Cough and its treatment

1. What can we do at home for cough?

Here are some easy precautions that can be taken at home when the cough first starts:

• First of all, it is necessary to drink plenty of warm water, the most appropriate treatment to soften the secretions is to drink plenty of water, but it is appropriate to drink warm water, not cold. At least two lukewarm waters per day, and more if possible, are recommended.

• If the cough increases at night – especially during the first hospitalization, it may increase due to post-nasal drip – the head of the bed should be elevated, and if necessary, a double pillow should be used.

• The nose should be kept strictly open. If the nose remains blocked, mouth breathing will occur and the throat will dry out and the cough will increase.

• It would be appropriate for the coughing person not to smoke if he or she smokes, not to smoke near him even if he does not smoke, and to stay away from all kinds of sharp odors during this period.

• Again, heavy exertion can trigger coughing, the patient with cough should avoid heavy exertion.

• If the cause of the cough is reflux, precautions should be taken, and if the diagnosis has been made before, the physician should be informed and the treatment should be reviewed.

• If cough exceeds 2 weeks and/or increases after URTI, a physician should be consulted.

• Cough suppressants are not suitable for the patient to use on their own, they should be used under the supervision of a doctor. Moreover, today, the use of cough suppressants is very limited, and it is preferred to treat the cause rather than cutting the cough.

1. How is cough treated?

Cough will go away if the cause is treated. As we often encounter, it is useless to use antibiotics and cough syrups if the tickling form of cough is related to asthma. What needs to be done is to arrange the treatment of asthma according to the level of asthma in line with the recommendations of a pulmonologist and to follow up. In the presence of reflux-related cough, the patient should be referred to gastroenterology and treated after the necessary examinations, and follow-up should be followed by a specialist physician. It is valuable to inform the patient about nutrition again. It may also be the blood pressure medication used by the patient causing the cough, in this case, the cough will be stopped by changing the medication. However, sometimes the cough may be prolonged up to 3 months after the cessation of treatment, and the patient should be informed about this. In the case of interstitial fibrosis with loss of stretching in the lungs, necessary treatment should be applied under the supervision of a pulmonologist. If the cough due to postnasal drip is allergic, it would be appropriate to plan surgical treatment with ENT intervention in the presence of a cause-oriented treatment in terms of allergy, and in the presence of a condition that requires surgery such as bone curvature. Sometimes, we may encounter coughs that are not due to a physical cause, which we call psychogenic cough. After all other causes have been ruled out, that is, if the patient’s examination findings, chest X-ray, respiratory function tests, ENT examination, evaluation in the direction of reflux do not reveal any pathology, but if the tickling cough continues, if the patient’s history also suggests psychic cough, it is useful to ask for a psychiatric consultation in these cases.

1. When should we go to the doctor if we are coughing?

If there is sputum with a cough and the sputum is yellow-green in color and thick consistency, if there is fever with it, we should definitely go to the doctor. Because a pneumonia, that is, pneumonia, should not be missed, the lower respiratory tract of the patient should also be examined by the physician. If bloody sputum comes out with coughing, we should apply to a chest diseases physician as soon as possible. This may be due to a much more important reason, such as an easy nosebleed or bleeding due to post-nasal drip after sinusitis. A tumoral mass in the lung or tuberculosis, that is, tuberculosis or bronchiectasis or pulmonary embolism, may be the subject of clotting in the pulmonary vein, and all of these conditions require very important treatment. Apart from this, any cough that lasts for a long time should be investigated. For coughs lasting more than 2 weeks, a doctor should be consulted. Bronchial hyperreactivity – airway edema – developing after viral URTI may cause a long lasting dry cough, and a long periodic cough may be the only symptom of mild asthma. In the case of re-interstitial fibrosis, which goes with loss of flexibility in the lungs, long-term cough is also the subject of speech, and it is seen only during exertion in the early period. In other words, in the presence of cough with effort, a doctor should be consulted. In summary, cough can be a sign of many important diseases, long-term cough should definitely be investigated.

1. What are the causes of cough?

Cough can be caused by various reasons. In order to determine the cause of the cough, it is valuable to take a detailed history, the duration of the cough, its character – whether it is sputum or not. In addition, the factors that trigger cough and accompanying complaints should be known. All this information is evaluated and the cause of cough is tried to be determined.

* The common cold is the most common cause of cough, but it often resolves in a short time.

*Asthma- Asthma is the most common cause of long-term cough. Sometimes the early sign of asthma is a tickling cough and the patient has no other complaints. Especially in the presence of a dry cough for more than 3 weeks, the patient should apply to the chest diseases department and be evaluated in terms of asthma, examined and a breathing function test should be performed. Triggering cough with strong odors, cold, and exertion are findings supporting asthma. A cough that increases again at night should bring asthma to mind.

*Chronic upper airway cough syndrome due to conditions such as chronic sinusitis and allergic rhinitis in the upper respiratory tract may cause a dry cough. It is more common in allergy sufferers.

*Gastroesophageal reflux–GER is the cause of a valuable portion of patients with chronic cough. Cough usually starts a few hours after a meal. Sometimes it can occur after going to bed at night. Cough may be accompanied by burning and heartburn in the stomach, bitter water in the mouth, a burning sensation in the chest, and hoarseness.

* It was determined that 50-90% of asthma patients had reflux. In other words, reflux is more common than usual in individuals with asthma. This is because asthma relaxes the muscles surrounding the stomach head. In this case, it is easier for the acidic contents of the stomach to escape into the esophagus. In addition, today, air pollution, additives, GMO foods, etc. For many reasons, the incidence of allergies and asthma is increasing all over the world. For this reason, especially the association of asthma reflux should not be overlooked.

*Cigaret

*Under the conditions of our country, tuberculosis – In 2010, 16,500 registered tuberculosis patients were detected in our country. Symptoms of TB are fever, night sweats, weight loss, loss of appetite and fatigue, especially in the evening. cough lasting more than two weeks, sputum production, coughing up varying amounts of blood, chest pain and shortness of breath. Complaints usually start mildly and progress slowly. Patients may attribute these complaints to other causes and go to the doctor late. For this reason, it is also valuable to evaluate the coughing patients who have tuberculosis in their relatives, that is, who have a contact history, in this direction. In-house contacts of patients are screened in VSDs, but there is no problem in screening, and it is valuable to be more vigilant for patients who have complaints afterward.

* Diffuse interstitial lung disease, that is, loss of flexibility in the lungs, fibrosis

*ACE inhibitor blood pressure medications

*Pleura-lung membrane-diseases

*Mediastinal diseases

*External ear canal diseases

*psychogenic

1. Is cough contagious?

If the cough is caused by an infection, it can also occur in the surrounding individuals with the transmission of the infection. This is due to the transmission of the infection, not the transmission of the cough. Especially children and the elderly, individuals with allergic structure, those with chronic lung, heart, kidney disease, diabetics, immunosuppressed individuals receiving chemotherapy and radiotherapy are more susceptible to all kinds of infections, especially respiratory tract viral and bacterial infections, and are more susceptible to epidemics in winter months. There may also be coughing complaints. Since TB disease is also contagious, individuals infected with this disease also have a cough.

Dry cough and its treatment**

1. Dry cough, how is it treated?

Treatment of dry cough should be directed towards the cause. The main causes of dry cough are asthma, postnasal drip and reflux due to upper respiratory tract problems. In the presence of dry cough due to asthma, treatment should be arranged according to the level of asthma, and bronchodilator (bronchodilator) and anti-inflammatory (protective) drugs should be given at the required dose. In addition, the patient should be informed about the disease and the details of the treatment, and it should be ensured that he/she uses his/her medications for the required duration and dose. If dry cough due to nasal discharge is allergic, cause-specific treatment should be applied in terms of allergy. If the result of allergy tests and the patient’s age, inhalation tests and other clinical findings are suitable for the vaccine treatment, which we call immunotherapy, immunotherapy, that is, vaccine treatment, should be applied to the patient. In the presence of chronic sinusitis, long-term antibiotic treatment under the control of an otolaryngologist; In the presence of a condition that requires surgical operation, such as intranasal polyp, curvature of the nasal bone, it would be appropriate to plan surgical treatment with ENT intervention. If there is a dry cough due to reflux, the patient should be referred to gastroenterology, if necessary, endoscopy should be performed and treatment should be arranged. It is valuable to inform the patient about nutrition again. Sometimes it is the blood pressure medication used by the patient that causes dry cough. In this case, changing the drug will be enough to improve the cough. Sometimes, we may encounter coughs that are not due to a physical cause, which we call psychogenic cough. If no other physiological reason to explain the dry cough can be found after all other causes have been ruled out, and if the patient’s history also suggests psychic cough, it is appropriate to ask for a psychiatric consultation in these cases.

1. What causes dry cough?

Cough is a mechanical defense barrier that prevents the ingestion of foreign and wasted bodies into the respiratory system, and protects the lung by removing excessive secretions from the airways. Cough, which is defined as dry cough, is a cough in which sputum does not come out, or very little sticky sputum can be forced out. It often comes in seizures, it is a cough that tires the patient. The most common causes of dry cough are cough triggered by nasal discharge due to upper respiratory tract problems, cough due to asthma and reflux. If the nasal discharge is small and sticky during URTI, it may cause a dry cough. Another cause of dry cough is asthma. Sometimes the only symptom of asthma – especially mild asthma – may be a long periodic dry cough. The increase in dry cough at night, triggered by exertion, sharp odors, exacerbation in a dusty environment, humid environment or seasonal changes suggest asthma. In addition, one of the most common causes of dry cough is reflux. There may be a burning sensation in the stomach and a feeling of pain behind the chest. Increasing cough after meals and increasing at night should bring reflux to mind. In addition, in our country, tuberculosis disease, some blood pressure medications, smoking, the condition we call fibrosis in the lungs, diseases related to the space in the middle of both lungs, which we call the mediastinum, mental causes, etc. Many conditions can cause a dry cough.

1. How to prevent dry cough?

The priority in the prevention of cough is to eliminate the causes.

For example, in the presence of asthma, it is valuable to stay away from triggers. If the patient is allergic, it should be ensured that precautions related to the allergic factor, ie allergen, should be taken, no smoking in the residence, avoidance of sharp odors, and most importantly, the patient should use the necessary drugs in the required dose. Of course, for this, first of all, early diagnosis of asthma is valuable. Because sometimes the only symptom of asthma is a long-lasting dry cough, and if the patient does not reach the pulmonologist and respiratory function tests are not performed, the diagnosis of asthma may be delayed.

Similarly, an asthma-like picture occurs in airway sensitivity after upper respiratory tract infections and causes long-lasting dry coughs, in this case, starting treatment for airway sensitivity early, especially in allergic patients, will prevent prolonged coughs. Taking a proper history in terms of reflux is also highly instructive. The increase in cough after meals and sometimes at night suggests reflux first. In this case, both the necessary treatment is started and the increase in cough is prevented by informing the patient about nutrition and lifestyle. When dry cough starts again, if the patient has other findings such as weight loss and night sweats, chest X-ray should be taken to evaluate the possibility of tuberculosis, that is, tuberculosis, and if necessary, sputum and blood tests should be requested. Sometimes used blood pressure medications can cause dry cough, if there is a medication that will cause this in the middle of the medications used by the patient, it is valuable to change it. In addition, smoking is a definite cause of cough and it is necessary for all individuals to be encouraged to quit smoking as early as possible.

1. Does smoking too much cause a dry cough?

Smoking is one of the most valuable causes of cough. There are more than 4000 different harmful aspects in cigarettes. Smoking is an irritant. The most common type of addiction in the world is cigarette addiction. Cigarette smoking is the cause of nearly 50 chronic diseases and nearly 20 fatal diseases. The most suitable known damage of smoking is on the lungs. Smoking is responsible for 80% of chronic lung diseases.

*80% of people with COPD are smokers, on the other hand, 20% of smokers develop COPD. There is a dose-dependent relationship between smoking and COPD, with heavy smokers at higher risk of developing COPD. Passive smoking exposure also increases the risk of developing COPD. COPD is one of the valuable causes of cough.

* Since smoking causes permanent damage to the airways, destruction of the lung defense systems, and unresponsiveness to the treatments for the lungs, it causes diseases that cause airway narrowing such as chronic bronchitis and emphysema.

* Half of smokers have chronic bronchitis. In these patients, morning cough and sputum begin first, and then shortness of breath is added.

*Smoking prepares a place for asthma, complicates the treatment of asthma, and causes significant asthma attacks. Environmental cigarette smoke exposure is the most frequently reported airway irritant in pediatric asthmatics. Reducing contact with environmental risk factors, especially smoking, is important not only to prevent the development of asthma, but also to control symptoms in those with asthma.

*Smoking increases reflux as it reduces the pressure of the lower end of the esophagus. Reflux is also one of the valuable causes of cough.

*Smoking suppresses the body’s immune system and prepares the ground for infection. Upper respiratory tract infections, sinusitis, otitis media, acute tonsillitis (tonsillitis), pharyngitis are common in smokers, and dry cough complaints are very common due to these.

*Lung cancer is 15-20 times more common in smokers than non-smokers, and cough is one of the most valuable symptoms in lung cancer.

Considering that every cigarette smoked shortens life by 5 minutes, I would like to remind you once again that smoking, which has an addictive effect 8 times more than cannabis and heroin, should be avoided.

EVERYTHING YOU KNOW ABOUT Cough

1. Why do we cough?

Cough is a reflex mechanism created by the lower respiratory tract for self-cleaning and self-defense. Often, coughing occurs as a result of involuntary stimulation of the membrane lining the inner surface of the bronchus, which is located in the middle of the larynx and bronchial tree. Irritants such as secretions and secretions in the airways, foreign bodies, mechanical factors pressing on the outer wall of the bronchi, nicotine, bleach and detergents, and polluted air are responsible for the initiation of the cough reflex. It is divided into 3 clusters according to the duration of cough.

*Acute Cough – Cough lasting less than 3 weeks. Of the upper respiratory tract infections, the common cold is the most common cause of acute cough. However, acute cough can also be seen in lower respiratory tract infections, asthma, bronchiectasis, exacerbations in COPD patients, pneumonia, foreign body aspirations due to inhalation of toxic gas, and pulmonary embolisms.

*Subacute Cough – Cough lasting in the middle of 3-8 weeks. As this cough is frequently seen after pneumonia, bronchitis and pertussis infections in children; also unrelated to infection; It is a prolonged and recurrent cough that is also encountered in upper respiratory tract cough syndrome, that is, due to postnasal drip, in asthma patients, GER and bronchitis.

*Chronic Cough- It is a cough that lasts longer than 8 weeks, and in this case, the first thing to ask is whether the patient smokes and whether he has taken ACE inhibitor cluster blood pressure medication. If these are not present in the patient’s history, then the most common causes of chronic cough are upper respiratory tract cough syndrome – that is, cough due to post-nasal drip-, asthma and GER.

1. Night cough can be a symptom of what ailments?

• A dry cough that increases at night, especially in the form of a tickling, should first bring to mind the asthma disease. Asthma patients often wake up at night with dry cough complaints. Subsequently, attacks of shortness of breath may be added. In addition;

• Nasal discharge due to conditions such as chronic sinusitis and allergic rhinitis in the upper respiratory tract, which we call chronic upper airway cough syndrome, can cause a tickling cough. This is more common in allergy sufferers. Finally

• Gastroesophageal reflux is another condition that often causes nighttime coughs. GER is the cause in 5-41% of patients with chronic cough. Cough usually starts a few hours after a meal. Cough often occurs after going to bed at night. Cough may be accompanied by a burning sensation in the chest, bitter water in the mouth, stomach complaints, hoarseness, but it is not a condition. Another issue to be considered is the association of asthma reflux. It has been determined that 50-90% of asthma patients have reflux. Especially today’s obesity, nutrition style, additives, GMO foods, etc. For many reasons, the incidence of allergies and asthma is increasing all over the world. Therefore, the coexistence of asthma reflux is a valuable problem that should be emphasized.

1. In which situations can cough be a sign of lung cancer?

Cough in lung cancer is the first symptom in a quarter of patients, but in the absence of other suspicious symptoms, it alone does not suggest lung cancer and may be overlooked. At the time of diagnosis, 50-75% of lung cancer patients have a cough and 25% have a cough with phlegm. Especially bloody sputum is valuable. Lung cancer should be considered as the cause of cough and examination should be performed in the presence of a new cough in smokers, a change in the character of the previous cough, and bloody sputum with cough. If there is exposure to carcinogens (cancer-causing substances) such as passive smoking, asbestos, and radon in the person’s history, lung cancer should be considered. If there is a history of cancer in the previous story, the possibility of lung metastasis should be considered.

For persistent coughs lasting more than three weeks, referral to a pulmonologist and chest X-ray is recommended.

In patients who smoke and have bloody sputum, it is recommended to continue the examinations even if it is usual to have a chest X-ray first. The rate of diagnosis of lung cancer was found to be 3-5% in the further examinations of individuals with bloody sputum, over 40 years of age and with a normal chest X-ray, and early diagnosis is very valuable in lung cancer.

1. My lungs hurt when coughing, why?

* Pain in the chest when coughing is the feeling of the fire in the airways due to the inability to produce sputum, mostly dry cough, by the patient.

* Other than that, sometimes long lasting coughs may cause cracks in the ribs, in this case the patient may feel significant stinging pain while breathing. Although this condition is mostly seen in patients with osteoporosis, it rarely occurs in younger patients.

* In the presence of reflux, a significant burning and stinging sensation may occur in the chest with the passage of acidic stomach contents from the esophagus to the larynx and even to the airways with aspiration, together with coughing. Sometimes this situation is so important that the patient may mistake it for heartache.

* Apart from this, there may be a feeling of pain in the chest in infectious diseases such as pneumonia (pneumonia), pleurisy (fluid accumulation in the middle of the lung membranes). In these cases, there are symptoms such as chest pain, high fever, cough, and sputum production. The pain often begins abruptly with other symptoms and is stinging in character and felt on the lateral part of the chest wall during coughing or deep breathing. With the treatment of the infectious disease, its severity decreases in a short time and disappears.

* Chest pain that occurs due to pulmonary embolism is again in the form of flank pain and often starts suddenly. In pulmonary embolism, apart from chest pain, there may be symptoms of fever, shortness of breath, cough, and coughing up blood, and this picture often forces the patient to apply to the emergency room. It occurs due to the interruption of the blood flow to the lung by the obstruction of the pulmonary arteries or one of the branches of the arteries for any reason. It is a life-threatening condition compared to the size of the clogged vessel. A blockage in one of the main arteries to the lungs can even lead to sudden death. Symptoms are sudden onset of severe and sharp chest pain. Chest pain increases with deep breathing or coughing. Other symptoms of pulmonary embolism are shortness of breath, rapid and short breathing, rapid heartbeat, restlessness and fatigue.

*Pneumothorax (Lung collapse) can occur as a result of trauma or injury, or as a complication of many lung diseases. In this case, a feeling of pain and pain in the chest suddenly appears with coughing, especially in the elderly and those with underlying advanced lung disease, it is accompanied by shortness of breath, forcing the patient to apply to the emergency room.