Cough, not as simple as you think.
Cough is a common symptom, which we all have in our daily life. It is a protective reflex to prevent any harmful substance entering in our lungs and also to clear our airway. It is not a disease, but a manifestation of many different disease processes.
When it is simply related to cold or minor viral flu we get an over-the-counter medicine. If it does not get any better in four to five days you should see your physician immediately.
A few notes about cough to remember. The term "smokers cough" is not so simple and could mean a permanent lung disease called emphysema or chronic obstructive pulmonary disease - COPD.
COPD or emphysema present with increasing shortness of breath and cough with thick and purulent sputum. Patients get increasingly tired and lethargic due to low oxygen saturation because damaged lungs can no longer maintain oxygen in blood as required. In the late stage of disease, patients experience an increase in carbon dioxide in their blood and need supplemental oxygen to maintain their breathing. If they get bronchitis or pneumonia it can cause rapid worsening of symptoms and patients may need ventilator support for respiratory failure. These patients are more susceptible to flu and respiratory infections and often it is difficult to treat them.
Cough can also be the result of bronchitis or pneumonia. Bronchitis is an upper respiratory infection and pneumonia is a lower respiratory infection. Both can present with cough. Both of these can present with cough with phlegm and/or blood. Simple bronchitis or pneumonia is easy to treat with antibiotics as an outpatient. However, when symptoms become severe patients may end up in the hospital. If a cough persists for a week with antibiotics, I recommend seeing a doctor and a chest X-ray as well as a blood work up to determine if there is a more serious problem.
Blood with a cough is seen with bronchitis or pneumonia, but when a significant amount of blood is present it could be cancer or a severe infection and immediate medical attention is needed. However, occasionally a little blood is seen with a cough from local oozing after a dental procedure and usually is not severe.
A lung disease called asthma can present with only cough or cough with breathing difficulty and wheezing. Allergy and sinus problems can also cause coughing. A few blood pressure pills may also cause severe coughing and may need to be stopped.
Remember when a person has a cough so severe that it wakes him or her from sleep there is always a possibility of a serious disease. So we should not ignore a cough as a simple disease. Seek medical help to avoid serious complications.
Dr. Sugata Sensarma is affiliated with Trimark Pulmonology.