See also CANKER SORE; CORNEAL INJURY; OCULAR
HERPES SIMPLEX.
cough The forceful expulsion of air through the
airway as a REFLEX designed to prevent matter,
including mucus, from entering the LUNGS. Cough
can be a symptom of many health conditions,
from minor and temporary irritations of the phar-
ynx (upper THROAT) and structures of the airways,
such as those COLDSand allergens can cause, to
serious and potentially life-threatening conditions
such as laryngeal CANCER, TUBERCULOSIS, CHRONIC
OBSTRUCTIVE PULMONARY DISEASE (COPD), and LUNG
CANCER. Cough also can signal a blockage of the
airway, which is a medical emergency. Occasion-
ally cough is an undesired SIDE EFFECTof certain
medications, notably the angiotensin-converting
enzyme (ACE) inhibitor medications prescribed to
treat HYPERTENSION(high BLOOD PRESSURE).
Coughs fall into two major classifications: acute
and chronic. Acute cough comes on suddenly and
lasts less than three weeks; chronic cough contin-
ues for longer than three weeks. Within these
classifications, cough may be productive (bring up
mucus or sputum) or nonproductive (typically a
dry, hacking cough). Treatment depends on the
kind of cough and focuses on first eliminating any
underlying causes. There are two main classifica-
tions of cough medications: antitussive (suppresses
the cough) and expectorant (thins the mucus).
When Cough Is an EmergencyA sudden cough, especially one that comes on
when eating, may indicate that the person has
aspirated (inhaled into the airway) a particle of
food or other object. Do not allow someone who
starts coughing while eating to leave the table
unattended. Instead, ask the person to give a ver-
bal answer to the question, “Are you okay?” If the
person cannot speak to answer the question, he or
she likely has a blocked airway.
Aspiration is a medical emergency that
requires prompt response. Perform a
HEIMLICH MANEUVER immediately for a
blocked airway. Call 911 for emergency
medical aid if the coughing or choking
continues.Acute Cough
An acute cough generally accompanies a health
condition of sudden onset such as an upper respi-
ratory INFECTION(colds, flu, BRONCHITIS, PNEUMONIA),
SINUSITIS (sinus infection), and PHARYNGITIS. An
acute cough can be either productive or nonpro-
ductive though is usually productive because the
IMMUNE SYSTEMincreases mucus production to help
rid the body of the PATHOGEN. ANTIBIOTIC MEDICA-
TIONSare necessary to treat infections that are bac-
terial. Viral infections typically run their course
and do not require medications except to relieve
symptoms. In infections, coughs are often produc-
tive, bringing up dead cells and other debris that
the body needs to clear from the airways. POST-
NASAL DRIP, which irritates the pharynx, is a key
cause of coughs related to upper respiratory infec-
tions.COVERING A COUGH
Coughs can spread infections both through
droplets in the air and through hand contact.
Health experts recommend coughing into the
crook of the arm rather covering the mouth with
the hands. Frequent HAND WASHINGalso helps
reduce the spread of pathogens.Chronic Cough
A chronic cough may signal an underlying health
condition or may exist as a response to continued
irritation, most commonly cigarette smoking.
Other common causes of chronic cough include- GASTROESOPHAGEAL REFLUX DISORDER (GERD), in
which gastric acid from the stomach enters and
irritates the throat - asthma and seasonal allergies
- chronic sinusitis
- pulmonary diseases such as chronic bronchitis,
COPD, and BRONCHIECTASIS
Generally, eliminating the underlying cause of
chronic cough also eliminates the cough. A signifi-
cant risk with smoker’s cough is that it develops so
gradually the smoker may not realize how often
he or she coughs. The cough may exist as a
response to the irritation of smoking or may signal
a serious health condition such as lung disease or18 The Ear, Nose, Mouth and Throat