Health Home >> >> Written by: MARILYN LINTON, Special to QMI Agency Feb. 28, 2011
As winter drags on, so does that scratching in your throat – so at what point should you worry?
Bark, hack, sputter, rattle, whoop! Sure, coughs are a normal part of having a cold or flu, but when should you see a doctor about that hacking, and what might your particular cough (wet, dry, phlegmy) say about you? As for cough medicine, should you believe all the hype in the ads – or can a teaspoon of honey do the trick as well as a $15 bottle from your local pharmacy?
Coughing is the most common symptom for which patients seek medical attention, says Dr. Robert Hyland, a respirologist at Toronto’s St. Michael’s Hospital. “Coughing is common but it can also be a very significant symptom of something else.” even animals cough occasionally to clear their throats or airways, but excessive coughing that continues long after having a cold should be investigated.
AdWell people who get a cough that lasts longer than six weeks usually have a post-viral cough, explains Dr. Hyland, who is also past-president of the Ontario Thoracic Society: “You get an infection and it goes into your chest. you get a cough, get sort of better and, though you have no fever and the sputum goes away, you are still coughing. In some cases this is an indication that this person has very mild asthma.”
A virus, he explains, can attack the tracheal bronchial lining; the cells can become damaged and the lining inflamed. “The irritation causes coughing and the more you cough, the more you irritate it. It’s a vicious cycle. Sometimes, whether someone is asthmatic or not, treatment with anti-inflammatory inhalers can interrupt the cycle.”
Coughs are known as productive if they produce phlegm or mucus. “The common belief is that the greener the mucus is, the more likely it is to be a bacterial infection and therefore the more likely antibiotics would be of benefit,” says Dr. Hyland. “But that’s not always true, as you can have greeny phlegm with a viral infection.”
A productive cough can also be a classic sign of chronic obstructive pulmonary disease or COPD. People who have COPD have enough to deal with in this challenging disease, but when they end up with chronic bronchitis they also have a cough that is filled with thick coloured hard-to-raise phlegm. COPD is a condition that benefits from early prognosis and treatment. and if you’re a smoker with COPD, stop now.
One serious cough in children is pertussis, a bacterial disease known as whooping cough. In the U.S. they’ve recorded the highest rates in 63 years; its steady rise has been blamed on a drop in vaccination rates. one of its symptoms is definitely the classic “whoop” – a violent, debilitating cough so strong that a child will gag or even vomit.
Coughs can also be due to allergies, says Dr. Hyland. “Lungs are the one internal organ in the body that’s directly exposed to the environment. so every time you take a breath, you’re also taking in any gaseous or particulate matter that might be in the air. The cough is a mechanism for getting that stuff out.”
One cough that has nothing to do with flu, colds or infection is the cough associated with acid-reflux disease. when you have chronic heartburn, the acid contents of the stomach back up into the esophagus and produce a cough. Antacids may be prescribed.
Assuming you don’t need antibiotics, what should you look for in a cough remedy? Expectorants claim to decrease the thickness of phlegm but Dr. Hyland doesn’t believe there’s enough evidence to back up that claim. Medications which contain dextromethorphan may suppress a cough and honey is a favourite that can calm that back of the throat tickle.
Coughing is pretty common and in most people it’s benign. “But there can be complications from coughing. People can break ribs and blood vessels,” says Dr. Hyland. and remember that the goal in treatment is not only to get you to stop coughing, but to diagnose and treat the underlying cause.
Call the doc
According to the University of Maryland Medical Center, you should call the doc when you have a violent cough that begins suddenly; cough up blood; have cough-accompanied shortness of breath; cough with fever, abdominal swelling or thick and smelly green phlegm; a cough that produces a high pitched sound (called stridor) when inhaling; or a cough in infants less than three months old. for more on coughs, go to umm.edu. Take the cough test at familydoctor.org to see if your cough is an emergency.
Cough causes
Get the right diagnosis so you can treat the cause behind the cough. causes of coughing include allergies, asthma, COPD, acid-reflux disease, cigarette smoking, postnasal drip, a respiratory tract infection or the aspiration of foreign matter into the lungs.
A shot of whisky
Grandma may have prescribed a shot of whisky, but there’s no proof that it works. plus, some cough medicines should not be taken when drinking alcohol, particularly those that may cause drowsiness, such as nighttime cold medicines. Hard candies may ease a dry cough and soothe an irritated throat.
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