Cough

Cause

The physiological action of coughing is responsible in part to the vagus nerve, which runs through the lungs to the brain. The vagus nerve is activated when capsaicin is released, which stimulates the sensory nerve endings. Centrally acting cough suppressants, such as codeine and dextromethorphan, reduce the urge to cough by inhibiting the capsaicin-induced sensory nerve by depolarization of the vagus nerve. One of the common presentations to the medical practitioner is dry cough. The common causes of chronic dry cough include post-nasal drip; Gastroesophageal reflux disease; Cough variant asthma; Drugs like beta blockers, ACE inhibitors, Aspirin , which should be investigated in people above 40 years; Post viral bronchial hyperresponsiveness; and Habitual Cough. When cough lasts for more than a few weeks multiple causes are likely and only when all the causes are treated will the patient be symptom free.

Beyond the physiological reasons for coughing there are also psychological reasons for coughing otherwise known as psychogenic coughing or habit coughing. (Such as a person who coughs or clears their throat before a public speech as a means to gain the attention of the audience or perhaps relieve their own nervousness) Steruphilia is a condition of loving the sound of coughing or sneezing. If one has ever sat next to someone who seems to enjoy coughing or sneezing loudly they might have hay-fever, or they might possibly be a steruphiliac.

Coughs can also be used to send information. See the Charles Ingram story.

Complications

The complications of coughing can be classified as either acute or chronic. Acute complications include cough syncope, fainting spells when coughs are prolonged and forceful due to decreased blood flow to the brain, secondary to raised intrathoracic pressure due to cough. Other acute complications include inability to sleep, cough induced vomiting, chest pain due to muscular strain of incessant coughing, rupture of bulla causing pneumothorax.In severe cases, prolonged coughing can cause fatigue fractures of lower ribs and costochondritis, an inflammation of the connective tissue between the breastbone and the ribs. Chronic complications are common. In certain cases, it can even lead to abdominal or pelvic hernias. In women with prolapse uterus, cough micturition (urination) can result, which can be a major social nuisance. Cough defecation can also occur.

Treatment

Coughs can be treated with cough medicines. Dry coughs are treated with cough suppressants (antitussives) that suppress the body's urge to cough, while productive coughs (coughs that produce phlegm) are treated with expectorants that loosen mucus from the respiratory tract. A recent study indicates that, because of the presence of theobromine in chocolate, 50 grams of dark chocolate may be an effective treatment for a persistent cough.