Coughing is always not good, what is the reason behind it? Invite Chang Chun, chief physician of the Department of Respiratory Medicine of Peking University Third Hospital, to answer questions for everyone.
Chang Chun, chief physician of the Respiratory Department of Peking University Third Hospital, said that 10 out of 20 patients in the respiratory specialist clinic came to see the doctor because of the symptoms of cough.
There are roughly three types of cough: one is called acute cough, which will heal within 3 weeks; the other is called subacute cough, which refers to cough between 3 and 8 weeks; and the most troublesome is chronic cough, which generally lasts more than 8 weeks.
The first culprit: allergens
The unexpected culprits of chronic cough include pollen, tiny particles in the air, and small bugs. Chang Chun, chief physician of the Respiratory Department of Peking University Third Hospital, said that dust mites, smoke, pollen, dog hair and cat hair are common allergens and the culprits of coughing. Especially coughing when exposed to pollen in the changing seasons, or when exposed to dog hair and cat hair, requires an allergen test.
Symptoms of an allergic cough tend to present with a dry cough, less sputum, and the patient may have an itchy throat before coughing.
Why is coughing related to allergies? Chang Chun, chief physician of the Department of Respiratory Medicine of Peking University Third Hospital, said that when exposed to allergen stimulation, the trachea of normal people does not contract, while patients with allergic cough will have spasms in the trachea after contact with allergens, and cough will appear. Find the allergen first, and then avoid contact with the allergen or desensitize therapy.
The second culprit: cough variant asthma
Chang Chun, chief physician of the Department of Respiratory Medicine of Peking University Third Hospital, said that dyspnea, wheezing, chest tightness or shortness of breath are considered to be typical manifestations of asthma, but there is a special type of asthma, which does not have obvious symptoms of dyspnea, wheezing and shortness of breath, but only appears as cough, this special type of asthma is called cough variant asthma. When exposed to some stimulating factors, the airway will spasm, the secretion of mucus in the airway will increase, the mucous membrane in the lumen of the airway will appear swollen, the lumen of the trachea will become narrow, narrow to a very serious extent, the airway will be blocked, if the blockage is not particularly serious, the airway spasms will appear as cough. This cough is caused by spasm of the airways, does not produce sputum, and is dominated by dry coughs.
Rhythmicity is an important feature that distinguishes between allergic cough and cough variant asthma. Rhythm refers to the rhythm of time, that is, cough variant asthma tends to have milder symptoms during the day, but more severe symptoms at night. This is related to the vagus innervation of the bronchi, because the vagus nerve at night has a higher tone and will be more active, so the vagus nerve is more likely to cough when stimulated at night. As long as the allergic cough is exposed to the allergen, the cough will appear day and night.
How is cough variant asthma treated? If cough variant asthma is treated with antibiotics, the bacteria will be killed, secondary fungal infections, and it is a three-point poison of the drug, and long-term antibiotics will affect liver and kidney function. And hormone drugs are the preferred drugs for cough variant asthma, because cough variant asthma is essentially asthma, the most effective for asthma is the hormone drug, hormone drugs are inhaled, the advantage of inhalation is that it acts on the airway, and is rarely absorbed by the whole body.
The third culprit: hiding in the nose
Cough caused by nasal diseases such as rhinitis or sinusitis, and part of it is due to diseases of the throat, cough caused by pharyngitis is called upper airway cough syndrome, cough is caused by the upper respiratory tract, also known as retronasal drip syndrome.
Chang Chun, chief physician of the Department of Respiratory Medicine of peking university third hospital, said that the nose is flowing to the throat and eyes, the site of the disease is in the nose, and the cough is caused by the backflow of the nose to stimulate the pharynx. Typical symptoms are discomfort in the pharynx, frequent throat cleaning, and the doctor will see obvious lesions in the throat when doing the examination. If it is simple rhinitis or pharyngitis, it will be effective after one or two weeks of treatment.
The fourth culprit: hidden in the stomach
Chang Chun, chief physician of the Respiratory Department of Peking University Third Hospital, said that chronic cough caused by stomach lesions is called gastroesophageal reflux. When the sphincter between the esophagus and the stomach is not functioning well, the contents of the stomach will come back, and when it reaches the junction of the trachea and the esophagus, the contents of the stomach will irritate the trachea and cause coughing. Because the acidity of the stomach acid is very high, the stomach acid stimulates the trachea and causes spasms in the trachea to cough.
Acid-suppressing drugs are commonly used to reduce the acidity of the stomach for the treatment of gastroesophageal reflux, or to use gastric motility drugs to let what is eaten go down. Such patients usually have symptoms relieved within two weeks. In life, try not to drink coffee, strong tea, avoid nervous and anxious emotions, avoid overeating, avoid doing some strenuous exercise before going to bed, and sleep with a slightly higher pillow to prevent gastroesophageal reflux.
The fifth culprit: hiding in the lungs
Chang Chun, chief physician of the Department of Respiratory Medicine of Peking University Third Hospital, said that tumors should not be ignored as the cause of chronic cough, and there are two misunderstandings in everyone's understanding of tumors, one is excessive panic, and the other is neglect. If an elderly person with a history of smoking or a woman who has been exposed to oil smoke for a long time has a cough, the first thing to rule out is a tumoric disease. Many tumor patients have no specific symptoms at the beginning, that is, a chronic cough, but as the disease progresses and invades the blood vessels of the airway mucosa, many patients are accompanied by coughing up blood; in the advanced stage, the tumor compresses the nerves and there will be hoarseness, and even venous anger.
High-risk groups, including the elderly and smokers, when these people cough repeatedly, especially with blood in sputum, they must be vigilant against the possibility of tumors. Source "The Road to Health" Proofreader Song Chunyan