Guide to your cough

What is the relevance of cough?
Cough is the most common complaint for which patients seek medical attention as per the national survey done by the US Department of Health and Human Services. It is estimated that Americans spend more than a billion dollars annually for medications for cough. Some cough is just a temporary problem—but some cough can affect quality of life significantly and may be an indication of a serious underlying problem.

Mechanism of your cough
Cough receptors are located in the nose, sinuses, throat, ears, and airways. Any stimulation or irritation of these receptors can produce cough.

What conditions can cause your cough?
The causes of cough vary depending on the age of the patient and its duration. Some specifics:

Acute cough: by definition lasts less than 2 or 3 weeks. Common causes include
· Viral upper respiratory infections like common cold
· Postnasal drip syndromes (allergic and non-allergic nose problems)
· Sinusitis
· Whooping cough
· COPD exacerbation

Sub-acute cough: by definition lasts from 2 or 3 to 8 weeks. Common causes include
· Postnasal drip syndromes (allergic and non-allergic nose problems)
· Post-infectious
· Sinusitis
· Asthma
· Whooping cough

Chronic cough: by definition lasts for more than 8 weeks. Common causes include
· Postnasal drip syndromes (allergic and non-allergic nose problems)
· Asthma
· Acid reflux disease
· Eosinophilic bronchitis
· Chronic bronchitis (smoking)
· Adverse effect of medications like ACE-inhibitors
· Psychogenic
· Habit cough/Tics
· Other rare causes include tumors compressing on the airways, foreign bodies in the airways, heart failure, cystic fibrosis, lung cancer, etc.

What is the success rate of treatment?
Several studies have suggested that with appropriate management the success rate in cough treatment can be over 95%.

How will you find out what is causing your cough?
Chronic cough can be caused by multiple causes at the same time in the same patient and this can sometimes be a very important consideration for appropriate and effective treatment. Although there are similarities in the management of cough in children and adults, differences do exist. It is important to determine the cause in an individual patient by doing a thorough history, physical examination and by conducting specific tests. The treatment approach needs to be individualized.

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