DEFINITION
Coughing is an action of the body to secrete substances that
irritate the respiratory tract, which is the tube that carries air from the
nose and mouth into the lungs. Coughing occurs when cells in the respiratory
tract is irritated and trigger a reaction. As a result, the air in the lungs is
forced out due to high pressure. Coughing can happen voluntarily (when a person
chooses to cough) or it could be involuntary (when the body reacts himself).
CAUSE
There are many things that can cause coughing, possible
causes can be determined from whether the cough has lasted for less than 4
weeks (acute) or more than 4 weeks (chronic).
The most frequent cause of acute cough is an infection of
the upper respiratory tract caused by a virus. Another possible cause is the
inhalation of foreign bodies into the airway or other respiratory tract
infections, such as pneumonia.
The most common cause of chronic cough are asthma,
gastroesophageal reflux, and the entry of fluid from the nose to the throat
(postnasal drip). In addition, chronic cough may also occur as a result of
foreign body aspiration, abnormalities inherited (such as cystic fibrosis
ataudyskinesia ciliary primer), a congenital defect in the airway or lungs,
inflammatory disorders of the airway or lungs, and it can also be due to stress
(cough psychogenic or habit).
In general, the cough can be caused by:
·
Infections, such as colds and croup
·
Reflux of stomach acid
·
Asthma
·
Allergies or sinusitis
·
Whooping cough or pertussis
·
Other causes such as aspiration of food or other
foreign objects, and exposure to air pollutants (smoke or fire)
SYMPTOMS
Signs and symptoms caused can also help determine the cause
of the cough.
1. Signs and symptoms of acute cough
- Signs and symptoms of cough due to infection:
Fever, chills, body aches, sore throat, nausea, vomiting,
headache, pressure in the sinus, colds, sweating at night and runny nose. The
presence of phlegm or mucus can be a sign of infection, but it can also be
found in non-infectious cough.
- Signs and symptoms of cough due to non-infectious
diseases:
Coughing occurs only if the person is exposed to irritants
(substances that cause irritation) dar surroundings, cough with wheezing
(wheezing), cough getting worse when positioned at specific locations or perform
certain activities or cough improved when given a drug allergy or Loose
breathing.
2. Signs and symptoms of chronic cough
Signs and symptoms of chronic cough is more difficult to
assess because many causes of chronic cough have similar signs and symptoms:
- If the cough associated with irritants in the environment,
the cough gets worse when in contact with the material. If the person has
allergies, then cough will get better when given anti-allergy medication. If
the cough is due to exposure to cigarette smoke, it will improve when quitting
and will worsen if the increased quantity of smoking.
- If the person has a chronic lung disease such as asthma,
emphysema or chronic bronchitis, then he may develop persistent cough or cough
that worsens when positioned in certain places or doing certain activities.
Cough which can occur with or without phlegm and often improved when given
lozenges respiratory or oral steroids or other drugs pernfasan reliever.
- If the cough occurs because of a chronic sinus infection,
chronic colds or runny nose constantly, then that person will have signs and
symptoms associated with the condition. Usually coughs will also deteriorate if
the problem worsens and usually cough will also be improved if the cause of the
problem has been addressed.
- If the cough is caused due to administration of certain
drugs, such as ACE inhibitors, the coughing often occurs after drug
administration began, although it can occur at any time during the
administration of drugs carried. Cough that occurred usually dry and will
improve when the drug is discontinued administration.
- Cough associated with GERD frequently associated with the
sensation of a burning sensation in the chest (heartburn). This type of cough
will worsen during the day or when lying on their backs. Furthermore, there are
some people who have a cough due to GERD do not feel the symptoms of acid
reflux, but most people will report an improvement in their GERD bilapenyakit
cough condition is handled properly.
- If the cough is an early sign of the presence of cancer
cells, then the tersbeut could have a collection of symptoms. If lung cancer or
cancer of the respiratory tract, then that person may experience coughing up
blood. Other signs and symptoms that may indicate the presence of cancer cells
is: worsening fatigue, loss of appetite, weight loss with no known cause or
decreased ability to swallow solid food or liquid.
DIAGNOSIS
Diagnosis of cough largely based on information provided by
the patient. Important information is given to help make the diagnosis is how
long the cough occurs, signs and symptoms related, activities or specific
location that makes the cough worse / better, the relationship between the
occurrence of cough at the time when it happened, a previous history as well as
treatment at home that never been done before.
- In acute cough, the doctor will be able to make a
diagnosis simply by doing an interview on the patient and performing a physical
examination. If the patient has an acute cough, examination by X-ray is usually
not necessary to obtain enforcement of diagnosis. The elderly, people with a
weakened immune system (such as cancer, diabetes or AIDS) and people with lung
sounds abnormal during the inspection can take advantage of the X-ray
examination to determine whether pneumonia or not.
- In chronic cough, doctors often rely on patient interview
and physical examination to help determine other necessary tests, so that
enforcement of the diagnosis can be done. Many people perform such an X-ray
examination to determine the cause. In addition, other tests may also be
advised by the doctor based on the results of interviews and physical
examinations. Several checks can be carried out at the request of general
practitioners and some others require a referral from a specialist. Specialists
are selected depending on the alleged cause of the cough.
- It is important for patients to become active participants
in maintaining their health and discussions with physicians to determine the
purpose of any investigation conducted and the significance of the results
obtained.
TREATMENT
Cough treatment depends on the severity of the cough and
causes first.
1. Treatment of acute cough
Treatment of acute cough is directed to reducing the
quantity of cough in addition to initially treat the cause.
- Symptomatic treatment of cough can be done through the
provision of cough medicine, both of which can be bought over the counter or by
prescription.
- If a bacterial infection is suspected, the doctor will
often prescribe antibiotics. If the suspected cause is a virus, then the
patient will not benefit from antibiotics and will be given medication to cope
with symptoms.
- In elderly patients, patients with bacterial infection /
virus severe, and patients with weakened immune systems may require
hospitalization in the hospital to address the cause of the problem.
2. Treatment of chronic cough
Treatment of chronic cough is also intended to address the
condition basically. It's important to know that treatment is undertaken may be
difficult to do and may require some different approaches, and may also not be
able to eliminate the cough as a whole.
- If the patient has a cough caused by cigarette smoke,
allergies or irritants from the environment, then the cough can be solved by
eliminating such things. It may take several weeks for doctors to be able to
assess the response of the approach because it takes a certain time to repair
the damage to the lungs and respiratory tract due to exposure to irritants.
- If the patient has lung disease, it will require ongoing
therapy to cope with the condition. Therapy is given depends on the type of
illness. Adherence to treatment is very important to help slow the progression
of the disease and to reduce the symptoms of the disease. In cases where home
treatment failed and the symptoms worsen, the patient needs to be hospitalized
in order to receive additional therapy or other more intensive therapies can be
done.
- If the cough is suspected due to a particular drug
treatment, then the patient will show an improvement when the drug is stopped.
For that, it takes several weeks to completely stop coughing. Then the drug is
stopped can be replaced with other medications.
- If the cough is suspected due to gastroesophageal reflux,
then needed therapy to reduce gastric acidity. This can usually be done by
changing the diet and administering drugs. The success of therapy may require a
certain time and a different therapy.
PREVENTION
Cough can be prevented by avoiding the health problems that
can cause coughing. In addition, the important thing that needs to be done to
prevent coughing is to stop smoking and avoid secondhand smoke, especially in
people who have asthma, chronic lung disease, and allergies.
In people with gastroesophageal reflux, cough can be
prevented by changing eating patterns, sleeping with the head higher, and
taking medication given by doctors.
For people who are undergoing treatment for chronic lung
disease, the precautions that can be done is to dutifully undergoing treatment
given by doctors.
REFERENCE
- B, Hansa D. Children's Cough. WebMD. 2012.
- C, Deborah M. Cough In Children. Merck Manual Home Health
Handbook. 2013.
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