Cough is a normal physiological mechanism that develops to clear the respiratory tract from a foreign stimulus.
Continuous cough is a sign of an underlying disease and needs to be investigated to determine the real cause. Treatment is possible after a definitive diagnosis is made.
STORY PHYSICAL EXAMINATION
Cough is one of the conditions in which the patient most frequently seeks medical help. Most cough-related diseases develop due to self-limiting viral upper respiratory tract infections.
When the cough is recurrent and continuous, an ear, nose and throat specialist may be consulted. The initial history should focus on the duration and character of the cough. Persistent and productive cough is associated with tracheobronchial diseases. Dry cough is more often caused by an upper airway lesion or asthma. Postnasal drip and reflux cause cough. Active or passive smoking is a common cause of chronic cough. In this case, it is necessary to investigate symptoms related to allergy, recurrent upper respiratory tract infections or sinusitis.
LABORATORY TESTS
For chronic coughs, complete blood and eosinophil count, lung Sputum should be examined for film, bacteria, tuberculosis and fungi.
Possible underlying sinusitis is evaluated with CT of the paranasal sinuses.
Pulmonary function tests are requested in those with a history of chronic obstructive or restrictive pulmonary disease. The ear, nose and throat physician tries to make a diagnosis by examining the relevant areas with endoscopic examination.
DIFFERENTIAL DIAGNOSIS
Patients with cough complaints of less than 4 weeks are easily diagnosed and treated.
Cigarette smoke, environmental fumes. and allergens are the most common stimulants. The hoarse, dry cough associated with smoking (smoker's cough) occurs as a result of chemical irritation of the lower and upper airways. It is thought that allergens affect the airways directly and indirectly by creating nasal and pharyngeal secretions and causing post-nasal drip.
The most common causes of cough seen from birth to 18 months of age may be reflux and the cough variant of asthma. It is most common between the ages of 1.5 and 6. The most common diagnosis is sinusitis followed by the cough variant of asthma. Cough seen between the ages of 6 and 16 is caused by the cough variant of asthma, psychogenic cough and sinusitis.
Cough is often the presenting symptom in chronic sinusitis. Facial pain and headache may occur in adults. Children usually have painless runny nose. A dry cough, often without phlegm, is most common at night. Treatment requires repair of the underlying infection.
Reflux, pulmonary aspiration, pulmonary edema, lung infection and edema involving the trachea or bronchus may initiate cough.
TREATMENT
General treatment. Methods include quitting smoking, avoiding environmental toxins, and controlling known allergic factors. Other specific types of treatment for cough include antibiotics for documented infection, bronchodilators for asthma, and antireflux therapy for reflux.
Expectorants and mucolytic agents exert their effects by increasing the volumes of respiratory secretions and decreasing mucus viscosity. Cough lozenges and syrups are common examples.
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