We’ll be talking about treatment of chronic cough including home remedies, medication and prevention and then finally we’ll review when and why to visit a pediatric pulmonologist. So first up why do we cough, we cough for many reasons, we cough to protect our airway from irritants, we cough to clear the mucus we make on a daily basis and the extra mucus we have when we’re sick and cough can be an early warning sign of disease and how do we cough? we have many cough receptors in our body, their job is to sense irritants and send signals up to the brain and that sends signals back to the body to produce that cough and so the definition of how do we know when a cough is chronic? the definition of chronic cough is based on time and for comparison, an acute cough or a shorter term cough is one that lasts for a month, less than a month and these are usually caused by viral illnesses, the symptoms last seven to fourteen days and in a ninety percent of the cases, the symptoms in the cough goes away on their own but the cough is called chronic if this cough lasts for more than a month, there are some viral illnesses that cause a cough that lasts for more than four weeks but the pediatric community uses this cut off to make sure we’re not missing any more serious underlying conditions so when the cough becomes chronic, if it affects daily functioning or is associated with any other health problems then this is when we become concerned and start looking for causes other than viral illness and discovering the cause of a chronic cough can be challenging because there are many causes, first up i’m listing the more common causes that we’re looking for and this is asthma, foreign body in the airway or even in the ear that can trigger those cough receptors.

Gastrointestinal issues can actually cause chronic cough, this would be gastroesophageal reflux or gerd where food is coming up towards the airway and irritating and causing cough or people or children can have trouble swallowing and food can go towards their airway, also there’s a tick cough and then there could be habit coughs, a habit cough is some cough that often starts as a viral illness but over time, the cough receptors become more sensitive and it turns into this vicious cycle of this harsh honking loud cough, the habit cough can go away sometimes fairly quickly with specialized therapy and cough biofeedback and then also there are infections that can cause chronic cough, a variety of them bacterial, sometimes viral and then there’s something called the upper airway cough syndrome formerly known as post nasal drip and this is actually caused by underlying issues such as allergies sinusitis irritants such as smoke or sometimes the tissue in the upper airway called the adenoids can be large and cause congestion and lead to cough post nasal drip and cough and there are many other common causes that are less common and these often are conditions that children are born with, sometimes there are some acquired causes such as lung damage after an infection or because of some of the other conditions and unfortunately there can be tumors so we have to be aware of causes such as that and that’s why it’s important to involve a pediatric pulmonologist because there are so many causes they’re trained to identify and treat and manage them and so next up we’d review the treatment for the chronic cough. Before we get into the details, just a couple words about the expectations when we’re treating a chronic cough and i wanted to get the bad news out of the way first so there’s not always a quick fix to treat chronic cough, unfortunately the mainstay of treatment is symptom management, close monitoring and reassurance and also a chronic cough can be very frustrating, it leads to poor sleep and children sometimes miss school work and sometimes even the cough becomes chronic and at some some point it’s not contagious anymore but children may get sent home from school and you know it’s also frustrating for health care providers because we all really want to get rid of this cough very quickly and sometimes it’s just not possible but then the good news is that the cause of the cough usually will be found, this may take thorough evaluation and frequent follow-up with the pediatric pulmonologist but the cause is usually discovered and many times the cough will go away depends on the underlying cause of what’s causing the cough.

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