Define cough
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Understanding Cough: Definitions, Classifications, and Implications
Definition and Mechanism of Cough
Cough is a reflex action of the respiratory tract aimed at clearing the upper airways. It typically involves a deep inspiration, glottal closure, and an explosive expiration accompanied by a sound. This reflex is essential for protecting the respiratory system from irritants and pathogens.
Classification of Cough: Acute, Subacute, and Chronic
Acute Cough
Acute cough lasts less than three weeks and is most commonly caused by respiratory infections, often viral, and exacerbations of underlying conditions like asthma and COPD. The common cold is a frequent cause, leading to direct irritation of upper airway structures.
Subacute Cough
Subacute cough persists for three to eight weeks. It is often a result of postinfectious cough or exacerbations of conditions such as asthma, COPD, and upper airway cough syndrome (UACS). This type of cough can follow a viral upper respiratory infection, leading to an inflammatory response.
Chronic Cough
Chronic cough lasts more than eight weeks and can significantly impair quality of life. Common causes include UACS from rhinosinus conditions, asthma, gastroesophageal reflux disease (GERD), and nonasthmatic eosinophilic bronchitis . Chronic cough is also associated with neuronal hypersensitivity, indicating a distinct intrinsic pathophysiology.
Causes and Pathogenesis of Chronic Cough
Chronic cough can be triggered by various factors, including cigarette smoke, environmental pollution, and diseases like asthma, eosinophilic bronchitis, and GERD. It is often linked to an increased response to tussive agents and structural changes in the airway mucosa. Effective management requires addressing both the underlying disease and desensitizing the cough pathways.
Cough in Specific Populations
Athletes
In athletes, cough is commonly associated with asthma, exercise-induced bronchoconstriction, respiratory tract infections, and environmental exposures. The management of cough in athletes should consider the specific training context and anti-doping regulations.
Occupational and Environmental Factors
Occupational and environmental exposures can contribute to cough through irritant or hypersensitivity responses. Common indoor irritants include cigarette smoke, cooking fumes, and allergens like dust mites and fungi. Recognizing these factors is crucial for effective intervention and management.
Complications and Impact on Quality of Life
Cough can lead to a wide range of complications, from minor issues like lightheadedness to severe conditions such as cervical artery dissection. It can also cause significant emotional and psychological harm, affecting patients' quality of life.
Conclusion
Cough is a complex reflex with various classifications and causes. Understanding its mechanisms, classifications, and the factors contributing to chronic cough is essential for effective diagnosis and management. Addressing both the underlying causes and the cough reflex itself can improve patient outcomes and quality of life.
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