Cough

Coughing is considered a reaction of the body, the purpose of which is to clear the airways. During the coughing process, the diaphragm contracts in a jerky manner, clearing the airways of the remaining air. With the flow of air, particles, foreign bodies and pathogens reach the outside air by being coughed up. However, if one suffers from cough for a prolonged period of time, the cause should be determined.

Coughing is not considered a disease in its own right but merely a symptom. The causes are therefore of a very varied nature. Thus, diseases of the lungs, heart or stomach can be triggers, as well as reactions to certain medications.

If the cough extends over a period of less than three weeks, it is called acute. A chronic cough, on the other hand, is one that does not subside after more than three weeks if left untreated. If this is the case, a doctor should be consulted.

The cough reaction is understood as a classic defence function of the body, which is triggered by foreign bodies (such as dust) in the respiratory tract.

Normally, there are no germs in the lungs and airways. However, this natural climate is destroyed when dust or dirt particles enter the lungs, as this creates better living conditions for bacteria. By reacting with a cough, the body expels bacteria and foreign bodies and prevents illness.

Acute cough usually results from a cold associated with inflammation of the respiratory tract by viruses or bacteria. Chronic cough can have many causes, which is why it should be clarified by a doctor. The following causes are possible: bronchial asthma, allergies, chronic obstructive pulmonary disease (COPD) or cardiac insufficiency (heart failure).

Cough can occur as a symptom of various diseases. The most common causes are colds. Depending on the duration of the cough, a distinction is made between acute and chronic cough.

Acute cough:

The duration of acute cough is less than three weeks. The cause is usually a cold, which triggers an inflammation of the respiratory tract by viruses or bacteria. In rare cases, a pulmonary embolism can also be responsible for cough.

Chronic cough:

Chronic cough extends over a period of more than three weeks. There are several possible causes, which should be found out through a medical examination. The most common causes include:

• Chronic bronchitis (for example, smoker's cough).
• Chronic obstructive pulmonary disease (COPD)
• Dilatation of the bronchial tubes (emphysema)
• Chronic sinusitis (inflammation of the sinuses)
• Allergy
• Asthma
• Heart failure (cardiac insufficiency)
• Reflux of stomach contents into the esophagus (gastroesophageal reflux)
• Side effects of medications (such as ACE inhibitors)

Rarely, a tumor disease of the lung can also be the trigger for a chronic cough.

Coughs can be differentiated according to the following criteria:

Mucus-producing (productive) cough:

The most common causes of cough are colds, pneumonia, chronic bronchitis, and chronic obstructive pulmonary disease. Increased mucus production can also be caused by asthma or other allergic reactions. This coughed up mucus usually has a liquid consistency and is crystal clear in color. In colds, it takes on a yellowish or greenish color and is tough.

Coughing up blood:

Cough with bloody sputum may have the following diseases as its cause: Pulmonary embolism, tuberculosis, heart failure or lung cancer. Rarely, clotting disorders, such as hemophilia, may also trigger the cough.

Irritative cough:

Irritative cough is triggered as a reflex to dust or particles in the lungs. However, it can also be caused by certain medications, such as ACE inhibitors, as a side effect. Sometimes, an irritating cough can also indicate a pulmonary embolism.

In order to determine the presence of a cough, the doctor asks about the patient's medical history and the nature of the symptoms (anamnesis). The person is then physically examined and, if necessary, subjected to further examinations. These include:

• Blood draw
• Examination of sputum (sputum) in the case of a productive cough
• X-ray of the lungs
• Lung function test
• Lung scintigraphy
• Skin tests (e.g. prick test) to rule out allergies
• Endoscopy of the airways (bronchoscopy)
• Ultrasound of the heart, vessels and abdomen

The first priority is to treat the underlying disease. To alleviate the cough, additional further measures can be applied:

• Cough-suppressing medications are only useful for dry coughs and after consultation with the doctor.
• Expectorants (mucolytics) can provide relief from a mucus-producing cough by liquefying the tough mucus. This process makes it easier to cough up.
• Inhalations with herbal infusions (such as chamomile oil) and chest compresses can also be helpful.
• Antibiotics are only effective for bacterial inflammation.

What you can do yourself:

• Avoid smoking
• Make sure you drink enough fluids. The amount should be at least two liters per day.
• If the air in the room is very dry, damp cloths hung up in the room or humidifiers can help.

If the cough does not go away after three weeks, if there is a fever or blood in the sputum, a doctor should definitely be consulted.

Normally, an acute cough heals without complications. The chances of recovery from a chronic cough depend on the underlying disease.

In general, one should avoid smoking when coughing and pay attention to strengthening the immune system through a healthy lifestyle. To support this, a balanced diet rich in vitamins and nutrients, as well as regular exercise help.

The risk group includes people over 60 years of age, patients with chronic diseases, as well as people with an increased risk of disease (for example, educators and teachers). These people should undergo vaccination against influenza and bacteria that can cause pneumonia (pneumococcus).

For coughs caused by allergies, a course of treatment (hyposensitisation) can be helpful. This involves the doctor injecting the allergen under the skin in ever increasing concentrations over a period of several years, or it can be dripped onto the tongue itself. This is intended to cause the body to become accustomed to the allergen.