If the cough does not go away: which specialist to rush to and why heartburn should alert you

Health Tips

When coughing for two weeks is the norm

Cough itself is a heterogeneous symptom. The presence or absence of sputum, its quantity and composition, the frequency of symptoms, the “depth” of cough – these are just a few important features that a specialist should clarify when analyzing a clinical case. For example, after completion of treatment for acute respiratory infections (laryngitis, tracheitis, bronchitis), the so-called “residual” cough can persist for up to two weeks. If the intensity and frequency of cough reflexes steadily decreases, then you can not worry much and give the body the opportunity to restore the status quo on its own.

However, it is not uncommon for a cough to persist longer and at a consistently “unhealthy” level. Coughing attacks are disturbing or “coughing” interferes with falling asleep, the cough is aggravated by a long conversation or by changing the position of the body (lying down, for example). There are cases when patients cough for months and even years, and here it is necessary to understand in detail, in the vast majority of cases this is a multidisciplinary problem, examinations and examinations by completely different specialists are necessary.

When to See a Cardiologist

When a productive, “wet” cough (with sputum) develops against the background of SARS and subsequent involvement of the tracheobronchial tree, it is more or less logical to assume the mechanism of cough development, the therapist or pulmonologist will quickly figure it out and prescribe the appropriate treatment. It must be emphasized that, in any case, this should be done by a specialist, since many questions immediately arise, from the appointment of antibacterial agents to antihistamines, from the use of physiotherapy to inhalations.

A productive cough outside of an acute or chronic infectious process should be analyzed by a cardiologist, in view of possible problems in the pulmonary circulation and heart disease leading to a violation of its pumping function. Extremely often, cardiologists are faced with a reflex dry cough caused by one of the most common groups of drugs for the treatment of hypertension. And then, the prescribed long-term therapy needs to be corrected.

A number of pathological processes that are within the competence of an otorhinolaryngologist lead to the development of such a symptom as a cough. Again, as part of seasonal SARS, with the development of laryngitis (inflammation of the larynx and vocal folds), a dry, hacking (it is also called “barking”) cough appears, accompanied by hoarseness and hoarseness of voice. In conditions of stable immunity, these phenomena are resolved independently, subject to vocal rest. In protracted cases, the otolaryngologist conducts one or a series of intralaryngeal infusions of anti-inflammatory drugs right at the reception, in some cases, physiotherapy department procedures and inhalations are effective.

What do cough and heartburn have in common?

Separately, I want to talk about the implicit mechanism for the development of cough. It is detected quite often and it must be excluded or confirmed as part of the examination of a long-term coughing patient. We are talking about such a gastroenterological problem as gastroesophageal reflux disease. When the acidic contents of the stomach are thrown into the lower esophagus. Moreover, the main symptoms of this disease (heartburn) can be expressed slightly and not cause much concern to the patient. If the valve between the esophagus and the stomach fails, its acidic contents can also enter above the lower esophagus, this is especially easy to implement at night, when the person is in a horizontal position. The described chain of events and circumstances leads to chronic irritation of the hypopharyngeal mucosa, and then to cough, morning sore throat, hoarseness, etc.

Summing up, we can designate the following route for a long-term coughing patient. The movement of the patient begins with the therapist (pediatrician) for the initial examination, assessment of the general condition and assumptions about the possible causes of the development of symptoms. The pulmonologist will evaluate the contribution of the lower, and the otorhinolaryngologist of the upper respiratory tract to the pathogenesis of the problem.

Not getting an unambiguous understanding of the situation, we refer patients to a gastroenterologist and a cardiologist for an even more detailed examination.

Cough with coronavirus: what to look for

It makes sense to talk separately about coughing with COVID-19. According to clinical observations, a dry cough that develops with coronavirus pneumonia (more precisely, interstitial pneumonitis) may be accompanied by shortness of breath. However, only two out of three patients with a moderate course of coughing, in the majority of young and relatively healthy people, COVID-19 is asymptomatic.

It is not worth suspecting coronavirus in every cough reflex, just as if a positive test for coronavirus is detected without symptoms, immediately start taking cough medicines, or even more so antibiotics!

If symptoms of malaise appear, it is necessary to consult a doctor, and at the reception a decision will already be made on the need for testing and its volume, qualitative or quantitative: PCR for the presence of a virus in the nasopharynx and / or ELISA for the presence of antibodies.

Photo: Pexels.com

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