Causes of coughing

The most common cause of cough is smoking. In 93.6% of cases, three pathological conditions cause cough in non-smokers: postnasal drip syndrome, bronchial asthma, and gastroesophageal reflux disease. The most common cause of acute cough is acute respiratory viral infection. It can also be a consequence of aspiration or inhalation of irritants. When cough occurs, both the patient and the doctor assume, first of all, a disease of the respiratory system, the bronchopulmonary apparatus. However, cough can be a manifestation of pathology of other organs and systems - circulatory and digestive, ENT organs, etc. In total, about 50 causes of cough are distinguished, which can be (conditionally) divided into groups.

• Inhalation of irritants (smoke, dust, gas);
• Aspiration of a foreign body, discharge from the upper respiratory tract (with sinusitis or rhinitis, discharge from the nose flows down the back of the throat - postnasal drip syndrome) or stomach contents (with gastroesophageal reflux disease).
• Inflammation of the respiratory tract.

Infectious causes of cough:

• ARVI:
• laryngitis, pharyngitis (may also be of non-infectious origin), chronic tonsillitis;
• acute and chronic bronchitis (after acute bronchitis, the cough may persist for several weeks due to increased sensitivity of the bronchi);
• pneumonia:
• lung abscess;
• bronchiectasis;
• pleurisy;
• whooping cough (can cause prolonged cough in both children and adults).

Allergic causes of cough:

• bronchial asthma:
• "eosinophilic" bronchitis; allergic rhinosinusitis.

Airway infiltration:

• in lung cancer:
• in carcinoid;
• in sarcoidosis:
• for tuberculosis.

Compression of the trachea and bronchi by enlarged lymph nodes, mediastinal tumor or aortic aneurysm, laryngeal cancer, goiter, strumectomy.

Interstitial, parenchymatous lung diseases (histiocytosis X, cryptogenic fibrosing alveolitis, etc.), pathology of the trachea and bronchi (tracheobronchial dyskinesia), diffuse connective tissue diseases (Sjogren's syndrome, etc.).

Cardiovascular causes of cough:

• heart failure (peribronchial and interstitial edema);
• aortic aneurysm:
• pulmonary embolism;
• heart defects;
• pericarditis.

Use of medications (taking ACE inhibitors, oxygen therapy, inhalation of powdered medicinal forms, "amiodoron lung"),

Psychogenic causes of cough.

Reflex causes of cough:

• in case of pathology of the external auditory canal (cerumen plugs), middle ear sound, etc.;
• with a long uvula;
• in gastroesophageal reflux disease (reflex as a result of stimulation of the vagus nerve receptors in the distal part of the esophagus);
• in hyperventilation syndrome.

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Mechanism of cough development

Cough as a protective reflex aimed at clearing the respiratory tract occurs with mechanical, chemical, thermal irritation of cough receptors or with the development of an inflammatory process. The reflex arc consists of five components:

1. Cough receptors.
2. Afferent nerves.
3. Medullary cough center.
4. Efferent nerves.
5. Effectors (respiratory muscles).

The cough reflex can be caused by stimulation of receptors in the oral cavity, paranasal sinuses, larynx (especially the interarytenoid space), vocal cords, pharynx, external auditory canal and auditory tube, trachea and its bifurcation, bronchial division zones, receptors in the pleura, pericardium, diaphragm, distal esophagus and stomach. The speed of the air flow created is slightly lower than the speed of sound. It should be clarified that not all foreign bodies inhaled with air are removed by coughing; a significant amount of dust particles, as well as mucus formed in moderate quantities, are removed from the bronchial lumen by the ciliated epithelium.

A long-term or regularly recurring cough usually reflects a pathological process. A high correlation has been proven between the degree of inflammation of the bronchial tree and the sensitivity of cough receptors. A lower cough threshold has been determined in women, i.e. coughing occurs faster in women than in men under the same provocation. The cough reflex is controlled by the cerebral cortex and can be suppressed to a certain extent. Like any other unconditioned reflex, cough does not always perform the function of protecting the respiratory tract. In some cases, it is a manifestation of a pathological process without any positive results.