1. What are the effects of coughing on the organism?
Coughing is a protective reflex of the respiratory tract and helps to expel airway secretions from the body. However, frequent and violent coughing can increase the pressure in the thoracic and abdominal cavities, which can increase the burden on the heart and even cause hemoptysis, pneumothorax, musculoskeletal pain, rib fractures, hernias and urinary incontinence.
2. Can frequent coughing lead to lung cancer and chronic bronchitis?
On the contrary, both lung cancer and chronic bronchitis can be manifested as coughs of different degrees and other related symptoms.
3. How is cough classified?
Cough can be classified according to its duration: acute <3 weeks; subacute 3-8 weeks; chronic R8 weeks. By nature, it can be divided into: dry cough and wet cough.
4.Do I need to use antibiotics for acute cough caused by the common cold?
The principle of treatment for the common cold: treatment is mainly symptomatic and antibacterial drugs are generally not needed.
Drugs that can be used include.
(1) Decongestants: pseudoephedrine hydrochloride, etc.
(2) antipyretic drugs: antipyretic and analgesic class.
(3) Anti-allergic drugs: the first generation of antihistamines, such as chlorpheniramine maleate, etc.
(4) Cough suppressants: If the cough is severe, central or peripheral cough suppressants and Chinese medicines can be used if necessary.
5.How to treat cough and sputum caused by acute bronchitis?
Symptomatic treatment is the main principle of treatment. For severe dry cough, cough suppressants can be applied appropriately, and for cough with sputum that cannot be easily coughed out, expectorants can be used. If there is a bacterial infection, such as coughing up purulent sputum or an increase in peripheral blood leukocytes, antibacterial drugs can be chosen for treatment.
6. Is chronic cough always due to chronic bronchitis?
Chronic cough has many causes and chronic bronchitis is one of the most common causes. Chronic bronchitis is defined as coughing and coughing for more than 2 consecutive years, accumulating or lasting for at least 3 months each year, and excluding other causes of chronic cough. Cough and sputum are usually obvious in the morning, coughing white foamy sputum or mucus sputum, and nocturnal cough is also present during the exacerbation period.
7. How to treat cough caused by chronic bronchitis?
During acute attacks and chronic extensions, infection control, cough suppression and expectoration should be the main focus; during clinical remission, exercise should be strengthened to enhance physical fitness, improve body resistance and prevent relapse. Patients who smoke should consciously quit smoking and reduce the time of outdoor exercise during severe air pollution and hazy weather.
8.What is chronic cough of unknown origin?
It refers to cough symptoms lasting more than 8 weeks, cough as the main existing symptom, no hemoptysis, sputum or no sputum, normal chest radiographs, and no history of recurrent respiratory tract infections.
9. What diseases need to be considered for chronic cough?
Common diseases to consider include: cough variant asthma (CVA), upper airway cough syndrome (UACS, also known as PNDS), eosinophilic bronchitis (EB), and gastroesophageal reflux cough (GERC). Other rare conditions include chronic bronchitis, bronchiectasis, bronchial tuberculosis, allergic cough (AC), and psychogenic cough.
10. Why does my doctor want me to have a chest X-ray when I go to the doctor for a cough?
Because X-ray chest radiographs can determine the location, extent and morphology of lung lesions, and even their nature, leading to a preliminary diagnosis and guiding empirical treatment and related laboratory tests. Therefore, X-ray chest radiographs can be used as a routine examination for chronic cough, and if organic lesions are found, relevant examinations are selected according to the characteristics of the lesions.
11.Why do doctors sometimes want me to continue with a chest CT examination after having a chest X-ray?
This is because CT examination of the chest helps to detect anterior and posterior mediastinal lung lesions, small nodules in the lungs, enlarged lymph nodes in the mediastinum and smaller masses in the marginal lung fields, which are often difficult to detect or identify on a chest X-ray. High-resolution CT is helpful in diagnosing early interstitial lung disease and atypical bronchiectasis.
12. What is the relationship between cough and asthma?
Patients with asthma often present with wheezing, dyspnea and cough when they are poorly controlled. cVA is a specific type of asthma in which cough is the only or main clinical manifestation without obvious signs or symptoms such as wheezing and shortness of breath, but with airway hyperresponsiveness. Clinical manifestations: The main manifestation is an irritating dry cough, usually more intense, with nocturnal cough as its important feature. Cold p cold air, dust and oil fumes can easily trigger or aggravate the cough.
13.How should cough variant asthma (CVA) be diagnosed?
The diagnosis mainly relies on the following clinical manifestations: chronic cough, often accompanied by nocturnal irritant cough; cough is its only or main clinical manifestation; no symptoms such as wheezing or shortness of breath; high airway reactivity; positive bronchial excitation test or maximum expiratory flow (PEF) variability ≥ 20%; effective treatment with bronchodilators and glucocorticoids; and exclusion of other causes of chronic cough.
14. How should CVA be treated?
The principles of CVA treatment are the same as those of bronchial asthma treatment. Most patients can inhale small doses of glucocorticoids plus β2 agonists (bronchodilators) and rarely need oral glucocorticoid therapy. The duration of treatment is not less than 6-8 weeks.
15.Why do doctors often arrange for pulmonary function tests when I go to the doctor with chronic cough?
This is because the ventilation function and bronchodilation tests in the pulmonary function test can help diagnose and identify airway obstructive diseases, such as asthma, chronic bronchitis and large airway tumors. And if the routine lung function is normal, a positive excitation test can diagnose CVA.
16.What is the bronchodilator test?
Bronchial dilation test (BDT) is a kind of examination method in pulmonary function test. It is commonly used to determine the airway reversibility by inhaled bronchodilators such as salbutamol, terbutaline and ipratropium bromide, etc. Effective bronchodilators can improve the airway spasm during the attack and improve the lung function index.
Diagnostic criteria for a positive diastolic test.
①Exertional expiratory volume in one second (FEV1) increases by 12% or more compared with the pre-drug period, and its absolute value increases by 200 ml or more;
② PEF increased by 60L/min or increased by >20% compared with that before treatment.
17.What is the bronchial excitation test?
Bronchial excitation test is a kind of examination method in pulmonary function test. It uses stimulating drugs such as acetylcholine to make bronchial smooth muscle contract, and then use pulmonary function as an indicator to determine the degree of bronchial stenosis, so as to determine airway hyperresponsiveness (AHR). Its clinical application is mainly to assist in the diagnosis of asthma, as a reference indicator for asthma treatment, and to study the pathogenesis of asthma and other diseases. The diagnostic criteria for a positive excitation test is a decrease of 20% or more in the force expiratory volume in one second (FEV1) compared to the pre-drug level.
18.What is the variability of peak expiratory flow?
Peak expiratory flow (PEF) refers to the highest expiratory flow rate (L/min) during forceful expiration, also known as the highest expiratory flow rate, maximum expiratory flow rate, etc. Peak expiratory flow variability ( PEFR ) refers to the degree of variability of PEF at each time point within a certain period of time (such as 24h).
19. Why do doctors sometimes arrange for bronchoscopy?
This is because some causes of chronic cough cannot be determined by chest X-ray, CT or lung function alone, and performing bronchoscopy can effectively diagnose lesions in the tracheal lumen, such as bronchopulmonary cancer, tracheobronchial foreign bodies, and tracheobronchial tuberculosis.
20. What is upper airway cough syndrome (UACS) a disease?
UACS is a syndrome in which secretions flow backward behind the nose and throat, or even backward into the vocal cords or trachea due to nasal diseases, resulting in a cough as the main manifestation. Since it is not possible to clarify whether upper respiratory tract-related cough is caused by stimulation of postnasal drip or direct stimulation of upper respiratory tract cough receptors by inflammation. It is one of the common causes of chronic cough. In addition to nasal diseases, it is often associated with diseases of the pharynx, larynx, and tonsils, such as allergic or non-allergic pharyngitis, chronic tonsillitis, and laryngitis.
The diagnostic criteria for UACS are.
①Cough as the main clinical manifestation with or without postnasal drip influenza ;
② History of underlying nasal and pharyngeal diseases;
③Cough relief after treatment for nasal and pharyngeal diseases.
21.What are the main clinical manifestations of UACS?
Patients often have the following symptoms: in addition to cough and sputum, they may have cold manifestations: nasal congestion and increased nasal secretions. There may be, frequent throat clearing, posterior pharyngeal mucus attachment, and postnasal drip of influenza. Allergic allergic rhinitis manifestations: nasal itching, sneezing, watery snot, itchy eyes, etc. Rhino-sinusitis manifestation: mucopurulent or purulent snot, may have pain (facial, toothache, headache), smell disturbance, etc. Allergic pharyngitis is characterized by itchy throat and paroxysmal irritating cough. Non-allergic pharyngitis is often characterized by sore throat, foreign body or burning sensation in the pharynx. Inflammation of the larynx and neoplastic organisms are usually accompanied by hoarseness.
22. How should UACS be treated? Do I need to use antibiotics?
The treatment of UACS depends on its cause. In case of year-round rhinitis, first-generation antihistamines (e.g. paracetamol, etc.) + decongestants (e.g. pseudoephedrine, etc.) should be preferred; in case of allergic rhinitis, nasal inhaled glucocorticoids (e.g. beclomethasone propionate, etc.) and oral or inhaled new-generation antihistamines (e.g. loratadine, etc.) should be used as the first choice. Improving the environment and avoiding allergenic stimuli are effective measures to control allergic rhinitis, and the treatment of acute bacterial sinusitis relies mainly on antibiotics. If there is no accompanying bacterial infection, antibiotics are not needed.
23. What is a cough sensitivity test?
It is performed by nebulizing the subject to inhale a certain amount of irritant aerosol particles, which stimulate the corresponding cough receptors and induce coughing, and using the inhalation concentration as an indicator of cough sensitivity. Capsaicin inhalation is commonly used for cough provocation tests. Increased cough sensitivity is commonly seen in allergic cough (AC), eosinophilic bronchitis (EB), and gastroesophageal reflux cough (GERC).
24. What is eosinophilic bronchitis (EB) a disease?
It is a non-asthmatic bronchitis characterized by airway eosinophil infiltration and is an important cause of chronic cough. It often presents as a chronic irritant cough, which is often the only clinical symptom. Patients are mostly sensitive to fumes, dust, odors or cold air. There are usually no symptoms such as shortness of breath or dyspnea, and the physical examination is unremarkable. Pulmonary ventilation function and peak flow rate variability (PEF) are normal on pulmonary function tests, and there is no evidence of airway hyperresponsiveness (AHR).
25. How should eosinophilic bronchitis be diagnosed?
Its diagnosis relies mainly on induced sputum cytology. Its diagnostic criteria are as follows: chronic cough, mostly irritating dry cough, or with a small amount of mucous sputum; normal X-ray chest radiograph; normal pulmonary ventilation, negative AHR, normal PEF variability; sputum cytology with an eosinophil ratio of ≥ 3%; exclusion of other eosinophilic diseases; and effective oral or inhaled glucocorticoids.
26. What is allergic cough a disease?
In some patients with chronic cough with some atopic factors and effective treatment with antihistamines and glucocorticoids, but without a diagnosis of asthma, allergic rhinitis or eosinophilic bronchitis, we refer to this type of cough as allergic cough. Patients are often sensitive to fumes, dust, cold air, and speech, and are accompanied by a tickling throat.
Pulmonary function ventilation is normal and the percentage of eosinophils on induced sputum cytology is not high. One of the following indications is present: history of exposure to allergic substances, positive allergen skin test, increased serum total IgE or specific IgE, increased cough sensitivity, exclusion of other causes of chronic cough such as CVA, EB, PNDs, and effective antihistamine and/or glucocorticoid therapy.
27. Do blood pressure lowering drugs also cause cough?
Cough is a common side effect of taking angiotensin-converting enzyme inhibitors (ACEI) class of antihypertensive drugs (e.g., captopril, etc.). The incidence of cough is about 10% to 30% and accounts for 1% to 3% of the causes of chronic cough. The diagnosis can be confirmed by cough relief after discontinuation of ACEI. The cough usually disappears or is significantly reduced after 4 weeks of discontinuation. If the cough is indeed caused by this class of antihypertensive drugs, other classes of antihypertensive drugs can be used instead.
28. Can cough suppressants be used casually?
Coughing is a protective reflex that has the effect of promoting the discharge of phlegm and foreign bodies from the respiratory tract and keeping the respiratory tract clean and unobstructed. Before applying cough suppressants, the cause should be clarified and the treatment should be tailored to the cause.
For violent non-sputum coughs, such as chronic coughs caused by viral infections of the upper respiratory tract or coughs that are not relieved by allopathic treatment, cough suppressants should be used in order to relieve pain, prevent the development of the primary disease, and avoid complications caused by violent coughs. If the cough is accompanied by difficulty in coughing up sputum, expectorants should be used and cough suppressants should be used with caution, otherwise the accumulated sputum cannot be discharged, which can easily lead to secondary infection and obstruct the respiratory tract and may even cause asphyxia.
29.Why is it not recommended to use cough and cold medicine for children under 4 years old?
In the United States, cough and cold medicines are not recommended for children under 4 years of age for simple symptom control, and in Canada and Australia, the recommended age for such medicines is 6 years or older. The term “cough and cold medicine” refers to a range of commercially available cold medicines that contain multiple active ingredients, such as aminophenanthramine, aminoglutethimide, phentermine, etc. There are three main reasons why these cough and cold medicines are not recommended for use in young children abroad.
One, cough and cold medicine in young children have done very little research, usually based on the adult dose projected dose of young children, can not guarantee the safety of medication; two, cough and cold medicine is mostly compounded, the different drugs produced by different pharmaceutical companies on the market usually contain the same active ingredients (such as anti-allergic paracetamol, decongestant pseudoephedrine, cough dextromethorphan, antiviral amantadine, etc.), if taken at the same time containing the same ingredients If you take drugs containing the same ingredients at the same time, it is easy to overdose of drugs causing poisoning; three, young children’s colds are mostly caused by viruses, which are self-limiting diseases and can heal on their own. The course of the disease is usually 5-7 days, and cough and cold medicine will not shorten the course of the disease.
For children under 4 years old with cough and cold, it is generally recommended to drink more water, take more rest and eat lightly. There should be no rush to use medicines that simply relieve symptoms. Gentle physical therapy is recommended first, such as inhaling hot water vapor to moisten the airway (but be careful to avoid burns) and elevating the head of the bed at an angle of 30 degrees when sleeping to avoid irritation of the throat by nasal secretions.
Not recommending compounded cold medicine that simply controls symptoms does not mean that you don’t take medicine when you are sick. If your child has a heavy cough and other symptoms, or if they are not relieved by using physical therapy, you should promptly seek medical attention to clarify the cause of the onset. Cough is not a disease in itself; it is a symptom that manifests itself in different diseases. Therefore, cough control cannot rely on cough and cold medicines that relieve symptoms, but requires treatment of the disease itself that is causing the cough.
If the cough is caused by a bacterial infection, antibiotics need to be used under the guidance of a doctor; if the cough is caused by allergies, anti-allergy drugs need to be used; if the cough is caused by a viral cold, there are no effective anti-viral drugs available, but happily, our body itself can clear the cold virus and we have to wait patiently for our body to develop immunity against it.
If you have to choose a medicine to relieve symptoms, you can choose a single-component medicine for the following cases: if your child has a cough with a lot of phlegm, you can use an oral or nebulized inhalation phlegm medicine under the guidance of a doctor’s pharmacist; if the cough is accompanied by shortness of breath, you can use a nebulized bronchodilator under the guidance of a doctor’s pharmacist.
30.What is psychogenic cough?
Psychogenic cough is caused by the patient’s serious psychological problems or intentional throat clearing, also known as habitual cough or psychogenic cough. Psychogenic cough is relatively common in pediatric patients and accounts for 3% to 10% of the causes of cough in children. It typically presents as a daytime cough that disappears when the patient is preoccupied with something and at rest at night, often accompanied by symptoms of anxiety. However, the diagnosis of psychogenic cough is an exclusionary diagnosis and can only be considered after other possible diagnoses have been excluded.