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Violent Coughing

Is there a cure for my bouts or violent coughing?

Question

Last spring I started to suffer from a persistent cough, which later became associated with mucus passing down to my throat and into my mouth. This resulted in periodic bouts of violent coughing. My GP prescribed a nasal spray, but this had no effect. What can you suggest?

Answer

There are many factors which can cause a persistent cough. Below I outline some of the different possible causes. I suggest that you try to identify what is happening, then go back to your doctor and discuss it.

When you cough, your abdominal muscles contract suddenly and push up your diaphragm. At the same time, the vocal cords narrow, increasing the force. Coughing is a reflex action or defensive reaction to some from of irritation or obstruction in the airway path from the throat to the lungs. This path goes through the larynx, trachea (windpipe), bronchial tubes and alveoli (air sacs). A problem at any point on this path will lead to coughing.

Irritations:

Irritations can be caused by bacterial or viral infections or by inflammatory conditions, such as bronchitis, pharyngitis or laryngitis. If you have a fever, then the cause is an infection.

Inflammations are not always due to infections. For example, after a course of antibiotics, the germs may die but the inflammation caused by the original infection may continue. Treating this type of persistent cough with more antibiotics simply won’t work; equally, treating a virus with antibiotics has no effect.

If the cough is in the throat, the irritation is usually caused by postnasal drip - that is, mucus coming down from the sinuses, or by chronic (ie long-term) inflammation.

Another likely cause is acid regurgitating from the stomach into the throat. In this case, the cough starts soon after lying down. If the cough is moist with phlegm and you cough continuously until the phlegm comes out, the likelihood is that the cause is an inflammation.

Obstructions:

The most common obstructive cause of persistent coughing is bronchial spasm akin to asthma. In this case, the cough is triggered because the body is reacting against the intake of either cold air or particles to which it is allergic, such as pollen, dust or chemicals. The bronchial tract then goes into a spasms with an audible whistling wheeze.

If a cough is dry, ahs a high-pitched sound and is of moderate intensity, occurring spasmodically but worsening in the early hours of the morning after 4 am, then it is likely that this asthma - like bronchial spasm is taking place.

Other obstructions can include mucus or phlegm, dust particles or being growths. In rare cases, parasites called roundworms lodge in the bronchial tract and cause a persistent cough. More worryingly, a persistent cough can be caused by a tumour (which may be carcinogenic), or by permanent infection in the lung tissues caused by a viral condition such as viral pneumonia or tuberculosis, or , in rare cases, by a fungal infection. In the case of these infections, the cough is usually accompanied by a high fever which tends to peak after 4pm.

Smokers often suffer from coughs with phlegm. The cure is usually simple: stop smoking.

You could try the following tips to cure a persistent cough, but if you are worried, please see your doctor immediately and make sure that your symptoms are thoroughly investigated.

  • Drink only warn water – not just room temperature, warm!
  • Avoid mucus-producing foods such as dairy products, bananas, excess carbohydrates and spicy food.
  • Avoid acid-producing foods such as citrus fruits, chillies, vinegar, mushrooms, nuts. Also, try the following:
  • The Unani remedy Lauq sapistan which reduces mucus: ½ tsp daily for 15 days.
  • Kuka which helps reduce irritation in the throat: suck one tablet twice daily for seven days.
  • Dr Ali’s Sinus Oil, which helps prevent postnasal drip: two drops in each nostril, while lying on the back, once or twice daily.
  • Buttercup syrup, which eliminate phlegm and soothe ticklish coughs: 1 tsp in warm water twice daily for ten days.
  • Vicks VapoRub – use as a steam inhalation.
  • Consider a course of acupuncture and/;or homoeopathy.
  • If possible, take a short break in a hot, dry place, which will help heal the bronchial tract.

The soothing Breath:

    The following breathing exercises may help ease a cough.

  • Looking up, contract your diaphragm in quick succession 15 times, breathing in and out rapidly through your nose. Repeat this, looking ahead, then looking down.
  • Look to the right and inhale through your nose, then look to the left and exhale forcefully through your mouth, pushing the air out of your body. Switch to the left side. Do this lateral breathing 15 times on each side.
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