Want to stop that persistent cough?Doctors say it often just takes patience and time

A persistent, nagging cough. They are unpleasant, aggravating, and unfortunately all too common after various viral infections.

Research shows that 'post-infectious cough', which refers to symptoms that last three to eight weeks after an initial respiratory infection such as a cold, flu or coronavirus, affects up to a quarter of adults. is suggested.

So what can you do to permanently cure such a persistent cough?

Often it's a matter of patience and time, but Suggest a trio of doctors said in an article published Monday in the Canadian Medical Association Journal (CMAJ).

“In most cases, a cough will go away on its own without medication or treatment, but it can last much longer than you think,” says Kevin, one of the authors of the article and a Vancouver-based family physician. Dr. Liang said in an interview. Along with CBC News.

Liang, a clinical lecturer in the Department of Family Practice at the University of British Columbia, said patients often worry about a persistent cough and wonder if the initial infection is still present.

But that's usually not the case, he stressed.

What is actually happening, Liang et al. write, is that the preceding infection sets off an “inflammatory cascade” that increases bronchial hyperresponsiveness and mucus production while decreasing mucus clearance.

In other words, the inflammation makes your nose runny and makes parts of your lungs more sensitive, a combination that causes your body to cough over and over again.

And Liang says there is no quick fix.

The length of a prolonged cough is important.

The question of how to deal with an unpleasant cough is an old one.

For many years, doctors have classified coughs into two categories. One is an acute cough that is short-term, and the other is a chronic cough that lasts for more than a few weeks. However, more recently, Guidance has begun to shift to the third category of 'subacute' coughs It lasts only 3 to 8 weeks. Short enough to solve, but long enough to solve. very Annoying.

In one study, Published nearly 20 years agoevaluated approximately 200 patients with persistent cough and found that the most common cause of “subacute” cough was simply a past infection, and not a more serious ongoing health problem. discovered.

That's the same conclusion in a new article in CMAJ. But the Canadian doctors' peer-reviewed practice proposal also emphasizes the importance for clinicians to consider other possibilities.

For someone's persistent hacking to be considered a post-infectious cough, doctors need to see an early respiratory infection. You should also rule out other health problems that can cause similar symptoms, such as asthma, chronic obstructive pulmonary disease (COPD), and whooping cough. “Whooping cough” for something distinctive Oops The sounds it might bring.

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Certain red flags, and a cough lasting longer than eight weeks, should also prompt further follow-up, the doctors wrote.

Symptoms such as coughing up blood, difficulty swallowing, hoarseness, a history of recurrent pneumonia, or a long history of smoking may indicate another health problem.

In such a case, persistent cough “It could be a symptom that requires more aggressive treatment,” said Dr. Imran Satir, a pulmonologist who runs the cough clinic at McMaster University in Hamilton, Ont. And he was not involved in writing the CMAJ article.

If someone's cough continues to get worse, or if the patient has a fever, difficulty breathing or constant wheezing, those are other signals that someone may have another underlying medical condition. He said that there is.

“There are big nuances in how to deal with this,” Satya stressed. That's because a persistent cough can be a symptom of a variety of serious conditions, including pulmonary fibrosis, lung cancer, heart failure, and tuberculosis. “It's important not to miss these,” he says.

But doctors agree that simple cases of persistent cough caused by a previous viral infection usually resolve on their own.

'No evidence' treatments can help

The problem is that it takes time. And there is “no evidence” that the treatment options are helpful, the authors write in the CMAJ paper.

Systematic studies cited by the group include: Published in British Journal of General Practice In 2018, we reviewed six randomized controlled trials involving hundreds of people with subacute cough, suggesting no clear benefit to any treatment.

“A systematic review of randomized controlled trials evaluating inhaled corticosteroids, bronchodilators, and oral medications for post-infectious cough concluded that there was no evidence of benefit,” the CMAJ authors noted. did.

“Most trials have found that cough symptoms improve without the use of drugs, highlighting the natural suppressive nature of cough after infection.”

Commonly offered options such as inhalers and codeine are expensive and can come with “troublesome side effects,” Liang added.

For example, codeine, an opiate-based painkiller, is found in certain cough syrups and, when taken in high doses, can lead to drowsiness, headaches, decreased breathing, and even nausea and vomiting.

On the other hand, most inhalers are the primary treatment for chronic lung diseases such as asthma and COPD, rather than short-term cough concerns.

Antibiotics don't work either. They are used to fight active bacterial infections rather than viral infections or post-infectious inflammation. (Doctors are also concerned that it is being prescribed too often, leading to rising rates of drug resistance as bacteria evolve to evade existing drugs. cause an untreatable infection. )

Satya agreed that these options are meaningless for mundane hacking. “There's not much evidence to suggest that inhaled steroids, bronchodilators, antibiotics, and steroids reduce cough and make you feel better.”

There's that too anything Is there anything people can do to reduce coughing in the weeks following a viral infection?

Liang said patients' hacking often flares up at night, so he often recommends propping up some pillows instead of lying down in bed. But beyond that, it's pretty much just a waiting game.

“At the end of the day, it’s time to stop coughing and figure things out.”