(also referred to as ...) Acute Cough, Chronic, Cough
Description A cough is defined as the sudden and explosive expulsion of air from the lungs, typically in a series of efforts. It is generally an automatic reflex, however, we can make ourselves cough to clear our throats, et cetera. When the body detects an irritant in the air passages, we automatically take in a deep breath. At this point, the glottis closes over your trachea. Our thoracic and abdominal muscles contract to push air against the closed glottis, thus building up pressure. The glottis then opens and the air is released in an explosive manner so as to remove the irritant from the air passages. Coughs can be described as being acute or chronic. An acute cough is one that lasts less than three weeks. A chronic cough is one that persists for more than three weeks.
Symptoms and Signs: A cough is a symptom of another illness or condition. It is thus important to treat the underlying cause.
Causes:
There are hundreds of conditions that can cause you to develop a cough. What follows is a focus on the more common causes for a cough.
Acute Cough Typical cause of an acute could include the following: The common cold can cause a cough due to post-nasal drip. Mucous forms in the back part of the nose (nasopharynx) and trickles down the back of the throat to the top of the windpipe (trachea). You may notice more coughing during the night, as this process happens more easily when lying down. See Common Cold for more information. Influenza or pneumonia can cause a cough due to acute irritation of the trachea and large bronchi. This type of cough is usually a dry, hacking cough. See Influenza and Pneumonia for more information.
Chronic Cough The more common causes for a chronic cough are the following: Post-nasal drip syndrome (PNDS) is a chronic case of post-nasal drip often caused by allergies or sinusitis. This is one of the most common causes of a chronic cough in non-smokers. Asthma is often accompanied by a cough and is sometimes the only symptom of mild cases of asthma. See Asthma for more information. Smoke is an irritant to the throat and lungs, often causing chronic coughing. Most smokers expect to cough and often do not see their health care provider about it. This can be particularly dangerous in this case due to the possibility of various lung cancers and lung diseases that can be caused by smoking and in which coughing is one of a variety of symptoms. Gastro-esophageal reflux disease (GERD) can cause a cough due to irritation of the airways by stomach acid. Some medications can cause chronic cough in some people. ACE-inhibitors (for high blood pressure) and beta-blockers (for high blood pressure, migraines, or glaucoma) are just two examples of such medications. This cough is generally a non-productive cough that stops when you discontinue the drug. If the cough becomes bothersome, you may see your naturopath or other health practitioner to find ways to suppress it. (NOTE: Do not discontinue use of any medications without first discussing the matter with your naturopath or other health practitioner). Chronic bronchitis is also a cause of chronic cough and is generally a productive cough. There is a high incidence of chronic bronchitis among smokers. The tobacco smoke causes airway inflammation, excessive mucous secretion, and impairment of the normal clearance of mucous from the air passages. See Bronchitis for more information. Pulmonary tuberculosis (TB) can cause a cough due to irritation of the large bronchi. This typically occurs with sputum and pain in the side. Bronchiectasis is a lung disease whereby the bronchial tree is chronically dilated and colonized with bacteria. This can cause a chronic cough. Cancer of the lungs or bronchi can cause a cough due to irritation by the presence of a tumour. See Cancer for more information. A habit cough or nervous cough is one that may be expressed by people that are nervous or very self-conscious, like a nervous laugh. This condition may overlap with PNDS. Psychogenic coughs are those with no apparent physical cause. They are a result of emotional or psychological problems and are more common in children than adults. Whooping cough or pertussis is an illness resulting from infection with the bacteia Bordella pertussis. Coughing attacks, followed by a loud "whoop" as a deep breath is drawn into the lungs, is characteristic of this illness. Pertussis is more common in children than adults. Croup is also more common in children than adults. It is caused by the same virus that causes laryngitis in adults (usually parainfluenza 1). This cough usually sounds worse than it is (sounds like barking) and breathing may be noisy. It is important to see your naturopath or other health practitioner if the fever is greater than 39°C, if breathing is difficult and rapid, if there is a severe sore throat, new or increased drooling, or if the child refuses to swallow or experiences discomfort with lying down. Chronic interstitial pulmonary disease is actually a grouping of various lung diseases, many of which have a cough as one of many symptoms. Post-infectious cough is a cough that persists for more than 3 weeks as the only symptoms after a cold or other upper respiratory tract (URT) infection. It will generally go away with time, without treatment. You should see your naturopath or other health practitioner if you have been in contact with someone with whooping cough to rule out whooping cough or any other possible complications. Some infants and children will also experience a cough with sinusitis, congenital diseases or abnormalities of the heart and lungs, a foreign body stuck in airways, chronic aspiration of milk into airways while bottle feeding, and exposure to second hand smoke.
What to Expect:
When dealing with a cough, knowing what to expect all depends on the cause. If a cough is productive (bringing up mucous), it may be best not to suppress it, as this is a way for your body to clear out the irritant. You naturopath or other health practitioner may advise you to suppress the cough if it is making you very fatigued or significantly disturbs your sleep. If a cough is non-productive (not bringing up mucous), your naturopath or other health practitioner may suggest suppressing it. Generally, if your cough is not causing a great disturbance to you, it may be best just to leave it alone. NOTE: See your naturopath or other health practitioner provider if: You are running a temperature of more than 38.5oC (101oF).You are coughing up thick, yellow/green phlegm.You are having drenching sweats at night whereby your sheets and pajamas are soaking wet.A violent cough begins suddenly with a high pitched sound when inhaling (you may have inhaled a small object -- treat as an emergency).Blood is brought up with the cough (treat as an emergency).A cough begins in an infant less than three months of age.You have shortness of breath or difficulty breathing.The cough accompanies unintentional weight loss.The cough lasts more than 10 days
Remedies
As a cough is a symptom of another underlying problem, it is imperative to consult with your naturopath or other health practitioner to determine the root cause of the cough. The most suitable approach would be to then treat the cause, followed by the cough, if necessary.
Conventional Approaches The pharmaceutical market abounds with cough preparations, many of which contain multiple medicinal ingredients, while some of which actually contradict each other's actions. In choosing a conventional preparation, it is best to take a single ingredient medication that is specific to your complaint. Expectorants make a cough more productive making it easier to cough and clear your airways. Guaifenesin is the most popular and most effective expectorant in conventional preparations. An antitussive (cough suppressant) makes you cough less frequently, with the most popular being dextromethorphan (DM). However, as a cough is part of the body's natural defense mechanisms, an antitussive may not prove appropriate. Decongestants help cut down the amount of mucous produced by the body, but this may also make it more difficult to cough out the irritant. If deciding to use a conventional approach, but are unsure as to which would most suit your needs, consult with your naturopath or other health practitioner regarding these medications.
Aromatherapy Add 2 to 3 eucalyptus drops oil to a hot, steaming bowl of water and inhale to soothe your cough.
Herbs Borage is a known demulcent and helps sooth coughs. To prepare an infusion, pour 1 cup of boiling water over 1 teaspoon of herb and infuse 10 minutes. Take 3 times daily. If using in tincture form, take 15 to 20 drops 3 times daily. The leaves and flowers of coltsfoot have long been used as a cough remedy. They relieve dry coughs, wheezing, asthma, bronchitis, emphysema, whooping cough, difficulty in breathing, or any congestion in the respiratory system. Coltsfoot is very mucilaginous and is soothing to the mucous membranes. It has anti-inflammatory properties which is useful in sore throats, laryngitis, flu and colds. The leaves also demonstrate high levels of zinc, which would explain some of the plant's anti-inflammatory and immune-boosting properties. The leaves can also be smoked to help clear the lung passages and relieve chest discomforts. To prepare an infusion, pour 1 cup of boiling water over 1 teaspoon of flowers or leaves. Infuse for 10 minutes and take 3 times daily. This herb combines well with hyssop and white horehound (both below) for treating coughs. Horehound (white horehound) can be used as an expectorant, to decrease the thickness of mucous, and to boost the immune system. This herb combines well with coltsfoot (see above) and hyssop (see below) for treating coughs. Hyssop is a decongestant and can help lower a fever. To prepare an infusion, add 1 to 2 teaspoons to one cup boiling water. Take 3 times daily. This herb combines well with coltsfoot and horehound (both above) for treating coughs. Licorice is a demulcent and expectorant. It also decreases the thickness of mucous and can lower fever, and has anti-viral and antibacterial properties. To prepare a decoction, gently boil 1/2 tsp. powdered root in 1 cup of water for 10 minutes. Drink up to 2 cups daily. Licorice tea is rather sweet tasting. If supplementing, take 4,000 to 5,000mg daily. If using in tincture form, take 20 to 40 drops up to 2 times daily. PRECAUTIONS: Do not take licorice for more than seven consecutive days. Licorice is known to raise blood pressure, so use the deglycyrrhizinated preparations. Licorice is NOT to be used if you are pregnant or if you suffer from diabetes, glaucoma, heart disease, high blood pressure, have severe menstrual problems, or have a history of stroke without consulting with your naturopath or other health practitioner. Marshmallow has demulcent and expectorant properties. To prepare a decoction, add 1 teaspoon chopped root to one cup hot water. Take three times daily. To prepare an infusion, add 1 to 2 teaspoons leaves to one cup hot water. Take three times daily. If using in tincture form, take take 1 to 5mL, three times daily. Mullein is a demulcent, an expectorant, and is mildly sedating. To prepare an infusion, add 1 to 2 teaspoons dried leaves or flowers to one cup water, steep for 15 minutes and take three times daily. If using in tincture form, take 1 to 4mL three times daily. Some studies indicate the use of red clover to help treat whooping cough. To prepare an infusion, add 1 to 3 teaspoons dried herb per cup of hot water. Drink up to 3 cups daily. This dosage can have a strong cleansing effect on the body and may be too much at first. Build up to this dose over a few days. If supplementing, take 100mg three times daily. If using in tincture form, take 40 to 100 drops, three times daily. St. John's Wort is an expectorant and sedative. Avoid exposure to the sun when taking this herb. This herb also interferes with the absorption of iron and other minerals. Savory may be used as an expectorant.
Homeopathy Certain remedies can be used in acute situations if your symptoms fit the symptom picture of the remedy. For dosages, see the dedicated section on Homeopathy. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy. Aconite: Cough comes on suddenly and is dry and irritating. Often associated with croup, the common cold, and the flu. Belladonna: Dry, tickling cough that comes in bouts, often ending with a whoop or sneeze. Head is congested and bursting. Adam's apple is tender. Bryonia: Cough is hard and dry. Person holds chest or head, craves cold drinks but finds hot ones more soothing. Drosera: Tickly, violent chest cough, with retching and gagging. Pain below ribs. Symptoms worse at night and when outside. Hepar Sulph.: Temperature is higher than normal. Cough makes a "croaky sound" and is made worse by drafts and cold, dry weather. Person is chilly, irritable, and craves hot drinks. This remedy is often used in later stages of a cough. Nux Vomica: Dry cough with retching. Person is chilled and feverish, oversensitive and very irritable. Symptoms made worse when exposed to cold. Pulsatilla: Cough is moist in the morning and dry at night. Yellow or greenish phlegm. Person lacks thirst, is tearful and miserable. Symptoms aggravated by warm, stuffy rooms. Spongia: Croupy, harsh cough. Cough is dry, loud, and raspy. Symptoms made worse with excitement, talking, alcoholic beverages, lying, and ice-cold drinks. Less cold fluids and eating may improve symptoms. Sticta: Dry, hacking cough at night. Symptoms made worse when bringing up phlegm.
Lifestyle If you smoke, quit. Coughing can spread infection. Cover your mouth and nose while coughing and then wash your hands. A cool air humidifier can be used to help decrease the thickness of mucous, making it easier to cough up, and can help soothe an irritated throat. To help soothe a raw throat, drink hot water (or tea) with lemon and honey. A dry, hacking cough may be relieved by sucking on a throat lozenge or hard candy. See also Minerals, below. Drink plenty of fluids. This can help thin mucous, especially if taking a preparation containing guaifenesin. Aim for 8 glasses of pure water daily. If you are not accustomed to drinking this quantity, start with 4 to 5 glasses daily and work your way up over the course of a week.
Minerals Zinc lozenges may prove useful in coughs due to colds or flu. Take 13 to 25mg elemental zinc from zinc gluconate in lozenge form every few hours for no more than 7 days. Be sure to fully dissolve the lozenge in your mouth. Supplementation for more than one week can suppress the immune system. Avoid lozenges that contain sorbitol, mannitol, and citric acid. Some studies indicate that a high zinc dosage at the beginning of a cold (90mg daily) more effective shortens its duration. Discuss this option with your nutritionist, naturopath, or other health practitioner.
Actions and Remedies Listing
See also Asthma, Bronchitis, Cancer, Common Cold, Influenza, Pneumonia, Smoking Dependency, and Sore Throat
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