Cough is a strong reflex that protects the respiratory tract. It can occur as a result of stimulation of mechanical or chemical receptors. It can be classified as acute, subacute, or chronic based on its duration. Acute coughs typically occur with conditions like cold, flu, or pneumonia and are usually short-lived. Subacute coughs can persist after an infection, while chronic coughs lasting more than 8 weeks can indicate serious illnesses such as asthma, reflux, and upper respiratory infections. Chronic coughs that require treatment necessitate identifying the underlying cause.
Cough is an airway protective reflex. It is a reflex that can be chemically or mechanically stimulated by something entering our throat or windpipe. It is characterized by an explosive release of air. It is a strong reflex and can lead to chest pressure increase and complications like eye bleeding, urinary incontinence, rib fractures, and lung ruptures in uncontrolled or prolonged coughs. Prolonged coughs, in addition to causing clinical discomfort, are also socially disruptive and can be difficult to conceal, disrupting the comfort of those around us.
The entire brain and peripheral nervous system play a role in the mechanism of cough formation. We can voluntarily create coughs, or cough reflex can occur as a result of the stimulation of mechanical or chemical receptors. These coughs are uncontrollable and can be regulated by the brain. This especially gains importance in psychologically induced coughs.
Although there are various criteria for classifying cough, the most valid classification is based on duration. According to duration, cough can be:
* Acute if it lasts less than 3 weeks,
* Subacute if it lasts between 3-8 weeks, and
* Classified as chronic if it lasts more than 8 weeks.
Acute coughs arise with conditions like cold, flu, pneumonia, congestive heart failure, and pulmonary embolism and disappear with treatment of the underlying cause.
Subacute cough can persist after an infection and can also occur with allergen or irritant exposure in asthma or sinusitis. Although its treatment is relatively challenging, it can be alleviated with causal treatments.
Chronic coughs, lasting more than 8 weeks, necessitate investigation. Its cause can range from a simple reflex or the use of an ACE inhibitor to serious diseases like tuberculosis and lung cancer.
The most common causes of chronic cough include asthma, upper airway cough syndrome (associated with post-nasal drip), and gastroesophageal reflux, which rank in the top 3. Chronic occupational or continuous indoor allergen exposure, psychogenic cough, chronic bronchitis, COPD, interstitial lung diseases as well as chronic lung diseases related to upper airway cough syndrome, and idiopathic neuroinflammatory cough are among the other reasons for chronic cough. When diagnosing chronic cough, additional complaints that may accompany cough should be queried. The presence of phlegm, shortness of breath, chest pain, bloody sputum, and history of medication use are important. Additional diseases should be questioned. Treatment should be approached algorithmically, and after eliminating all causes, psychogenic cough should be considered.
