to cough

What is cough?

Cough is not a disease, but a protective reaction of the body to expel mucus or foreign objects from the airways.

Millions of cilia sit on the mucous membrane of our airways and can move like a lawn swaying in the wind. There is a thin layer of mucus on these cilia. Pathogens (such as bacteria, fungi or viruses), dust, pollen and other small molecules get stuck in this mucus and are transported together with the mucus towards the throat, where the mucus is either swallowed or coughed up. However, this effective cleaning system is hampered if there is a respiratory infection. Then more and more viscous mucus is produced, which can no longer be easily removed and which accumulates on the mucous membrane. The body responds with a cough to remove the mucus from the airways.

But not only diseases such as or caused by viruses or bacteria can cause irritation to the respiratory tract. Also, smoke, gases and swallowed objects can cause coughing fits.

causes

Respiratory tract infections are caused by a large number of viruses and occur more frequently the younger the child and the more they are in contact with other children (time to get used to community facilities). In young children, such infections can occur six to eight times a year. The frequency of diseases decreases with increasing age.

The risk of infection is greatest two to four days after the onset of the disease. About droplet infection, i.e. Transmission takes place via tiny droplets that cough or sneeze infected people and those close to them, or via infected nasal secretions that get into the mouth, nose or eyes through hands and objects.

symptoms & disease

Cough usually begins with a burning sensation in the chest, which develops into a painful, dry cough – usually associated with a feeling of illness. In the course of the cough becomes looser and the mucus dissolves.
There are two subdivision schemes for cough. A distinction is made between dry (unproductive cough or irritable cough) and wet (productive) cough. A cough can also be differentiated according to the duration. With a duration of less than eight weeks, one speaks of acute cough, from a duration of more than eight weeks or months of chronic cough.

Dry cough (unproductive cough or irritable cough)

As the name suggests, this cough is unproductive, i.e. there is no expectoration. It occurs mainly at the beginning of colds, also in bronchitis, bronchial asthma and when foreign bodies have entered the airways.

Wet cough (productive cough)

During productive cough, mucus that has accumulated in the airways is coughed up. It usually occurs in the later stages of colds, bronchitis or pneumonia. The coughed up mucus is usually clear. If there is a bacterial infection, it becomes yellowish and greenish and clumps.

Acute cough

Coughing is usually caused by infections with viruses (more than 90%) of the upper and middle respiratory tract as part of a flu infection and does not last longer than 8 weeks. Slight fever and colds therefore occur in many cases. There are a total of over 200 cold viruses. Second infections with the same viruses are also quite common. The cough is initially dry and then becomes "wet" when phlegm begins to dissolve. Sometimes a bacterial infection can be associated with a viral cough, then one speaks of bacterial superinfection (e.g. by pneumococci, staphylococci).

Children are at risk of foreign objects such as small-sized toys, erasers and the like. a. http://www.kinderaerzte-im-netz.de/bvkj/contentkin/show.php3? >

Chronic cough

If the cough (possibly with expectoration) lasts longer than eight weeks, it is called chronic. The causes should always be clarified by the pediatrician. The most common causes of chronic cough are asthmatic diseases (including food intolerance), chronic bronchitis, chronic sinusitis, pneumonia (pertussis) and constant inhalation of air pollutants, such as cigarette smoke, can lead to chronic cough.

diagnosis

The pediatrician recognizes an acute cough through the parent / patient survey and examination (including eavesdropping). In some cases, he has to clarify whether it is not an infection but an allergic asthma.

Foreign body aspiration may also be present in young children with a cough. If suspected, this can be confirmed by imaging procedures (e.g. x-rays) or invalidated. Even with suspected pneumonia, further investigations required.

Nocturnal cough can indicate, for example, croup or even heartburn (reflux). In rare cases, chronic diseases lead to repeated coughing or pneumonia such as Cystic fibrosis (cystic fibrosis: CF).

Accompanying breathing sounds and additional symptoms such as Rashes, pain, the appearance of the sputum, nocturnal mouth breathing give the doctor important information for his diagnosis. How much testing is required depends on the severity and duration of the cough. The diagnosis can range from the patient’s medical history and blood collection to differentiated lung function diagnostics and – if necessary – invasive measures such as endoscopy.

therapy

Cough is a protective mechanism of the body and should therefore not be suppressed with medication. In exceptional cases, if the cough is excruciating or especially occurs at night and hinders sleep, after consultation with the pediatrician, medications can be given to suppress the cough (cough suppressant, antitussive drugs) or to resolve it (cough releasers, expectorants).

In any case, a lot of liquid, especially warm drinks such as tea, should be drunk, as this will make the mucus in the airways more fluid and easier to cough up. Steam baths and inhalations have a similar effect.

To soothe the throat irritated by the cough, there are cough syrups, syrups, lozenges, cough drops and garlic solutions that briefly numb the cough receptors. The effectiveness of these aids has not yet been proven by scientific studies.

Anti-inflammatory substances (corticosteroids), which are inhaled or sprayed in, relieve the cough in asthma.

Dry cough

Old home remedies such as hot milk with honey or over-the-counter cough syrups often help against dry cough. Soothing cough blockers (antitussives), which in extreme cases contain codeine and suppress the urge to cough, require a prescription and must be prescribed by the pediatrician. They should therefore only be used when the cough is dry and when the cough affects sleep very badly at night. Extracts of medicinal plants, such as from marshmallow root or Icelandic moss, can have a soothing effect on irritable cough.

Wet cough (productive cough)

If the cough is moist or productive, expectorants can help expectorate the viscous mucus. The active ingredient acetylcysteine, for example, changes the structure of the mucus, makes it less tough and thus makes it easier to remove. Active ingredients such as ambroxol or bromhexine stimulate the production of a thin slime. Expectorants are available – depending on the active ingredient, of course – in a wide variety of dosage forms, as juice, capsules, as effervescent tablets or as granules to dissolve. The last-mentioned preparations have the advantage that, in addition to the active ingredient, you also consume liquid.

Antibiotic therapy is not a primary cough treatment and will only be used by the pediatrician if there is evidence of a bacterial infection.

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