Author:
Amelicheva Alena Aleksandrovna medical editor
Cough is a reflexive protective reaction of the body when the respiratory tract is exposed to various irritants (dust, smoke, pollen), mucus, liquids, foreign bodies, pathogens.
In most cases, cough goes away within 3 weeks and does not require treatment, but sometimes it can be a sign of a serious illness: tuberculosis, bronchial asthma, bronchitis, coronavirus infection (COVID-19) and others.
The following symptoms may accompany a cough: fever, sore throat, runny nose, weakness, headache, hoarseness, increased fatigue, increased sweating, muscle pain, difficulty breathing, loss of smell or taste.
The child's cough does not go away
Coughing is a protective reflex that helps clear the airways, including secretions constantly produced by the bronchi. Therefore, a completely healthy child can cough several times a day. Normally, episodes of coughing are isolated, occur mainly in the morning and do not cause much discomfort. If a child experiences severe coughing attacks, including at night, then with a high degree of probability we can talk about pathological processes in the body. The cough can be either dry, persistent and painful, or wet, with sputum production.
Common reasons why a child’s cough does not go away for a long time:
- residual effects after acute respiratory viral infection and other diseases - due to the persistence of increased sensitivity of cough receptors;
- unidentified respiratory diseases;
- allergic reaction (additional symptoms: runny nose, sneezing, red and itchy eyes, tearing);
- gastroesophageal reflux - the movement of acidic food from the stomach back into the esophagus.
If a child has a prolonged cough without fever after suffering bacterial or viral diseases, then the therapy prescribed by the doctor should be continued. In this case, it is worth observing the cough itself (the intensity should decrease over time) and the sputum, which should be almost transparent. It is normal if there is not much or no sputum at all. Too much or purulent sputum, a progressive cough signal complications.
Walking in the fresh air, ventilating the room, drinking warm drinks throughout the day, breathing exercises and warming massage will help speed up the healing process and improve the child’s condition. In consultation with the pediatrician, take medications that thin the mucus and help remove it from the lungs.
If the disease has not been previously diagnosed, it is necessary to undergo an examination and determine the cause of the cough, which should be addressed by treatment.
Symptoms and signs of bronchitis
Bronchitis most often manifests itself against the background of an acute respiratory disease. The viruses themselves prefer the upper respiratory tract, but the infection almost always reaches the bronchi4.
Before the child starts coughing and the doctor diagnoses bronchitis, symptoms characteristic of acute respiratory diseases appear. The following symptoms and signs of bronchitis in children may appear:
- Heat;
- Headache, anxiety;
- Weakness, decreased activity, muscle pain, constant fatigue
- Runny nose, manifesting itself in the form of nasal congestion, mucous discharge;
- Sore throat, sore throat, hoarseness;
- The most characteristic symptom is cough and shortness of breath. First dry, then productive with sputum.
Cough is highlighted for a reason; it is the main symptom, after which a treatment plan is developed. A cough can occur even after ARVI has completely subsided. This is often observed due to weakening of general and local immunity when bacterial infection develops. A cough in the acute form of bronchitis can be called persistent; its duration indicates the development of a protracted or chronic disease.
Cough in children can also be caused by other diseases of the respiratory system - laryngitis, tracheitis, and in the worst case, pneumonia. Even more often, the virus affects several areas at once, tracheobronchitis or laryngotracheitis develops.
Cough is a physiological reflex process that occurs due to irritation of the mucous membrane of the respiratory tract. With bronchitis, this is how the body tries to cleanse the bronchi, trachea and larynx from the result of the inflammatory process - phlegm4.
Cough does not go away in an adult
The reasons why a cough does not go away for a long time in an adult can be the same as in children: a consequence of a cold, bronchitis or pleurisy; allergies to pollen, dust, pets, less often - to food and food additives. A prolonged productive cough (with sputum) may be the first sign of the development of chronic lung diseases.
But there are also differences: for example, a dry, lingering cough without fever in adults often occurs due to gastroesophageal reflux disease (GERD) - when food is regularly thrown from the stomach into the esophagus, causing bronchospasm. In this case, an additional sign of the disease is heartburn.
Other reasons:
- pathologies in the respiratory tract due to smoking, recovery after quitting smoking;
- work in hazardous work (in a dusty room, with toxic substances);
- whooping cough is an acute bacterial infection;
- tuberculosis;
- tumors;
- diseases of the cardiovascular system (heart failure, pericarditis).
For residual (post-infectious) cough without fever, adults, as well as children, are recommended to walk in the fresh air, drink plenty of fluids, exercise and breathing exercises, and massage. And also a healthy diet and good sleep - for the overall strengthening of the body. If the cause of the cough is not clearly established, you should make an appointment with a therapist. Under no circumstances should you self-medicate, especially with antibiotics and other potent drugs. While waiting for your appointment, you can soothe your cough with herbal teas and lozenges.
If you suspect an allergy, you should minimize contact with a potential trigger - a substance that triggers an allergic reaction. Smokers should give up the bad habit, which in 100% of cases leads to coughing.
Which doctors should I contact about a cough?
To determine the causes of cough, diagnose the condition and treat it, you must consult a therapist or pediatrician. If your cough doesn't go away within a few weeks, make an appointment with a pulmonologist or gastroenterologist (if you have acid reflux or established GERD).
A cough that occurs due to a cold or flu usually goes away on its own. You need to drink as much fluid as possible and get plenty of rest; to relieve pain and reduce high fever, you can take paracetamol or ibuprofen (attention: you should not give aspirin to children to reduce fever, its use is associated with the development of Reye's syndrome).
The effectiveness of multi-ingredient over-the-counter cough and cold medications in relieving symptoms is questionable. Research shows that not only do they not improve the condition, but they may have potentially serious side effects. They may also contain paracetamol and may cause an overdose if you are already taking it. It is not recommended to give over-the-counter multi-ingredient cough and cold medicines to children under 12 years of age. Cough lozenges (for children over 4 years old) and honey (for children over 1 year old), humidification and ventilation of the room can alleviate the condition.
Cough does not go away after coronavirus
A long cough after coronavirus is observed in about a quarter of those who have recovered from the disease. However, cough may not only be a residual symptom, but also indicate complications. Therefore, it is better to play it safe and undergo a full examination at the clinic, especially if the cough is unproductive or unproductive, debilitating, and shortness of breath persists. If the lungs are clean, without new foci of inflammation, and there is no cardiac pathology, additional therapy is not needed.
General recommendations for improving the condition:
- adhere to a healthy lifestyle;
- perform breathing exercises;
- do chest massage;
- take vitamin D.
How long a cough can persist after a coronavirus infection depends on the severity of the disease and the condition of the body as a whole. Sometimes a cough after Covid lasts three months or more.
Causes of bronchitis in children
As in adults, bronchitis in children develops mainly due to a viral infection. In the summer the child gains strength, but in the fall, winter and spring he gets sick very often. This is a common picture, especially if the child goes to kindergarten or an educational institution. The child’s body is attacked by the following viruses:
- influenza types A, B, C and parainfluenza;
- adeno- and rhinoviruses;
- corona virus
- respiratory syncytial virus
- metapneumovirus
Much less often than viruses, but much more often than in adults, bacterial infections become the cause of bronchitis in young children:
- the causative agent of whooping cough (bordetella);
- chlamydia;
- mycoplasma;
- staphylococci;
- pneumococci;
- streptococci.
How to treat a persistent cough
In addition to the general health measures that we talked about above, taking medications agreed with your doctor will help get rid of a lingering cough. Medicines that suppress the cough reflex will help combat a lingering dry cough, which is hysterical and painful. If you have a prolonged cough with the release of thick and viscous sputum, you need expectorants and mucolytics, which thin the mucus and facilitate its removal.
In addition to the nature of the cough, you need to consider why the cough persists. So, to relieve an allergic cough, you will need a drug with antihistamine properties, and for a cough caused by bronchospasm, you will need a bronchodilator.
In order not to check the instructions of different medications, you can choose a drug with a combined action. These include Rengalin, which helps with all types of coughs and relieves coughs in chronic respiratory diseases, including COPD. A pronounced result is observed already on the third day after taking the drug, which is confirmed by the results of the study. Relief occurs from the first day of use. "Rengalin" does not have a hypnotic effect, does not lead to changes in mental state, is suitable for children from three years of age and can be combined with other types of therapy prescribed by a doctor.
Features of acute and chronic bronchitis in children
In most cases, doctors cope with the treatment of acute bronchitis in children. If after four weeks the child continues to cough, then the diagnosis is changed to prolonged bronchitis. This condition continues for up to several months.
The main danger of the acute form lies in the consequences and complications of bronchitis in children. The risk of developing chronic bronchitis or pneumonia has already been discussed. It is also possible to develop into obstructive bronchitis, in which problems with breathing itself begin due to swelling and spasm. Respiratory failure, shortness of breath develops, it becomes difficult to breathe, which poses a real threat to life, especially if the child is still small and can hardly explain his feelings. In this case, you should consult a doctor as soon as possible, and if your condition suddenly worsens or there is severe breathing restriction, you should immediately call an ambulance5.
Pediatricians successfully treat acute bronchitis in children, but the chronic form is more difficult. It is quite difficult to detect it in a child, because officially, the diagnosis is made after at least two years.
To identify the chronic form, additional diagnostics, observations, and anamnesis (questioning) may be required from parents. By comparing all the data and observations, the doctor can make the correct diagnosis.
When identifying a chronic form, it is important to promptly notice exacerbations of the disease, as well as its remission (subsidence). When a child’s body experiences another attack, the following symptoms of intoxication appear:
- Headache, weakness occurs, general health worsens;
- Increased sweating, especially at night;
- Feeling constantly tired;
- Your temperature may rise.
When remission occurs, all symptoms go away, like the cough itself5.
Recently, the terminology of chronic bronchitis in children has generated controversy in the medical community. In adults, the impetus for the formation of a chronic disease is smoking or work associated with hazardous chemical or mechanical production (for example, miners). For obvious reasons, this cannot apply to a child. However, chronic bronchitis occurs quite often in children.
Children are also more likely to suffer from bacterial infections. This may be due to the fact that immunity is still poorly formed at an early age. Any acute respiratory disease opens up access to bacterial infection; the immune system simply does not have time to react, as it is busy with a viral infection2.
2. Reasons
The main causes of nonproductive cough include:
- irritation of the respiratory tract by chemical and/or physical factors (toxic substances, aggressive fumes, active or passive smoking, dusty air, thermal effects, etc.);
- foreign bodies;
- mechanical pressure on the airways from the aortic aneurysm, growing tumor, enlarged lymph nodes;
- chronic obstructive pulmonary disease (COPD);
- fibrosing processes (proliferation of scar-connective tissue);
- bronchial asthma;
- respiratory infections (including pulmonary tuberculosis);
- allergic reactions;
- diseases of the esophagus and stomach, occurring with reflux syndrome;
- occupational pneumoconiosis;
- cardiovascular diseases (for example, left ventricular failure);
- long-term use of ACE inhibitors (angiotensin-converting enzyme);
- diseases of the central nervous system (damage to a special “cough” center in the medulla oblongata causes the so-called cough of central origin);
- thyroid diseases;
- high altitude hypoxia.
In many cases, a dry cough is caused not by one reason, but by two, three or more.
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Diagnosis of cough
This article was not able to list all the diseases in which cough occurs as a symptom. To summarize, we can say that cough is characteristic of many diseases and occurs for various reasons; in some cases, it does not require treatment in itself. To assess this symptom in the pathogenesis of the disease and prescribe adequate therapy, a complete and comprehensive diagnosis is necessary, which includes consultation with a therapist, ENT doctor, pulmonologist, and, if necessary, a cardiologist and neurologist, and perhaps other specialists.
The gold standard for diagnosis is Rg-diagnosis of the chest organs, and, if necessary, computed tomography. A research method such as fiber or video bronchoscopy (FBS) is often prescribed for coughing; it allows you to visually assess the patency and condition of the mucous membranes of the bronchial tree, as well as obtain swabs and tissue samples for laboratory and cytological studies. A functional study of the respiratory system is spirography or external respiration function. It gives an idea of how fully or limitedly the respiratory system works.
In conclusion, I would like to note that chronic cough is a factor that significantly worsens a person’s quality of life, and in addition, it can be a symptom of serious diseases, which, if left untreated, can lead to disability and death.
Treatment of cough and cold
The most common cause of cough is colds. These are relatively harmless diseases caused by hypothermia or infections entering the body. But without proper treatment, even a “harmless cold” can develop into a chronic cough or lead to other complications.
The cough can be dry or wet. Typically, a dry cough appears at the beginning of the disease, and then (after 2-3 days) sputum production begins.
To treat dry cough, which is more painful, antitussive drugs are used, which cannot be used if sputum is produced: they do not allow the airways to clear, which leads to a protracted course of the disease and complications. For a wet cough, expectorants are needed. As therapeutic methods, symptomatic anti-cold medications, inhalations, and the use of herbal decoctions and preparations can be used.
Cough with bronchial asthma
This is a disease that has different clinical manifestations, including a cough form. With this form of the disease, cough may be its only manifestation and the only complaint of the patient. However, adequately selected anti-asthma therapy brings a good treatment effect, which confirms the correctness of the diagnosis.
For bronchial asthma, basic therapy is prescribed, including inhaled corticosteroids and bronchodilators. Bronchodilators, in turn, can be divided into drugs that act for a short time and drugs that act for a long time. Doctors also have combination drugs in their arsenal to treat this disease.
