1. We breathe irritating substances such as dust, smoke, aerosols or cold air.
2. When they reach the throat, they irritate it and send a nervous stimulus to the brain.
3. The brain responds by sending an order for the muscles of the chest and abdomen to contract abruptly, causing air to come out of the mouth quickly and forcefully, this is coughing.
¿Para qué sirve la tos?
1. mobilize mucus It occurs naturally in our respiratory system.
2. expel harmful substances that enter our body when breathing, such as microorganisms that cause infections, and foreign bodies that get trapped in our respiratory tract, such as pieces of food or objects...
Types of cough
Rates according to their duration (in weeks)
acute cough
When does it appear?
1. Respiratory infections.
2. When we inhale irritating substances such as smoke, pollen or strong vapors.
3. If we have asthma and it is not well controlled.
Causes of each type
subacute cough
It usually appears after:
1. A respiratory infection.
2. An exacerbation of diseases such as asthma and COPD.
Chronic cough
It can originate from:
1. Respiratory infections.
2. Diseases that affect the respiratory system such as bronchitis, asthma, cystic fibrosis...
3. Tumors.
4. Cardiological problems.
5. Gastroesophageal reflux.
6. Taking certain drugs.
7. Smoking.
8. Inhalation of contaminated air.
Prevalence
Other prevalence data
Reports of chronic cough in populations vary between 1% in India, 9% in Eastern Europe, and 5-12% in China with increases in areas with higher air pollution.
Diagnosis of persistent cough
What can tell us that we are facing a case of persistent cough?
We will be facing a case of persistent cough if you have a cough that lasts more than 8 weeks and is accompanied by any of these symptoms:
You cough up blood or bloody phlegm (hemoptysis).
You are hoarse
You have a lot of phlegm or secretions.
You suffer from symptoms of general malaise.
Burning sensation (gastroesophageal reflux).
changes in radiographs.
What specialist do I go to?
How is persistent cough diagnosed?
See your primary care doctor, if he cannot find the cause or a solution to your cough, then he can refer you to a specialist for a more intensive study.
Until now, the clinical diagnosis of persistent cough was based on finding a cause-effect relationship, that is, doctors looked for the cause that produced this cough and treated it. This occurs in cases where the persistent cough is due to asthma, gastroesophageal reflux (GERD) or postnasal drip.
In other cases, this cough does not have this cause and effect relationship, but there are diseases such as chronic obstructive pulmonary disease, cases of cancer that affect the respiratory system or heart failure, which may have cough as symptoms, but are not their cause of appearance.
New research is beginning to point to an origin in which multiple factors are involved, so it is necessary to open your mind when making a diagnosis of this health problem. It seems that the cause of this problem is outside of this classic triad (asthma, reflux and drip), so it must be sought in new locations such as chronic involvement of the vagus nerve.
Due to how complicated it is to diagnose this problem on many occasions, the intervention of different specialists is necessary to achieve it. Among them we can highlight pulmonologists, allergists, digestive and otolaryngologists, although the participation of some other specialist is not ruled out.
Highlighted
Links:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225816/
https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/chronic-cough/
https://www.europeanlung.org/assets/files/es/publications/chronic-cough-spanish.pdf
Bibliography:
Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J 2019
Richard S. Irwin, MD, Master FCCP; Cynthia L. French, PhD, RN, ANP-BC, FCCP; Anne B Chang, MBBS, PhD, MPH;
Kenneth W. Altman, MD, PhD; on behalf of the CHEST Expert Cough Panel* Classification of Cough as a Symptom in Adults and Management Algorithms. CHEST Guideline and Expert Panel Report. Evidence-Based Medicine. CHEST JANUARY 2018
Adalberto Pachecoa, Alfredo de Diego, Christian Domingo, Adelaida Lamas, Raimundo Gutierrez, Karlos Naberan, Vicente Garrigues and Raquel López Vime. SEPAR regulations. Chronic cough. 2014 SEPAR. Published by Elsevier Spain, SLU
Adalberto Pacheco, Christian Domingo. Airway reflux: an emerging topic in respiratory medicine. Lancet Respir Med 2018
Christian Domingo Ribasa, Ana Sogo Sagardía. Chronic cough: old problems, new perspectives. Rev Asthma. 2016;1(3):98-105
Adalberto Pacheco, Ignacio Cobeta and Carolin Wagner. Refractory chronic cough. New perspectives in diagnosis and treatment. Arch Bronconeumol. 2013;49(4):151–157
Moneo Hernández I, Asensi Monzó M, Rodriguez Fernández-Oliva CR. Guide to Algorithms in Primary Care Pediatrics. Chronic cough in PA. AEPap. 2017 (online) consulted on 30/12/2019
