A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.Frequent coughing usually indicates the presence of a disease. Many viruses and bacteria benefit, from an evolutionary perspective, by causing the host to cough, which helps to spread the disease to new hosts. Most of the time, irregular coughing is caused by a respiratory tract infection but can also be triggered by choking, smoking, air pollution, asthma, gastroesophageal reflux disease, post-nasal drip, chronic bronchitis, lung tumors, heart failure and medications such as angiotensin-converting-enzyme inhibitors (ACE inhibitors). Treatment should target the cause; for example, smoking cessation or discontinuing ACE inhibitors. Cough suppressants such as codeine or dextromethorphan are frequently prescribed, but have been demonstrated to have little effect. Other treatment options may target airway inflammation or may promote mucus expectoration. As it is a natural protective reflex, suppressing the cough reflex might have damaging effects, especially if the cough is productive. Presentation
Complications
The complications of coughing can be classified as either acute or chronic.
The treatment involves anti-acid medications and lifestyle changes with surgery indicated in cases not manageable with conservative measures. Air pollution
Coughing may be caused by air pollution including tobacco smoke, particulate matter, irritant gases, and dampness in a home. The human health effects of poor air quality are far reaching, but principally affect the bodys respiratory system and the cardiovascular system. Individual reactions to air pollutants depend on the type of pollutant a person is exposed to, the degree of exposure, the individuals health status and genetics. People who exercise outdoors on hot, smoggy days, for example, increase their exposure to pollutants in the air. Foreign body
A foreign body can sometimes be suspected, for example if the cough started suddenly when the patient was eating. Rarely, sutures left behind inside the airway branches can cause coughing. A cough can be triggered by dryness from mouth breathing or recurrent aspiration of food into the windpipe in people with swallowing difficulties. Angiotensin-converting enzyme inhibitor
ACE inhibitors are drugs often used to treat high blood pressure that can sometimes be the cause of a cough as a side effect, and stopping their use will stop the cough. Tic cough
A tic cough, previously called a habit cough, is one that responds to behavioral or psychiatric therapy after organic causes have been excluded. Absence of the cough during sleep is common, but not diagnostic. A tic cough is thought to be more common in children than in adults. A similar disorder is the somatic cough syndrome previously called the psychogenic cough.