Cough, Chronic
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What is a cough? Well, the medical world describes a cough as an
explosive expiration that provides a protective mechanism for clearing
the tracheobronchial tree of secretions and foreign material.(1
<#fn107457>) Did you know that a cough is one of the most common
symptoms for which patients seek medical help? Reasons include
discomfort from the cough itself, interference with normal lifestyle,
and fear of the connection with cough to some underlying illness.
Coughing may be initiated either voluntarily or as a reflex. Cough
receptors are located in the pharynx, stomach, external auditory canal,
diaphragm, nose, and the large airways of the tracheobronchial tree.
These receptors react to a stimulus and then initiate the cough
reflex.(2 <#fn107459>) Coughs can be brought on by inhaling things that
irritate the airways such as smoke, dust, or fumes; or by breathing in
such things as contents of the stomach, upper airway secretions, or
foreign bodies. When the irritations are due to upper airway secretions,
as is seen in postnasal drip, or gastric contents, as in
gastroesophageal reflux disease (GERD), the actual cause may go
unrecognized and the cough may be persistent. Prolonged exposure to
irritants often causes airway inflammation, which itself can trigger
cough, and make the airway more sensitive to other irritants.
Any disorder that causes inflammation, irritation, constriction, or
compression of airways can lead to coughing. Airway inflammation
commonly results from bacterial or viral infection. In viral bronchitis,
airway inflammation sometimes persists long after the acute symptoms are
gone, thereby producing a prolonged cough lasting for several weeks. The
duration of a cough is a vital clue to its cause. The most common causes
of chronic cough are postnasal drip, bronchial asthma, GERD, chronic
bronchitis, and bronchiectasis.(3 <#fn107460>)
The smoking of cigarettes, pipes, and cigars irritates the airways and
reduces the efficiency of the ciliated cells that move particle-laden
mucus upwards and outwards causing a characteristic hacking "smoker?s
cough." There are many other factors that would be associated with
coughing and your healthcare professional is the best person to help you
determine the cause. Some of the more serious causes include congestive
heart failure, and lung diseases.
About the Author
Footnotes Back to Top <#top>
^1 Weinberger SE, Braunwald E. Cough and Hemoptysis. In: Fauci As,
Braunwald E, Isselbacher KJ, et al, eds. Harrison?s Principles of
internal Medicine, 14th ed. New York: McGraw-hill; 1998:194-196.
^2 Zervanos NJ, Shute KM. Acute, disruptive cough. Postgrad Med.
1994;95:153.
View Abstract </SHK/view-abs.asp?fnid=107459&absid=104059>
^3 Irwin RS, Curley FJ, French CL. Chronic cough. Am Rev Respir Dis.
1990;141:640.
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