sudden appearance. First, cautiously: a slight pulsing in the chest, with effort, turned into a slight cough. However, the cough soon turned into a ruthless alien that has invaded the life of the person writing this article for four weeks. A violent, guttural, uncontrollable cough can take on different faces, each one more noticeable. Because, as Ramón Gómez de la Serna already described in his “Greguerías”, a cough has many faces: it can be a “barking of the lungs” or a “cough with a trigger that bursts out” , or “cough with gears.” .
As with sounds, there’s just one cough; ours: “There are as many types of coughs as there are people,” explains Dr. Anthony Russell. The expert, clinical director of the chest department at the University Hospital Triaspujl in Germany, still remembers his first lesson on coughing in medical school. “The first thing they explained to us was the physiological part of it: coughing is a reflex, a defense mechanism that the body has to react when something irritates the throat or airway.” The mechanism (“Super Fast” , defense”) stimulates nerves and sends messages to the brain. The brain then tells the muscles in the chest and abdomen to release air from the lungs and expel the irritant.
A cough can be a sign of a variety of illnesses: from the common cold or flu to rare diseases and even cancer.
The pulmonologist added that the cough is a symptom: “That’s the second thing they explain to us: it’s a manifestation of various diseases.” In fact, the cough is caused by tuberculosis, a disease that Serious disease that killed millions before the discovery of antibiotics and the widespread availability of vaccines. The same goes for whooping cough: another highly contagious bacterial respiratory infection that manifests itself as a dry, violent cough that emits a series of blood-curdling high-pitched sounds that resemble a scream when inhaled. Whooping cough is a current epidemic, with outbreaks affecting unvaccinated children and adults who have lost immunity.
Cough is also common in children, and primary care is often saturated with multiple consultations regarding its cause.
“Pulmonologists need to be aware of more than two dozen diseases that cause cough,” Dr. Russell concluded. In addition to the above two, we must not forget “cough caused by the common cold, flu, cough caused by swallowing foreign bodies;” This is caused by rare diseases (such as fistulas between the esophagus and trachea), intestinal diseases or cancer. The list quickly reaches “twenty-five or thirty conditions.” “We all have coughs, and as doctors it’s our job to recognize cough patterns because patients don’t always understand 100 percent what’s in the manual.” What was said. Physicians have to ask, understand and adapt to the circumstances under which the cough occurs,” said Russell.
The problem is that, unlike fever, another very common symptom, a cough is not usually considered a symptom serious enough to warrant a visit. You may spend days or even weeks stuck in it before taking action.
It’s a matter of scale: millions of people have been infected with COVID-19, and a certain percentage have this bronchial hyperresponsiveness
Are we coughing harder today than before?recent article Washington postThe article titled “Can’t Stop Coughing?” describes a “constant cough” that makes this virus season “exhausting.” While the report acknowledges that cases of such coughs are not officially controlled and therefore cannot be compared, some doctors interviewed claimed that they had seen higher rates of prolonged coughs. The article quoted experts’ descriptions that patients were “kidnapped by a cough that lasted for a month or two.” When they came for consultation, they were “exhausted from lack of sleep, and they coughed so hard that their muscles were torn.”
Chronic cough cases rise post-pandemic
The article stated that coronavirus may be the cause of this phenomenon. This is partly because people are paying more attention to respiratory symptoms since the pandemic. But, as Dr. Russell also points out, there’s more to it than that: “I would look at this in terms of scale: millions of people have been infected with COVID-19, and a certain percentage of people have this bronchitis “Highly reactive.” So there will be more coughing: “Because millions of people are infected with a virus they’ve never had before.” “It’s a matter of scale,” he reiterated.
Don’t forget pollution, which the expert says “without a doubt” affects people’s coughs. “Depending on the type of toxic substances in the air, the number of people affected will be higher. Like those days when many cruises were in Barcelona, or due to temperature inversions, the layer of pollution is growing.” Although some deny it, all these pollutants These are attacks that the body detects and reacts to avoid them…by coughing.
What’s the red line for seeing a doctor? 1) Time (more than three weeks); 2) Intensity; 3) If accompanied by blood or chest pain
Such is the case with Montese, a woman from Barcelona who started coughing last Halloween (“due to a poorly treated cold”) and was rushed to the emergency room after Christmas where she was diagnosed with pneumonia. “He kept coughing, especially at night. It was a nasty cough but it was syrup, paracetamol and ibuprofen. I felt terrible but I gave up because in my mind it was no big deal ‘s, and I’m embarrassed to have abused the system because of… coughing and stuff like that. Plus, I’m a smoker.” Queta is another Barcelona man who has been suffering from a cough for weeks. He described it as a “dry, irritating” cough without any other symptoms that led to a month of “generally terrible living” and sleepless nights. Like Montese, she was anxious to see a doctor: “And, I’ve already gone once and the reply was: ‘It’s just a cough,’ which means I have to live with it. It’s not a priority, and I partly understand that.” a little.”
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This kind of modesty is common in consultations, and there’s also a certain indifference shown by doctors when faced with what is effectively a vulgar symptom. “Part of the reason this is happening is because there are so many inquiries about the same thing. It’s saturated, but we would say, that’s bad practice,” Dr. Russell said. Because, no matter how common and repetitive the cough is, you have to “start from scratch” with each patient: “even if you’ve already seen eight of the same patients that day.”
For patients: What’s the red line to see a doctor immediately? “First, timing: A cough that persists for more than three weeks must be seen by a doctor,” Russell said. “The second factor is the intensity of the cough: you should also seek counseling if the cough prevents you from talking or sleeping, as it will affect your quality of life. Of course, if it is accompanied by any significant symptoms, such as choking, coughing up blood, persistent chest pain and purulent, thick, yellow or green mucus.”
Cough Anatomy
Hippocrates had already addressed coughing in his Corpus Hippocrates, a treatise that laid the foundations of medicine as a science. He carefully describes Perinthus Cough: a winter epidemic in this small town in ancient Greece in the 5th century BC. Cough occurs: “Due to frequent changes in north-south wind direction and snowfall.” The epidemic attacks the upper respiratory tract, affecting men, women and children. The main symptom of this epidemic is coughing, which may lead to pneumonia. This event is believed to be the first recorded influenza epidemic in history.
Hippocrates also gave folk remedies for treating coughs in children in his corpus, which can be considered a parenting classic. Hippocratic remedies included oral medications, inhaled medications, and suppositories, as well as certain herbs mixed with flour and barley. The father of medicine didn’t mention cutting an onion in half: a desperate home remedy for 21st-century parents for their children’s nightly coughs. Dr. Russell revealed that his two daughters were never given onions to treat their coughs as children: “The truth is,” he said, “onions made them cough really bad. I gave them very little cough medicine.” is the name of a drug that theoretically relieves coughs: a branch of modern pharmacology that, unlike other branches, does not seem to have experienced huge advances. While fever reducers are amazing at reducing fever, cough suppressants are extremely slow to work. This is an area where science seems stuck in the days of 19th-century spas, steams, pills and classic syrups, all part of a powerful industry surrounding coughs.
Only codeine is used to relieve coughs, but it is not magical and requires a prescription because it is a derivative of morphine and slows down the respiratory center
“The truth is, there are very few drugs that actually stop a cough: basically codeine, which was the classic treatment from a hundred years ago,” Russell said. He adds that they won’t give you this treatment without a prescription: “It’s a derivative of morphine, and in addition to blocking the cough center, it also slows down the respiratory center. So codeine works well, is our action medicine, but it is also not magic.” In any case, the expert points out that the situation is changing: “Today we are talking about chronic cough, and when you have gone through the whole list of possible diagnoses, you can define chronic Cough. People with this reaction have an allergy where anything makes them cough, so the industry is working on addressing the nerves, the sensory receptors, that cause this reflex. We’ll see how it develops.”
There are few effective cough medicines
Don’t forget about corticosteroids, whose function is to reduce inflammation. Respiratory inflammation is one of the obvious effects of coughing and one of the reasons why it lasts longer. Russell compared the phenomenon to what happens when your skin burns in the sun: “You get injured, you get inflamed, and you have trouble or pain for several days… Well, something like that happens when you get a virus. Situation: Sensory sensations are altered, everything is exposed and inflamed.” When the respiratory system is so sensitive, normal things (such as laughing, shortness of breath, cold air, and even talking) can cause a cough: “It’s like a cough reflex reaction The threshold is lowered, that’s why ‘every now and then'” Then you cough. “
Reducing inflammation is a slow process, for which inhaled cortisone is increasingly used. The answer to traditional pills for the 21st century. Russell also mentioned bronchodilators, drugs that can restore the bronchi to their original size.
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