Coughing can be a nuisance to many people, but some think that just coughing will go away on its own. However, if the cough persists continuously for a long time, it is definitely not good because it may signal the onset of various diseases.
Mechanism of Coughing
Coughing occurs when foreign substances cause irritation or when mucus is present in the bronchial tubes, prompting the body to try to expel it by coughing. In some cases, it is not a foreign substance but something pressing on the lung tissue or bronchial tubes, causing coughing, such as a mass or lung cancer. The body tries to expel it but cannot, resulting in chronic coughing.
What diseases cause chronic cough?
- Pulmonary Tuberculosis Found in the general population even without a history of exposure. In the early stage, there are no symptoms, but it can be detected by chest X-ray. As the disease progresses, chronic cough, fever (often at night), fatigue, loss of appetite, and weight loss occur. Some may cough up blood, have chest pain, and shortness of breath.
- Lung Cancer In the early stage, there are no symptoms. As the disease advances, chronic cough occurs. Some may cough up fresh blood, have chest pain, fatigue, loss of appetite, weight loss, or fever. Patients often have a long history of heavy smoking, but some may have no smoking history.
- Emphysema Often found in people with a long history of heavy smoking. Patients usually have chronic cough with sputum and are easily short of breath with noisy breathing.
- Asthma Can occur at any age. Usually presents with coughing, especially at night or in cold weather. The severity depends on the degree of narrowing of the small airways. Symptoms range from difficulty breathing, severe coughing, wheezing, and shortness of breath. Symptoms often worsen with respiratory infections.
- Allergic Rhinitis Usually causes itchy nose, itchy throat, cough, sneezing, and sometimes clear nasal discharge. Symptoms occur when exposed to allergens such as dust mites, pollen, animal dander, or cold air.
- Gastroesophageal Reflux Disease (GERD) Causes dry cough, especially after meals or when lying down. There may be heartburn or acid regurgitation, but not always.
- Sinusitis Usually preceded by a cold or allergic rhinitis. Some cases improve initially but worsen later. Coughing often occurs at night due to postnasal drip.
- Airway Hyperresponsiveness Occurs after respiratory infections. When the cold symptoms have resolved but coughing persists, especially at night or in cold air or wind.
What types of cough are dangerous and require immediate medical attention?
- Cough lasting more than 2 weeks
- Increasingly severe cough
- Cough accompanied by other symptoms such as blood in sputum, weight loss, loss of appetite, shortness of breath, fatigue, chest pain, etc.
Investigations for the cause of chronic cough
Since chronic cough can be caused by different diseases, it is important to see a doctor promptly. The doctor will perform a chest X-ray to check for tuberculosis or lung cancer. If sinusitis is suspected, a sinus X-ray can be done. If asthma is suspected, lung function tests are required. If gastroesophageal reflux disease is suspected, initial treatment will be given. If symptoms do not improve, endoscopy of the esophagus and stomach may be necessary.
Self-care when having a cough
- Avoid triggers that worsen the cough, such as setting the air conditioner to 25 degrees Celsius, not setting it too cold, wearing a scarf, avoiding direct fan exposure, avoiding cold foods or drinks, fried or greasy foods. If the cough is due to acid reflux, avoid alcohol, smoking, sour and spicy foods.
- See a doctor to find the cause and receive appropriate treatment. Some chronic cough cases may have multiple causes, such as allergic rhinitis, asthma, and acid reflux occurring together.
- If you smoke, you must quit smoking.
Dr. Pimthira Sujaritwongsanont
Specialist in Respiratory Diseases
Internal Medicine Center Phyathai Nawamin Hospital
