Cough 196974 225894182 2008-07-15T22:11:14Z Diligent Terrier 2499413 Reverted edits by [[Special:Contributions/92.22.83.54|92.22.83.54]] to last version by Bigtophat (using [[WP:HG|Huggle]]) {{SignSymptom infobox | Name = Cough | ICD10 = {{ICD10|R|05||r|00}} | ICD9 = {{ICD9|786.2}} | }} A '''cough''', also known as '''tussis''' is a sudden, often repetitive, [[spasm]]odic contraction of the [[thoracic cavity]], resulting in violent release of air from the [[lung]]s, and usually accompanied by a distinctive sound. Coughing is an action the body takes to get rid of substances that are irritating the breathing passages. A cough is usually initiated to clear a buildup of [[phlegm]] in the [[vertebrate trachea|trachea]]. Coughing can also be triggered by a [[Bolus (digestion)|bolus]] of food entering the trachea rather than the [[esophagus]] due to a failure of the [[epiglottis]]. Frequent or [[Chronic (medical)|chronic]] coughing usually indicates the presence of a [[disease]]. Provided the patient is a non-smoker and has a normal chest [[X-ray]], the cause of chronic cough in 93% of all patients is due to [[asthma]], [[heartburn]] or [[post-nasal drip]]. Other causes of chronic cough include [[chronic bronchitis]] and medications such as [[ACE inhibitor]]s. Coughing can happen voluntarily as well as involuntarily. ==Physiology== A cough is a protective, primitive [[reflex]] in healthy individuals. The cough reflex is initiated by stimulation of two different classes of [[afferent nerve]]s, namely the [[myelin]]ated rapidly adapting receptors, and nonmyelinated [[Group C nerve fiber|C-fibers]] with endings in the [[lung]]s. However it is not certain that the stimulation of nonmyelinated [[Group C nerve fiber|C-fibers]] leads to cough with a [[reflex]] as it's meant in [[physiology]] (with its own five components): this stimulation may cause [[mast cell]]s [[degranulation]] (through an asso-assonic reflex) and [[Edema|edema]] which may work as a stimulus for rapidly adapting receptors. ==Cause== "Persistent cough can be debilitating, socially distressing, and adversely impair quality of life."<ref name="omaretal">{{cite journal | author = Omar S. Usmani, Maria G. Belvisi, Hema J. Patel, Natascia Crispino, Mark A. Birrell, Marta Korbonits, Dezso Korbonits, and Peter J. Barnes | title = Theobromine inhibits sensory nerve activation and cough. | journal = The FASEB Journal | volume = 19 | pages = 231–233 | year = 2005 | url = http://www.fasebj.org/cgi/reprint/19/2/231.pdf | format = pdf | language = english}}</ref> One of the more common presentations to a medical practitioner is a dry cough. The common causes of chronic dry coughing include [[post-nasal drip]], [[gastroesophageal reflux disease]], [[asthma]], [[post viral cough]] and certain [[drug]]s such as [[beta blocker]]s, [[ACE inhibitor]]s and [[aspirin]]. One of the causes of chronic coughing might even be [[mouth breathing]] induced dryness in the throat. If a cough lasts for more than three weeks, multiple causes are likely and symptoms will abate only when all the causes are treated will the patient be symptom free. Individuals who [[Smoking|smoke]] often have a [[smoker's cough]], a loud, hacking cough which often results in the expiration of [[phlegm]]. In Third World countries, where endemic tuberculosis and HIV related lung disease predominate, structural damage of the airways often occurs with resulting chronic cough.{{Fact|date=March 2008}} Coughing may also be used for psychological or social reasons, such as the coughing before giving a speech. This is known as psychogenic, habit or tic coughing, and may increase in frequency in social situations featuring conflict.<ref>{{citation | title = Coughing as an Indicator of Displacement Behaviour | url = http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ33337.pdf | author = Arella, A. | year = nd }} (Unpublished thesis)</ref> Given its irritant nature to mammal tissues, [[capsaicin]] is widely used to determine the cough threshold and as a tussive stimulant in clinical research of cough suppressants. == Complications == The complications of coughing can be classified as either [[Acute (medicine)|acute]] or [[Chronic (medical)|chronic]]. Acute complications include cough syncope ([[fainting]] spells due to decreased blood flow to the brain when coughs are prolonged and forceful), [[insomnia]], cough-induced [[vomiting]], rupture of [[bleb]]s causing [[Pneumothorax#Spontaneous Pneumothorax|spontaneous pneumothorax]] (although this still remains to be proven), [[subconjunctival hemorrhage]] or "[[red eye (medicine)|red eye]]," coughing [[defecation]] and in women with a [[prolapse]]d [[uterus]], cough [[urination]]. Chronic complications are common and include abdominal or pelvic [[hernia]]s, fatigue [[fracture]]s of lower ribs and [[Tietze's syndrome|costochondritis]]. == Treatment == Coughs can be treated with [[cough medicine]]s. Dry coughs are treated with cough suppressants (antitussives) that suppress the body's urge to cough, while productive coughs (coughs that produce [[phlegm]]) are treated with expectorants that loosen [[mucus]] from the [[respiratory tract]]. Centrally acting cough suppressants, such as [[codeine]] and [[dextromethorphan]] reduce the urge to cough by inhibiting the response of the sensory endings by [[depolarization]], or a dulling, of the [[vagus nerve]], the nerve leading from the brain stem and serving the chest area. A recent study indicates that, because of the presence of [[theobromine]] in chocolate, 50 grams of dark [[chocolate]] may be an effective treatment for a persistent cough.<ref name="omaretal"/> Research has demonstrated that gargling with a mixture of warm water and [[salt]] washes away the layer of mucus on the throat containing bacteria and proteins that cause inflammation, according to the American Academy of Otolaryngology.<ref>[http://healthletter.tufts.edu/issues/2003-01/asktufts.html Ask Tufts Experts (Tufts Health & Nutrition Letter, January 2003)<!-- Bot generated title -->]</ref> ==During injections== Coughing during an [[Injection (medicine)|injection]] can lessen the pain of the needle stick caused by a sudden, temporary rise in pressure in the chest and spinal canal, inhibiting the pain-conducting structures of the spinal cord.<ref>{{cite journal | pmid = 14742367 | title = Reducing venipuncture pain by a cough trick: a randomized crossover volunteer study | last = Usichenko | first = TI | coauthors = Pavlovic D, Foellner S & Wendt M. | year = 2004 | journal = Anesthesia and Analgesia | pages = 952–3 | volume = 99 | issue = 3 | doi = 10.1213/01.ANE.0000131941.61962.09 | doi_brokendate = }}</ref> ==Psychological causes of Cough== Sometimes a cough can be found to have no apparent physical or medical cause. In these instances emotional and psychological problems are likely causes and the cough is often called a "psychogenic cough" (also known as a "[[habit cough]]" or "tic cough"). However, other illnesses have to be ruled out before a firm diagnosis of psychogenic cough is made. Psychogenic cough is thought to be more common in children than in adults. A possible scenario: psychogenic cough develops in a child who has a chronically ill brother or sister. ==Social aspects of coughing== Coughing is not always involuntary, and can be used in social situations. Coughing can be used to attract attention, release internal psychological tension, or become a maladaptive displacement behavior. It is believed that the frequency of such coughing increases in environments vulnerable to psychological tension and social conflict. In such environments, coughing may become one of many [[displacement]] behaviors and/or [[defense mechanism]]s. == See also == *[[Croup]] *[[Pertussis]] *[[Kennel cough]] ==References== {{reflist}} * {{cite journal | author = McCool F | title = Global physiology and pathophysiology of cough: ACCP evidence-based clinical practice guidelines. | journal = Chest | volume = 129 | issue = 1 Suppl | pages = 48S–53S | year = 2006 | pmid = 16428691 | doi = 10.1378/chest.129.1_suppl.48S | doi_brokendate = }}''[http://www.chestjournal.org/cgi/content/full/129/1_suppl/48S Full text]'' *{{cite journal | author = Irwin, RS, Glomb, WB, Chang, AB | title = Habit Cough, Tic Cough, and Psychogenic Cough in Adult and Pediatric Populations. | journal = Chest | volume = 129 | issue = 1 Suppl | pages = 174S–179S | year = 2006 | pmid = 16428707 | doi = 10.1378/chest.129.1_suppl.174S | doi_brokendate = }}''[http://www.chestjournal.org/cgi/reprint/129/1_suppl/174S.pdf]'' == External links == {{Wiktionary}} *[http://cough-germproof.com Children's Cough Resource] *[http://www.undiag.com/symptoms/cough.php Cough details, causes and treatment] *[http://familydoctor.org/handouts/237.html FamilyDoctor.org &ndash; Chronic cough: causes and cures] {{Circulatory and respiratory system symptoms and signs}} {{Common Cold}} [[Category:Reflexes]] [[Category:Symptoms]] [[Category:Abnormal respiration]] [[ar:سعال]] [[ay:K'aja]] [[bs:Kašalj]] [[ca:Tos]] [[cs:Kašel]] [[de:Husten]] [[et:Köha]] [[es:Tos]] [[eu:Eztul]] [[fr:Toux]] [[io:Tuso]] [[id:Batuk]] [[it:Tosse]] [[he:שיעול]] [[la:Tussis]] [[lt:Kosulys]] [[ml:ചുമ]] [[ms:Batuk]] [[nl:Hoest]] [[ja:咳嗽]] [[no:Hoste]] [[pl:Kaszel]] [[pt:Tosse]] [[qu:Uhu]] [[ru:Кашель]] [[scn:Tussi]] [[simple:Cough]] [[sl:Kašelj]] [[sr:Кашаљ]] [[fi:Yskä]] [[sv:Hosta]] [[te:దగ్గు]] [[tr:Öksürük]] [[zh:咳嗽]]