Cough

Cough That Does Not Go Away in Adults and Children

Sometimes a Protective, Sometimes a Frightening Reflex: COUGH

What is cough?

Cough is essentially a complex reflex that protects the lungs against mechanical, chemical and thermal factors and, in this respect, is one of the defense mechanisms of the respiratory system. Its purpose is to prevent foreign substances from entering the airways and to ensure that these substances, as well as secretions in the airways, are expelled. The cough reflex can be voluntary, but it can also sometimes occur involuntarily. Cough receptors are located in the sensitive areas that trigger coughing. They are most commonly found in the larynx, trachea and main bronchi, but cough receptors can also be found in the nose, sinuses, pharynx, eardrum, external ear canal, pericardium and even the stomach. In addition, there is a cough center in our brain, near the respiratory center. This center is activated by stimuli received through nerves from the cough receptors, and as a result, necessary signals are sent via nerves to the structures that will produce the cough.

Cough has three phases.

In the first phase, a deep breath is taken.

In the second phase, the larynx closes and the respiratory muscles contract against the closed larynx. During this phase, which lasts 200 milliseconds, the pressures inside the lungs rise rapidly.

In the third phase, the larynx suddenly opens and the air trapped in the lungs is forcefully expelled due to the large pressure difference between the lungs and the outside atmosphere. Thanks to these rapid airflows, secretions accumulated in the airways and foreign substances are expelled. During this time, the familiar ‘cough sound' is heard due to the vibration of the secretions in the airways, the bronchial walls and adjacent tissues.

What Causes Cough?

What are acute and chronic cough?

Acute cough generally develops due to short-lasting, episodic illnesses. When the illness is treated, the cough also goes away after a while. Chronic cough, on the other hand, is the opposite: it is a type of cough that lasts a long time and which can certainly be accompanied by a serious illness.

Respiratory system diseases

Cough can appear not only in lung diseases but also together with diseases of other organs. The respiratory system extends from the nose to the lungs. Therefore, a problem arising in the nose also affects the respiratory system. A problem inside the nose, such as a foreign body in the nose, nasal discharge, nasal congestion, problems related to the sinuses, and any problems that may occur in the throat or mouth; cough may be the first sign of many problems such as pharyngitis, flu, tonsillitis and the common cold. Today, pneumonia ranks first among all infection-related causes of death. Patients may come to the doctor with cough alone. Apart from these, there is bronchiectasis, a disease characterized by widening of the airways, in which cough can also easily occur. COPD, a disease group that is caused particularly by smoking and which is currently the 4. most common cause of death in the world, is one of the most common causes of cough. In addition, asthma is among the causes of cough.

Stomach problems

In esophageal problems and inflammations, particularly when stomach contents flow back upward, this is called reflux. Reflux is also one of the causes that lead to cough.

Heart diseases

Heart failure is one of the very important causes of cough. Sometimes no cause can be found. This can be called a cough that develops due to habit.

Lung and cancer diseases

Lung cancer may be seen in patients who most commonly present with a complaint of cough. Therefore, people who come in with a cough require a much more detailed examination. In addition, any tumor or inflammation that may develop in the airways, such as chronic bronchitis, and pneumonia, which is a microbial disease of the lungs, are among the conditions to consider. Today, pneumonia ranks first among all infection-related causes of death. People may consult a doctor with cough as the only sign. Apart from these, cough may be seen as a sign of bronchiectasis, the disease that emerges with widening of the airways.

The disease known as tuberculosis may also have cough as its only symptom.

What Are the Types of Cough?

Dry cough

In dry cough, generally no phlegm is present, but it causes significant irritation in the throat. Cough accompanies diseases such as flu, pharyngitis, asthma, reflux, common cold, heart failure and tuberculosis. Dry cough that does not go away for a long time may cause pain in the lungs and even muscle aches. If your dry cough does not go away and you have one or more of the following symptoms, be sure to see a doctor.

Severe chest pain

Sweating during sleep

Wheezing

Fatigue

Loss of appetite

Persistent high fever

Productive cough

A fluid called phlegm may accompany a cough. Sinusitis and bronchitis are the most common causes of phlegm. Productive cough, which is common in people who smoke, is not, contrary to what is believed, a normal condition. This cough, which can become a chronic disease, may also be bronchiectasis, known as smoker's cough.

Allergic cough

In people with allergies, cough occurs periodically, especially in the airways. For coughs caused by allergies, allergy tests must be done to determine which allergen is causing the problem. Once the type of allergen is identified, protective medications and allergy treatment must be started to prevent the cough.

How Does Cough Go Away?

If a disease the person has had is causing the cough complaint, medical treatments aimed at resolving the cough are applied. For coughs lasting up to 3 weeks, an opinion must be obtained from a chest diseases specialist. For cough caused by infectious diseases, a treatment to dilate the bronchi may be applied. If deemed appropriate by the doctor, a chest X-ray and a pulmonary function test may also be performed. You can read our article for detailed information on Cough in Children That Does Not Go Away.

In Which Situations Should Cough Be Taken Seriously?

Cough is not something that should be taken lightly, and it cannot resolve on its own. It can be the most important sign of a serious illness in a person. Therefore, cough must be taken seriously in the situations listed below. These are:

If it has lasted more than 15 days and does not go away with medical treatment,

If high fever and shortness of breath accompany the cough,

If the cough produces phlegm and there is blood, you must consult a specialist.

Treatment must be started without delay once the cause of the cough has been diagnosed. If the cause of the cough is viral (infectious), some protective measures may also be taken alongside treatment. These are:

Getting vitamin C from fruits and vegetables during the winter months,

Preferring healthy foods and eating regularly,

Drinking 8 glasses of water and taking plenty of fluids during the day,

Doing regular exercise or walking during the day, even if for short periods,

Paying attention to sleep times and not going to bed late,

Preferring ginger or licorice root teas to soothe a sore throat,

Staying away from cigarettes,

Not using any medicine or syrup other than medical treatment are among the basic measures that can be taken.

Cough in Infants and Children

Although cough is a protective reflex, it is one of the most common symptoms of respiratory tract diseases in children. A cough lasting less than 15 days is called acute cough, a cough lasting more than 15 days is called prolonged cough, and a cough lasting more than 1 month is called chronic cough. In children, cough can be a simple cold but can also be a sign of a serious illness. Cough caused by viruses, that is, flu, is very common in children, especially those attending preschool. These coughs can usually last up to about 10 days.

A sudden-onset cough resembling a bark should bring croup to mind. In croup, shortness of breath can sometimes be severe and requires emergency treatment.

If a coughing child produces phlegm and has a fever reaching 39 degrees, or has shortness of breath, pneumonia should come to mind.

Exposure to cigarette smoke and pungent odors can also cause cough.

What are the causes of prolonged cough in children?

It usually occurs when germs are added on top of a flu-like infection, resulting in the development of sinusitis or pneumonia. A doctor must be seen for a cough that lasts a long time.

A cough lasting more than 1 month, that is, chronic cough, may be due to more serious problems.

One of the most common causes of chronic cough is asthma. If the cough wakes the child from sleep, causes shortness of breath, or worsens toward morning, asthma should come to mind.

In young infants, cough due to reflux may occur.

Rarely, cough is caused by a foreign object such as a sunflower seed entering the lungs. Especially in a child who develops a coughing fit while eating seeds or peanuts, the possibility that a foreign object has entered the lungs should be considered.

Congenital lung and heart problems may cause cough. Development of heart failure can lead to cough and shortness of breath.

Earwax can also cause cough.

If the cough sounds like choking and is followed by a deep, whooping inhalation, or if vomiting occurs, pertussis may come to mind.

A prolonged cough with weight loss and bloody phlegm may be due to tuberculosis, that is, consumption.

If there is frequent cough along with delayed growth and development, cystic fibrosis may come to mind.

What can be done if your child is coughing?

Cough is a frequently seen complaint in children. Since cough is a symptom rather than a disease, giving cough suppressant medications without determining its cause is not a correct approach. The use of herbal remedies is also not recommended. It is necessary to diagnose the illness causing the cough and to provide the correct treatment.

If the cough is due to a flu-like infection, the use of antibiotics is not correct, because antibiotics have no benefit in flu-like infections. If there is nasal congestion due to a flu-like infection, nasal decongestant drops or sprays may be used. Taking plenty of fluids and resting may be recommended. If there is postnasal drip, treatments that reduce postnasal drip may be given.

In children under 3 months, it is absolutely necessary to consult a doctor, because in these children, cough can progress rapidly and cause shortness of breath.

In children over 3 months, if there is a mild cough, lukewarm water or lukewarm fruit juices may be given. If there is nasal congestion, saline nasal drops may be given. Saline drops may be instilled into the nose frequently. If there is wheezing, shortness of breath or high fever, they must see a doctor.

In children over 1 year old, it may be recommended that they take plenty of fluids. If the nose is blocked, saline nasal drops may be given.

In children over 6 years old, if the nose is blocked, saline nasal sprays may be used.

If the cough has lasted longer than 15 days, a doctor must see the child, because an underlying condition such as sinusitis or pneumonia may be present. In children under 1 year old, if frequent vomiting is accompanied by cough, the child must be seen by a doctor to be evaluated for reflux.

If there is cough with bloody phlegm and weight loss, it should be investigated for tuberculosis.

If a child has frequent cough along with delayed growth and development, it should be investigated for cystic fibrosis.

If a cough has lasted more than 1 month, especially a cough that wakes the child at night, a cough that worsens toward morning, or a cough that increases with exercise, underlying asthma may be present.

What situations make cough dangerous in children?

If a sudden barking-type cough, hoarseness of voice and difficulty breathing develop, croup should come to mind and the child must be seen by a doctor urgently, because sometimes shortness of breath can be life-threatening.

If cough is accompanied by a fever reaching 39 degrees and phlegm, pneumonia should come to mind and the child must be seen by a doctor urgently.

If cough develops in a child under 3 months old, the child must again be seen by a doctor urgently.

If cough is accompanied by bluish discoloration (cyanosis), the child must be seen by a doctor urgently.

If cough occurs in successive bouts and is choking-like, and is followed by vomiting, the child must be seen by a doctor urgently to be evaluated for pertussis.

What helps a child who is coughing?

In coughs caused by a flu-like infection, if there is nasal congestion, nasal decongestant drops or sprays may be used.

Taking plenty of fluids and resting may be recommended.

If the cough is caused by the common cold virus or a flu-like infection, it is contagious because of the spread of body secretions. If a child attending daycare has a cough due to a very intense virus, it is important for the health of other children that the child not be sent to daycare until the cough and contagiousness have passed.

To prevent transmission, the child should wear a mask, and we should wash our hands more frequently after contact with the sick child.

If a coughing child's condition is noticed to be dangerous, the child should be taken to a doctor urgently.