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Causes of cough
Last reviewed: 23.04.2024
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The most common cause of coughing is smoking. In nonsmokers, in 93.6% of cases, the cause of cough is three pathological conditions: postnasal permeation syndrome, bronchial asthma, gastroesophageal reflux disease. The most common cause of acute cough is ARVI. It can also be a consequence of aspiration or inhalation of irritants. When a cough occurs, both the patient and the doctor presume, first of all, the disease of the respiratory system, the bronchopulmonary apparatus. However, coughing can be a manifestation of the pathology of other organs and systems - the circulatory and digestive, ENT organs, etc. A total of about 50 causes of cough, which can (conditionally) be divided into groups.
- Inhalation of irritants (smoke, dust, gas);
- Aspiration of the foreign body, the separated upper respiratory tract (with sinusitis or rhinitis, the discharge from the nose flows down the posterior wall of the pharynx - the syndrome of the postnazal swallow) or the contents of the stomach (with gastroesophageal reflux disease).
- Inflammation of the respiratory tract.
Infectious causes of cough:
- SARS:
- laryngitis, pharyngitis (may be non-infectious genesis), chronic tonsillitis;
- acute and chronic bronchitis (after acute bronchitis, cough can persist for several weeks due to increased sensitivity of the bronchi);
- pneumonia:
- an abscess of the lung;
- bronchiectasis;
- pleurisy;
- whooping cough (may be the cause of a prolonged cough in both children and V adults).
Allergic causes of cough:
- bronchial asthma:
- "Eosinophilic" bronchitis; allergic rhinosinusitis.
Infiltration of the respiratory tract:
- for lung cancer:
- with carcinoid;
- in sarcoidosis:
- with tuberculosis.
The compression of the trachea and bronchi by enlarged lymph nodes, mediastinal tumor or aortic aneurysm, laryngeal cancer, goiter, and strumectomy.
Interstitial, parenchymal diseases of the lungs (histiocytosis X, cryptogenic fibrosing alveolitis, etc.), trachea and bronchial pathology (tracheobronchial dyskinesia), diffuse connective tissue diseases (Sjögren's syndrome, etc.).
Cardiovascular causes of cough:
- heart failure (peribronchial and interstitial edema);
- aortic aneurysm:
- pulmonary embolism;
- heart defects;
- pericarditis.
The use of therapeutic agents (the use of ACE inhibitors, oxygen therapy, inhalation of powder dosage forms, "amiodoric lung"),
Psychogenic causes of cough.
Reflex causes of cough:
- with the pathology of the external auditory canal (sulfur plugs), the mean of ud, etc.;
- with a long palatine tongue;
- at a gastroesophageal reflux disease (reflex as a result of stimulation of receptors of a vagus nerve in a distal part of an esophagus);
- with hyperventilation syndrome.
[Mechanism of cough development
Cough as a protective reflex, aimed at cleansing the airways, occurs when mechanical. Chemical, thermal stimulation of cough receptors or in the development of the inflammatory process. The reflex arc consists of five components:
- Cough receptors.
- Afferent nerves.
- Medullary cough center.
- Efferent nerves.
- Effectors (respiratory muscles).
The cough reflex can be caused by the stimulation of the oral cavity receptors, the paranasal sinuses, the larynx (especially the intercellular spaces), the vocal cords, the pharynx, the external auditory canal and the auditory tube, the trachea and its bifurcation, the bronchial divisions, pleural receptors, pericardium, diaphragm, esophagus and stomach. At the same time, the speed of the created air flow is not much lower than the speed of sound. It is necessary to clarify that not all foreign bodies inhaled with air are removed with the help of a cough; a significant amount of dust particles, as well as mucus formed in a moderate amount, are excreted from the lumen of the bronchi by the ciliated epithelium.
A prolonged or recurrent cough, as a rule, reflects a pathological process. Proved a high correlation between the degree of inflammation of the bronchial tree and the sensitivity of cough receptors. Women have a lower cough threshold, i.e. Cough with the same provocation occurs more quickly in women than in men. The cough reflex is under the control of the cerebral cortex and to a certain extent can be suppressed. Like any other unconditioned reflex, cough does not always perform the function of protecting the respiratory tract. In some cases, it represents a manifestation of the pathological process without any positive results.