Dear Readers,
ND is a 29-year-old lady with a chronic, recurring dry cough. ND has seen her family doctor in Portmore, St Catherine, twice in the past two months and was told that the cough wasn't serious, probably due to allergies. She did a chest X-Ray, and blood and sputum tests. Nothing has been found, yet the cough persists. She has been prescribed with anti-histamines and cough suppressant syrups. ND doesn't think that the medication has made much of a difference. She decided to write Lifeline to see if we could make the difference.
Lifeline will try to share with ND the various causes of a chronic cough which she can follow up on. However, a chronic cough which is not responding to prescribed medication over several weeks may well require further, specialist investigation.
Body's protection
Cough constitutes a form of protection to the body which is designed to clear dust, pollen and infective organisms. It commonly occurs in association with diseases of the ear, nose and throat and can be related to a bacterial or viral infection of the respiratory tract such as laryngitis, bronchitis or pneumonia. A cough can also be caused due to inhaling irritant substances such as cigarette smoke, chemical fumes and dust. Inhaling very cold or very hot air can also result in a cough. Another cause of a chronic cough is due to acid reflux when stomach acid flows backwards up into the oesophagus.
Coughs can be dry or wet with mucus and can be associated with an asthmatic wheeze. A cough can also be due to a foreign body in the air way. Any cough which persists past a week should best be evaluated by a doctor. More common causes of a persistent cough are:-
❒ Chronic bronchitis/pneumonia
❒ Gastro-oesophageal reflux
❒ Lung cancer
❒ Tuberculosis
❒ Heart disease
❒ Ace Inhibitor drugs used to treat high blood pressure eg Enalapril, Captopril, Lisopines (see a doctor before discontinuing the medication).
There are several prescribed and over the counter cough medicines which are available. Some prescribed cough syrups contain codeine which is a cough suppressant and works by turning off the area of the brain which controls the cough reflex. Codeine is a narcotic drug and can become addictive.
Many over the counter preparations contain dextromethorphan, which is also a cough suppressant, although non-addictive. Its presence in medications is usually indicated with the initial DM on the label. It has few side effects.
Cough exporants are also available and work by increasing the production of fluids in the respiratory tract which thins the mucus and makes it easier to cough out.
Soothe throat
Over the counter lozenges coat the throat and soothe an irritated throat, giving some relief to a cough.
When a cough is bothersome and persists the following guidelines may help to lessen the problem.
❒ Avoid dairy products and fried foods which tend to form increased amounts of mucus.
❒ Increase fluid intake and drink fluids at room temperature or warmer. Fluids thin the mucus and make it easier to cough up. Hot soups are helpful.
❒ Take sugar-free lozenges boosted with vitamin C or/and zinc which combat inflammative, soothes and improves the immune response.
❒ Menthol lozenges which contain peppermint oil also aid in cough
suppression.
❒ Use a cool aid in cough suppression.
❒ Use a cool mist humidifier in the room at intervals.
❒ Avoid smoking and contact with other respiratory irritants.
When cough persists, see a specialist or attend a government hospital for referral to their medical out-patients clinic. If in Kingston, St Andrew or Portmore visit the National Chest Hospital in Liguanea, Kingston Public Hospital or Spanish Town Hospital for Government aided attention.
Write to:
Lifeline
PO Box 1731
Kingston 8
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