Cough Diagnosis and Remedies for Cough

Cough Diagnosis

The diagnosis of a cough is based largely on the information you provide. Information necessary to help make an accurate diagnosis includes the duration of the cough, associated signs and symptoms, activities or locations that make the cough worse or better, relation between the cough and time of day, past medical history, and any home therapies already attempted.

• In an acute cough the doctor may be able to make a diagnosis simply by interviewing the patient, and performing a physical examination. If the patient has an acute cough, chest X-rays typically do not add to the doctor's ability to make a diagnosis. Elderly people, people with weakened immune systems (i.e., from cancer,diabetes, or AIDS), and people with abnormal lung sounds on examination may benefit from an X-ray to check for pneumonia.
• In a chronic cough, doctors will often rely on the interview and physical examination to aid them in determining what tests, if any, are appropriate in order to make a diagnosis. Many people will receive a chest X-ray to search for problems. Beyond this, other diagnostic tests may be ordered at the doctor's discretion and based on the interview and examination. Some of these tests may be ordered by a doctor, and others will require referral to a specialist. The specialist selected will depend on the suspected source of the cough.
• It is important that the patient be an active participant in his or own own health care, and discuss with a doctor the purpose of any test ordered and what the expected results will mean.

Remedies for Cough

Home care of a cough is often directed at treating its underlying cause.

• If the patient has an acute cough and have not been to a doctor, he or she may attempt to use over-the-counter cold remedies to relieve the symptoms. If a common cold or flu is suspected, these may provide relief until the infection resolves on its own. Acute coughs that are caused by allergies are often relieved with allergy medication, and coughs due to environmental irritants will respond to elimination of the irritating agent.
• Home care of the chronic cough with a known cause is directed at treating the underlying cause of the cough. This should be done in close consultation with a doctor or with a specialist. Although not every chronic cough can be eliminated, many people can find relief of their cough by following their doctor's recommendations closely.

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Cough Symptoms and When to Seek Medical Care

Cough Symptoms

What differentiates the cause of a cough are the associated signs and symptoms. Another important factor in determining the cause of the cough is whether it is acute or chronic.

Acute coughs have been divided into infectious and noninfectious causes.

• Signs and symptoms that point to an infection include fever, chills, body aches,sore throat, nausea, vomiting, headache, sinus pressure, runny nose, night sweats, and postnasal drip. Sputum, or phlegm, sometimes indicates an infection is present, but it is also seen in noninfectious causes.
• Signs and symptoms that point to a noninfectious cause include coughs that occur when a person is exposed to certain chemicals or irritants in the environment, coughs with wheezing, coughs that routinely worsen when an indivdual goes to certain locations or do certain activities, or coughs that improve with inhalers or allergy medications.

The signs and symptoms of the chronic cough can be hard for doctors to assess, because many causes of chronic cough have overlapping signs and symptoms.

• If a cough is related to environmental irritants, it will worsen when exposed to the offending agent. If a person has an environmental allergy, the cough may improve when using allergy medications. If a person has a smoker's cough, it may improve if they stop smoking and worsens with increased smoking.
• If a person has a chronic lung disease such as asthma, emphysema, or chronic bronchitis, they may have a persistent cough or a cough that worsens with certain locations or activities. An individual may or may not have sputum with a cough, and often have improvement with the use of inhaled or oralsteroids, or other inhaled medications.
• If a cough is caused by chronic sinus infections, chronic runny nose, or chronic postnasal drip, the person will often have the signs and symptoms associated with these conditions. A person may also notice that the cough worsens when his or her problem worsens, and often the cough will improve when the underlying problem is treated.
• If a cough is associated with medications, such as angiotensin converting enzyme (ACE) inhibitors, the cough often begins after starting the medication in question, but can come on at any point during the use of the medication. The cough is often dry and improves when the medication is stopped.
• A cough associated with GERD is often associated with a sensation ofheartburn. This type of cough worsens during the day or when lying flat on the back. Furthermore, a sizable minority of people with a cough caused by GERD will note no symptoms of reflux, but most people will report improvement in their cough when GERD is treated properly.
• If a cough is a warning sign of an underlying cancer, the person may have a group of symptoms. If lung cancer or a cancer of the air passages is present, the person may cough up blood. 

  When to Seek Medical Care 

  
  

  
  

  In general, contact a doctor if you experience the following:
  • Cough is associated with a fever and sputum production
  • Cough fails to get better after other symptoms go away or lessen
  • Cough changes in character
  • Trial therapy shows no signs of reducing the cough
  • You begin coughing up blood
  • Cough interferes with the activities of daily living or sleep cycles
  • Call a doctor immediately if you have shortness of breath or difficulty breathing.
  Most coughs do not require evaluation in the emergency department, and efforts should be made to discuss the situation with a doctor. But certain circumstances warrant emergency evaluation.
  • If you have a cough that is caused by a chronic condition, discuss what signs and symptoms warrant going to the emergency department with your doctor or specialist.
  • If you develop severe shortness of breath or chest pain with your cough, you could have any number of serious medical problems that require urgent intervention.
  • Elderly people or people with weakened immune systems who develop a cough and fever should be seen in the emergency department if they are unable to contact their doctor.
  • If you have lung disease and an acute worsening in your cough that does not respond to home therapy, you should go to the emergency department.

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Coughs Overview and Causes of Coughs

Coughs Overview

A cough is an action the body takes to get rid of substances that are irritating to the air passages, which carry the air a person breathes in from the nose and mouth to the lungs. A cough occurs when cells along the air passages get irritated and trigger a chain of events. The result is air in the lungs is forced out under high pressure. A person can choose to cough (a voluntary process), or the body may cough on its own (an involuntary process).

Causes of Coughs

Acute coughs can be divided into infectious (caused by an infection) and noninfectious causes.

• Infectious causes of acute cough include viral upper respiratory infections (the common cold), sinus infections, acute bronchitis, pneumonia, and whooping cough.
• Noninfectious causes of cough include flare-ups of chronic conditions such as chronic bronchitis, emphysema, asthma, and environmental allergies.

The easiest way to simplify the causes of chronic cough is to divide them into their locations with respect to the lungs. The categories are environmental irritants, conditions within the lungs, conditions along the passages that transmit air from the lungs to the environment, conditions within the chest cavity but outside of the lungs, and digestive causes.

• Any environmental substance that irritates the air passages or the lungs is capable of producing a chronic cough with continued exposure. Cigarette smoke is the most common cause of chronic cough. Other cough-producing irritants include dusts, pollens, pet dander, particulate matter, industrial chemicals and pollution, cigar and pipe smoke, and low environmental humidity.
• Within the lungs both common and uncommon conditions cause chronic cough. Common causes include asthma, emphysema, and chronic bronchitis. Less common causes of lung-induced chronic cough include cancer,sarcoidosis, diseases of the lung tissue, and congestive heart failure with chronic fluid build-up in the lungs.
• The passages that connect the lungs to the external environment are known as the upper respiratory tract. Chronic sinus infections, chronic postnasal drip, diseases of the external ear, infections of the throat, and use of ACE inhibitor medications for high blood pressure have all been implicated in chronic cough.
• In addition to disease processes within the lung and air passages, diseases elsewhere within the chest cavity may also be responsible for chronic cough. Conditions within the chest known to cause chronic cough include cancer, unusual growth of a lymph node, and an abnormal enlargement of the aorta, the main blood vessel leaving the heart.
• An often-overlooked cause of the chronic cough is gastroesophageal reflux (GERD). GERD occurs when acid from the stomach travels up the esophagus. This abnormal condition can cause irritation of the esophagus and larynx resulting in the reflex production of a cough.

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