Every autumn and winter, coughing occurs frequently. Finding a cough, taking medicine indiscriminately if the condition is not clear, may mask certain diseases. Clinically, chronic cough (more than 8 weeks of course) is the most complex, there are many causes that may be triggered, the characteristics of cough may also be different, it is best to go to the hospital to find the cause, symptomatic treatment. (Zhang Jianyin, attending physician of the Department of Respiratory Medicine, Ningxia Hui Autonomous Region People's Hospital, Liu Limei, deputy chief physician of the Department of Cardiology, Yinchuan Traditional Chinese Medicine Hospital)
<b>Cough chest tightness, walking breathlessness, vigilance for COPD</b>
Patients with COPD generally have three typical symptoms: cough, sputum, and wheezing. That is, coughing and phlegm constantly, walking or doing housework is prone to wheezing, and breathlessness. Chronic bronchitis, emphysema, and cor pulmonale are the "trilogy" of COPD development. Usually, a mild decline in lung function may be asymptomatic, but as the decline in lung function gradually worsens, symptoms such as shortness of breath, wheezing, and coughing may occur. For high-risk groups of COPD, such as men over 40 years of age who have smoked for a long time, people who have been in adverse environments such as dust for a long time, and those with a family history of COPD, such as repeated cough, shortness of breath, especially after activity, it is recommended to perform lung function tests. For patients with confirmed COPD, long-term and standardized treatment should be adhered to so as not to aggravate the disease.
<b>Cough is severe at night, beware of cough variant asthma</b>
Ms. Qin had rhinitis, and coughed, thinking it was a cold, and after eating a bunch of anti-inflammatory cough medicines, she still did not get better, especially at night and after exercise, she coughed more severely. After the cough persisted for 2 months and did not resolve, she was diagnosed with cough variant asthma in the respiratory department and needed to undergo standardized asthma treatment.
For people with allergic rhinitis, urticaria and other allergic constitutions, if the cough is more than two months, the cough is most obvious at night, or it is aggravated when getting up in the morning, and it may also be possible to cough after exercise, inhalation of cold air, and cough attack after a cold, the possibility of cough variant asthma should be considered. Cough variant asthma is an atypical asthma that often presents cough as the first symptom, antibiotics and antitussives are usually ineffective, and the diagnosis can be done with lung function measurements, bronchodilation tests, nitric oxide tests, etc.
<b>Poor breathing, choking cough after lying flat, check for heart failure</b>
Recently, Mr. Zhang, 70, often coughed suddenly in the middle of the night and could not breathe after lying flat. The son took him to the hospital for examination and was found to have heart failure.
Many elderly people often have coughs, believing that they are caused by respiratory diseases. In fact, repeated irritating coughs (especially severe choking coughs at night) may be manifestations of abnormal heart function, for example, when patients with heart failure lie flat at night, paroxysmal dyspnea, cough and other symptoms will appear.
<b>Repeated coughing with weight loss, fever, be careful of tumors</b>
Mr. Zhang coughed repeatedly for half a year, initially as a common cold treatment, but the cough did not get better, but also appeared fatigue symptoms, and he was recently diagnosed with lung cancer. Lung cancer may be without obvious symptoms in the early stages, and when the disease develops to a certain extent, chronic cough, blood sputum, hemoptysis, chest pain, shortness of breath, wheezing, unexplained fever and other symptoms often appear. In the absence of deliberate weight loss, if the weight is lost rapidly in a short period of time, it is significantly emaciated, which may indicate a tumor. The use of low-dose spiral CT for lung cancer screening is internationally recommended. The following high-risk groups are recommended to be screened regularly. 1. Long-term cough, coughing up blood and sputum. 2. People with a family history of lung cancer and long-term smoking. 3. Small nodules of the lungs have been found. 4. People who are older than 40 years old and have a previous history of lung diseases, such as tuberculosis, COPD, asthma, etc.
<b>Cough after meals is also pantothenic acid, mostly due to gastroesophageal reflux</b>
Ms. Sun inexplicably coughed for more than a month, especially after eating or falling asleep, coughing more severely, accompanied by pantothenic acid. The respiratory doctor recommended that she see a gastroenterologist, and after the examination she was diagnosed with gastroesophageal reflux disease and reflux cough. After taking stomach medicine, the discomfort is significantly reduced.
It is recommended that if cough, itching, etc. are aggravated after meals, lying flat, bending over, accompanied by symptoms such as flatulence and pantothenic acid, it is necessary to screen for gastroesophageal reflux disease. Mild gastroesophageal reflux can be improved by lifestyle modifications such as weight loss, reclining in a concave position, eating fewer and eating more meals.
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