Cough and its Treatment

Cough will only go away if treatment is applied to the cause. If you have a ticklish cough due to asthma, it is useless to use antibiotics and cough syrups, as we often encounter. What needs to be done is to organize the treatment according to the level of asthma and monitor it, in line with the recommendations of a pulmonologist. In the presence of cough due to reflux, the patient should be referred to gastroenterology and treated after necessary examinations and follow-up should be performed by a specialist physician. Again the patient It is important to be informed about nutrition. It may also be the blood pressure medication used by the patient that causes the cough, in which case the cough will stop by changing the medication. However, sometimes the cough may persist for up to 3 months after discontinuation of treatment, and the patient should be informed about this. In the case of interstitial fibrosis, where there is loss of stretching in the lungs, the necessary treatment should be applied under the supervision of a pulmonologist. Again, if the cough due to postnasal drip is allergic, it would be appropriate to treat the cause in terms of allergy, and to plan surgical treatment with ENT intervention 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 annoying cough continues even though the examination findings, chest X-ray, respiratory function tests, ENT examination, and evaluation for reflux do not reveal any pathology, and if the patient's history suggests psychic cough, it is useful to request psychiatric consultation in these cases.

If there is phlegm along with the cough and the sputum is yellow-green in color If it has a thick consistency and is accompanied by fever, we should definitely go to the doctor. Because pneumonia should not be overlooked, the patient's lower respiratory tract should also be examined by the physician. If bloody sputum is produced along with cough, we should consult a pulmonologist immediately. This may be a simple nosebleed or bleeding due to postnasal drip after sinusitis, or it may be due to a much more serious cause. There may be a tumor mass in the lung or tuberculosis, that is, tuberculosis or bronchiectasis or pulmonary embolism, which is a clot in the lung vessel, and all of these situations require very serious treatment. Apart from this, any long-lasting cough should be investigated. In case of cough lasting more than 2 weeks, a doctor should be consulted. Bronchial hyperreactivity - airway edema - that develops after viral URTI may cause a long-lasting dry cough, or the only symptom of mild asthma may be a long-lasting cough. Again, interstitial fibrosis causes loss of elasticity in the lungs. In this case, there is a long-term cough and in the early stages it is only seen during exertion. In other words, if there is cough with exertion, a physician should be consulted. In summary, cough can be a symptom of many serious illnesses, and long-term cough should be investigated.

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

*Cold - although it is the most common cause of cough, it usually gets better in a short time.

*Asthma - Long-term cough The most common cause of the complaint is asthma. Sometimes the early symptom of asthma is a wheezing cough and the patient has no other complaints. Especially if there is a dry cough complaint lasting more than 3 weeks, the patient should apply to the chest diseases department and be evaluated for asthma, examined and respiratory function test performed. Cough being triggered by strong odors, cold weather and exertion are symptoms that support asthma. Again, cough that increases at night should bring asthma disease to mind.

*Nasal drip 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 dry cough. can open. It is a condition mostly seen in allergy patients.

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

*It has been determined that 50-90% of asthma patients have reflux. In other words, reflux is more common than normal in people with asthma. This is because asthma relaxes the muscles surrounding the head of the stomach. In this case, the acidic contents of the stomach escape into the esophagus. It gets easier. In addition, nowadays 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 and reflux should not be overlooked.

*Smoking

*Tuberculosis, that is, tuberculosis, in our country in 2010 16,500 registered tuberculosis patients were identified. Symptoms of tuberculosis are fever, which increases especially towards the evening, night sweats, weight loss, loss of appetite and weakness. Cough lasting more than two weeks, expectoration, 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 reasons and visit the doctor late. For this reason, it is important to evaluate coughing patients, especially those with a history of tuberculosis in their relatives. In-home contacts of these patients are screened in VSDs, but there is no problem in the screening and it is important to be more vigilant for patients who have complaints afterwards.

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

*ACE inhibitor blood pressure medications

*Pleura-lung membrane-diseases

*Mediastinal diseases

*External auditory canal diseases

*Psychogenic

If the cough is caused by an infection, it may also occur in surrounding individuals as the infection spreads. This is due to the transmission of the infection, not the transmission of the cough. Especially children, the elderly, individuals with allergies, those with chronic lung, heart and kidney disease, diabetics, immunosuppressed individuals receiving chemotherapy and radiotherapy are more susceptible to epidemics during the winter months, as they are more sensitive to all kinds of infections, especially respiratory tract viral and bacterial infections. Therefore, cough complaints may also occur. Again, since tuberculosis is contagious, people infected with this disease also have a cough.

DRY COUGH AND ITS TREATMENT**

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 the required dose of bronchodilators and anti-inflammatory drugs should be given. In addition, the patient should be informed about the disease and the details of the treatment, and he should be ensured to use his medications for the required time and dose. Again, if the dry cough due to postnasal drip is allergic, the cause should be treated in terms of allergy. If the results of allergy tests and the patient's age, respiratory tests and other clinical findings are suitable for vaccine treatment, which we call immunotherapy, the patient should be given immunotherapy, that is, vaccine treatment. In the presence of chronic sinusitis, long-term antibiotic treatment under the supervision of an ear, nose and throat specialist; In the presence of a condition requiring surgical operation such as intranasal polyp or 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, and if necessary, endoscopy should be performed and treatment should be arranged. It is also important to inform the patient about nutrition. Sometimes, it is the blood pressure medication used by the patient that causes the dry cough. In this case, changing the medication will be sufficient 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 can be found to explain the dry cough after all other causes have been excluded and the patient's history suggests psychic cough, it is appropriate to request psychiatric consultation in these cases. 

Cough is a mechanical defense barrier that prevents the intake of foreign and harmful objects into the respiratory system and protects the lungs by removing excess secretions from the airways. A cough defined as dry cough is usually a cough in which the sputum does not come out or very little sticky sputum is forced out.

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