your chronic cough symptoms and medical history. As an example, if you have nasal allergies, medications are chosen to control allergy symptoms.
- Nasal glucocorticoids — A nasal glucocorticoid may help to reduce postnasal drip.
- Oral antihistamines — Antihistamines that are taken as a pill but can cause side effects such as drowsiness and drying of the eyes, nose and mouth. Most of these are available over the counter. Antihistamines that are less likely to cause sleepiness, such as loratadine or cetirizine, are less likely to help with cough.
- Decongestant — A decongestant that can improve nasal congestion.
- Nasal antihistamines — A prescription nasal antihistamine spray can relieve symptoms of postnasal drip, congestion and sneezing.
- Nasal sprays — The nasal spray ipratropium bromide can relieve runny nose, postnasal drip, and sneezing.
- Cough variant asthma — If your cough is due to asthma, you will be given the standard treatment for asthma, which includes an inhaled bronchodilator and inhaled glucocorticoid. These inhaled medicines act to decrease inflammation (swelling) of the airways.
- Acid reflux – Lose weight if you are overweight, stop smoking, avoid eating for 2-3 hours before lying down, elevate the head of the bed 3-4 inches.
- Eosinophilic bronchitis — Eosinophilic bronchitis is treated with inhaled glucocorticoids. These medications are also used for asthma and work to decrease inflammation in the airways.