Everything About A Cough

Talk about everything about a cough the possible causes and treatment, cough is less of a disease in its own right than a symptom of respiratory disease. It occurs, for example, when we have choked. However, coughing can also indicate serious medical conditions such as heart failure or reflux disease.

Definition

Who does not know the nights disturbed by a cold-related cough or the pain of a dry cough or dry cough? The bronchi are burning and you are short of breath. After a coughing fit, we sometimes feel like we have sprinted 100 meters. If the cough then loosens a little and produces sputum, this is often perceived as a relief.

Cough is not an independent disease in the medical sense, but a symptom. As a rule, a cough is triggered by illness. The most common are respiratory infections such as bronchitis, colds, or the flu. Allergies, asthma, or smoker’s cough are other common causes of coughs. Heart failure or drug side effects such as the ACE inhibitor cough are also causes of cough.

Symptoms

Doctors classify the symptom of cough into categories. First of all, a distinction is made according to the duration:

    • According to the medical definition, acute cough lasts up to 8 weeks.
    • Subacute cough is a classification that is sometimes used for coughs lasting between 3 and 8 weeks.
    • Chronic cough is the name given to a cough that lasts longer than 8 weeks.

In addition to this distinction based on duration, there is a division into productive and unproductive or dry cough:

    • Productive coughing is accompanied by increased secretion and expectoration.
    • Unproductive (dry cough) is also known as a dry cough. Mucus does not form with this form of cough. Therefore, unproductive cough is dry, so it remains without expectoration.

Everything About A Cough

Symptoms Of Productive Cough

A productive cough is characterized by the fact that the cough removes sputum from the airways or lungs. Often a productive cough begins with a dry cough. After usually 1 to 3 days, often accompanied by a sore throat, there is an increased production of mucus. This bronchial mucus is transported out of the airways or the lungs as sputum via the cough reflex.

Symptoms Of Unproductive Cough

An unproductive cough feels hard and painful, often burning. It does not produce sputum. Coughing fits that can last for minutes are also typical of dry coughs. Coughing attacks are said to occur more frequently at night and thus deprive the sick of sleep. Oftentimes, a dry cough is accompanied by allergy symptoms. Heartburn can also occur along with a dry cough.

More Symptoms Of Cough

The frequency and sound of coughing attacks are further characteristics that can sometimes even be used to determine the cause. Barking cough in small children, for example, suggests pseudo croup. An attack-like cough with a high repetition frequency like a staccato is typical of whooping cough (pertussis). A morning cough, often with copious expectoration, is particularly common among smokers.

Causes

The Cough Reflex

The cause of cough is the cough reflex. This is an innate protective mechanism of the body. The cough reflex has the task of protecting the respiratory tract from damaging influences and of removing secretions such as mucus and foreign bodies such as dust or swallowed items.

The cough reflex is triggered by receptors in the mucous membranes of the larynx, the trachea, and the larger bronchi. They react to mechanical stimuli such as those caused by secretions (mucus), foreign bodies (smoke, dust, swallowed things) or other stimuli (inflammation, gases). These stimuli reach a certain brain region, the medulla oblongata, via the vagus nerve (nervus vagus or 10th cranial nerve).

The medulla oblongata houses the respiratory center and is located in the brain stem. These nerve fibers are activated, which cause a sudden contraction of the diaphragm and the muscles of the abdominal wall and intercostal. In addition, the glottis is narrowed and extreme pressure builds up under the closed larynx.

When the lid of the larynx opens, exhalation occurs suddenly. With this impulse, foreign bodies or secretions are thrown out of the windpipe like an explosion. When coughing, enormous forces act on the larynx muscles. With strong coughing attacks, the air flows through the larynx at speeds up to the sound limit.

Causes Of Productive Cough

A productive cough is most often a symptom of a respiratory infection. These are, for example, the flu or cold, which in turn are accompanied by fever, runny nose, and a more or less pronounced feeling of illness. If the underlying disease is not healed properly or if there are constant new infections, the cough can become chronic; doctors speak of chronic bronchitis.

Causes Dry Cough

Dry cough is usually a reaction to a variety of harmful stimuli. These include smoke, dust, gases or chemical vapors. A very common typical example is the smoker’s cough.

Other causes of dry cough are severe respiratory diseases such as whooping cough, tuberculosis or lung cancer (bronchial carcinoma) as well as pulmonary embolism or emphysema. Allergic asthma or other allergies can also trigger a dry cough.

Other Causes Of Cough

Medicines can also trigger a cough. For example, this is a common side effect of some drugs for high blood pressure, such as ACE inhibitors.

Irritation from stomach acid when stomach contents flow back into the esophagus (reflux disease) also leads to coughing. This is often accompanied by heartburn and acid regurgitation.

Examination

Diagnosing cough is easy based on the symptoms. To find out the exact cause, your doctor will first ask you in detail. This is followed by a physical examination, during which mainly the breathing sounds are listened to.

In the case of a productive cough, the color and texture of the sputum indicate the possible cause:

    • Clear whitish sputum: mostly caused by viral upper respiratory infections such as colds or flu
    • Yellowish or green sputum: indication of a possible additional bacterial infection in viral respiratory diseases
    • The bloody build-up is an indication of serious lung diseases such as pneumonia, pulmonary embolism, or lung cancer. In addition, the sputum is sometimes bloody if the blood vessels in the airways or the lungs have been damaged by swallowed objects or other injuries. Bloody sputum is usually a medical emergency and should be investigated immediately.
    • Brown or black sputum: especially common in smokers, often signs of advanced lung damage from chronic bronchitis or COPD.

At times, complex diagnostics may be necessary to find the cause of the cough. These more extensive examinations are usually carried out by specialists. As a rule, your family doctor will refer you to a pulmonologist (pulmonologist) for this purpose. For heart-related coughs, cardiologists are the specialists of choice. In the case of gastrointestinal diseases as the cause, the path leads to the gastroenterologist and in the case of allergies to the allergologist.

Treatment

Treatment for cough is based on the cause. If a cough is not triggered by a serious underlying disease, home remedies are usually well suited to relieve the excruciating urge to cough. If the cough does not improve within a few days, the first thing you should do is see a family doctor so that the cause of the cough can be found. Only then can meaningful treatment be initiated.

There are a number of medications your doctor can use to treat coughs. If necessary, he will treat infection or inflammation as the cause of the cough, for example with antibiotics. If ACE inhibitors are responsible for the cough, he will change the medication. In the event of a cough accompanied by heartburn and acid regurgitation, the doctor will order a gastroscopy and then treat the gastric acid reflux.

Do not take coughing lightly. This is especially true if the cough:

    • lasts longer than 2 weeks (for infants, toddlers, or children: longer than 3 days)
    • is accompanied by fever or severe malaise
    • occurs new and without a traceable harmless cause
    • with bloody, brown, or black obstruction
    • is accompanied by a high fever and/or extreme fatigue.

More information about treatment and self-help, as well as home remedies for coughs:

    • bronchitis
    • COPD
    • cough

Prevention

Coughing as a result of respiratory infections can hardly be prevented in a targeted manner. Basically, it is advisable to strengthen the immune system. A varied diet rich in vitamins and exercise in the fresh air strengthens the immune system and therefore helps prevent coughs. Smokers should give up smoking, especially if they have a smoker’s cough.

Fluid in the Lungs – Causes and Treatment

Fluid in the lungs is a broad term to describe two possible states that can give characteristic symptoms, such as a bubbling noise in the lungs (rattling) when breathing. Fluid accumulation may be in the lungs (pulmonary edema) or outside the lungs (pleural effusion), in the space between the lungs and the chest wall. The term fluid in the lungs is also used in the lungs to refer to mucus. Mucus or phlegm is really a thick, sticky secretion even though lung water is a thin fluid. Other fluid accumulation can be the result of blood or pus.

The lungs enter the thorax (chest) and lie on either side of the heart. Air travels through the air passages that surround the nose, throat (neck), trachea (trachea) and bronchi. The lung tissue is made up of small air sacs, known as alveoli, which is thin and surrounded by blood capillaries. The structure of the respiratory system allows an exchange of gases, so that essential oxygen is taken into the body and waste products, along with gases, are excreted by the exhaled air. The lung is enclosed in an airtight pleural cavity, with a small pleural space separating the lungs from the chest wall. This cavity is lined by the pleural lining, which also creates a small pleural fluid to reduce the friction between the chest wall and lungs while breathing.

Fluid in the lungs

The most common cause of fluid in the lungs is mucus or mucous produced by the lining of the airways. The airway is lined with a mucous membrane that produces a specialized tissue that produces smucus. This mucus lubricates the lining, which can dry out due to the movement of air and out of the channels as well as stopping dust or microorganisms in the air. However, under certain conditions, the mucous membranes of the respiratory tract can generate excessive amounts of mucus and this can slowly sink down the air ducts until it settles in the lungs. The cough reflex or even spontaneous coughing will usually expel most mucus through the mouth (sputum), but in cases of excessive mucus production, obstructive airway disease or diminished cough, the build up of mucus will quickly settle in the lungs.

Lung water or water in the lungs usually results from the interstitial fluid or blood plasma and may be an indication of a serious underlying condition, usually cardiovascular disease. This fluid in the lungs is known as pulmonary edema and may be accompanied by shortness of breath or shortness of breath (dyspnoea), a feeling of suffocation, anxiety and restlessness. Abnormal breathing sounds are also present, especially crackling. Pulmonary edema could be considered a medical emergency and really immediate medical intervention is necessary.

Blood can also fill in the lungs, but this usually happens as a result of severe trauma and the cause is evident, as in a shot or puncture wound. In most trauma cases, where blood can fill the lungs, the lungs collapse and the blood in the lungs collects in the chest cavity (hematothorax). Infections such as tuberculosis (TB) or lung cancer can also lead to blood accumulation in the lungs. Depending on the severity of the trauma, blood in the lungs will cause drowning and requires immediate medical attention. Pus can also occur in the lungs due to a lung abscess and also requires immediate urgent medical attention.

Causes of the fluid inside the lung
    • Bronchitis is the most common cause of mucus in the lungs and is often characterized by persistent cough. This respiratory disease can develop after the common cold or flu (seasonal influenza). often as a result of a secondary bacterial infection, but may also be more chronic and non-infectious as in the case of smokers.
    • Infections may cause hypersecretion of mucus in the respiratory tract and / or pulmonary edema and this includes viral (eg H1N1 swine flu, SARS severe acute respiratory distress syndrome), bacteria (eg tuberculosis, streptococci or pneumococcal pneumonia), fungi (eg histoplasmosis, aspergillosis, candidiasis) and parasitic (example toxoplasmosis) infectious agents.
    • Pneumonia can also cause lung water or fluid with a thinner viscosity. This can only occur on the affected lung lobe due to inflammation of the lung tissue. Pneumonia is not only caused by infection, but may be due to gastric contents being aspirated from the stomach into the lungs.
    • Allergy symptoms typically lead to increased mucus production, however, in specific acute cases there might be pulmonary edema. Retronasal can often cause phlegm collection in the lungs and allergies can cause inflammation of the bronchi and mucus in the chest of the asthmatic.
    • Near drowning results in fluid in the lungs and even if all the fluid is drained from the lungs, it is important to monitor the patient in the hospital to prevent dry drowning.
    • Many cardiovascular conditions may cause pulmonary edema, including hypertension (high blood pressure), myocardial infarction (heart attack), valvular heart disease or cardiomyopathy (damaged heart muscle).
    • Hypoalbuminemia can be caused by kidney failure, liver disease, malnutrition or protein enteropathy.
    • Kidney failure pulmonary edema, as the kidneys may not be able to filter out toxins in the blood.
    • Smoke inhalation can cause severe inflammation of the lung tissue, which leads to fluid accumulation in the lungs.
    • Lymphatic insufficiency lead to inadequate drainage of lymphatic fluid.
    • Side effects of drugs in a pulmonary edema may result and this includes OTC (over-the-counter) or prescription drugs. Narcotics or anesthetics. This may also occur after the application of the drug, when the effect of the drug appear to have worn out.
    • Inhalation, Ingestion or Injection Toxins or toxins may increase the permeability of the vessel walls, resulting in pulmonary edema. Some toxins can also increase mucus production in the lining of the lungs.
    • Autoimmune diseases such as sarcoidosis can cause fluid in the lungs due to the inflammation of the lung tissue.
    • The lack of oxygen due to high altitude can cause pulmonary edema, COPD (chronic obstructive pulmonary disease) and suffocation.

fluid-in-the-lungs

Fluid outside the lungs

Pleural effusion is when the fluid around the lungs accumulates in the pleural space. Blood (hematothorax), fatty lymph fluid (chylothorax) or pus (empyema) can also fill the pleural space, although this occurs less frequently. Any fluid accumulation in the lungs should be taken seriously and require immediate medical attention. The fluid accumulation in the lungs compressing the lungs and this prevents normal breathing, which results in inadequate gas exchange. The types and causes of pleural effusions are discussed extensively with fluid in the lungs.

Some causes of fluid around the lung

    • Congestive heart failure is probably the most typical brings about of pleural effusion. This fluid is thicker (transudative) due to protein that is forced out of the blood vessels and into the pleural space.
    • Exudative effusion is an aqueous fluid accumulation due to inflammation caused by lung cancer such as pleural mesothelioma infections such as TB or pneumonia. Lung diseases such as asbestosis or drug reactions.
    • Hematothorax may be unusual in that a result of trauma or rupture of the large blood vessels in the case of an aortic aneurysm although the latter is caused by a pleural effusion.
    • Empyema is often due to the accumulation of pus in the pleural space to a lung abscess.
    • Chylothorax is the accumulation of lymph fluid, which has a high concentration of fat, and occurs in certain cancers, such as lymphoma.
    • Some of the causes of lung fluid accumulation can also cause pleural effusion, including kidney failure and liver disease.
The diagnosis of fluid in the lungs

During physical examination, your doctor will be able to identify unusual sounds, such as bubbling or crackling (rattling) with a stethoscope on your breathing. A whistling sound (Stridor) as well as clearly audible when you exhale. Percussion is a knocking motion done against the chest wall and will help your doctor identify with areas of the lungs that might be affected. Typically fluid accumulation causes a muffled sound compared to the normal hollow sound of the air filled lungs. Based on clinical findings and other signs and symptoms, your doctor may request further diagnostic tests that may include the following steps.

    • X-ray of the thorax is one of the most important diagnostic examinations performed to identify the severity and region that is affected. For further imaging, a thorax CT scan or chest ultrasound can be performed.
    • Due to the frequency of cardiovascular in the lungs fluid-related disorders, your doctor may perform an ECG (electrocardiogram), ultrasound of the heart (echocardiography) and other cardiac examinations.
    • Fluid may be aspirated from the pleural cavity, known as thoracocentesis, but this has been done carefully to prevent pneumothorax (accumulation of air into the pleural cavity). A pleural fluid analysis is then performed to identify the type of exudate or any microorganisms.
    • Sputum culture may be necessary to identify the cause of the infection.
    • Number of blood tests can be requested from your doctor to check kidney and liver function, proper gas exchange and heart disease.
The treatment of fluid in the lungs

Treatment depends on the cause of the fluid in the lungs. Some of the treatment options may include:

    • Antibiotics, antiviral or antifungals may be required in the event of infection.
    • Diuretics assist with additional fluid passing, but should be used cautiously in the case of heart disease.
    • Antihistamines may require allergic reactions, and these must be continued on a chronic basis to prevent exacerbations.
    • Corticosteroids can be useful for controlling inflammation and mucus production, as in asthma, and this can be used over the long term to prevent acute attacks.
    • Chest tube with a tube may be necessary for a empyema or a therapeutic pleural function, required for a pleural effusion.
    • Antihypertensives can be given in cases of hypertension.
    • Oxygen is administered in serious cases of fluid within the lungs, in which appropriate gas exchange is impaired. While this does not immediately treat the cause of the fluid in the lungs, except in a lack of oxygen, it helps with adequate gas exchange.
    • Physiotherapy could possibly be important to help with mucus drainage.