Non stop night cough: That Nagging Cough – Harvard Health Publishing
That Nagging Cough – Harvard Health Publishing
Persistent cough, common causes and cures
What’s that nagging cough, and what can you do to cure it? Cough for a minute or two, and you may think something has “gone down the wrong pipe.” Cough for a day or two, and you may think you’ve picked up a cold or the flu. After a week, bronchitis or allergies may come to mind. But after three or four weeks, your mind starts to race, and the worry begins to mount.
For many people, chronic coughing raises the specter of cancer. But is cancer really a common cause of a cough that lingers? And if it’s not, what is — and what can you do to quiet a nagging cough?
What is a cough?
Although folk wisdom views coughing as a grave portent of illness — What did one casket say to the other? “I hear you coffin” — the cough is actually a vital player in the body’s defense against disease. Coughing expels mucus, microbes, and foreign particles from the respiratory tract, protecting the lungs from infection and inflammation.
The cough begins with an initial gasp that draws air deep into the lungs. Next, the glottis snaps shut, putting a lid over the trachea, or windpipe. The third step is the forceful contraction of the muscles of the chest cage, abdomen, and diaphragm (see figure). In normal breathing, these muscles push air gently from the lungs up through the nose and mouth. But when the glottis is closed, the air can’t move out, so tremendous pressure builds up in the air passages. Finally, the glottis swings open and the air rushes out. And it is quite a rush; in a vigorous cough, the air travels out at nearly the speed of sound, creating the barking or whooping noise that we call a cough.
Anatomy of a cough
A cough can be a conscious, voluntary act or an uncontrollable, involuntary reflex. In the latter case, stimulation of nerves in the larynx (“voice box”) and respiratory tract initiates the entire process. These nerves can be irritated by infections, allergies, cold air, tumors, chemical agents such as smoke, mechanical factors such as dust particles, or by normal body fluids such as nasal mucus or stomach acid. It’s no wonder, then, that so many different things can trigger a cough.
The chronic cough
Everyone coughs, and nobody worries about an occasional cough. Many acute illnesses — ranging from hay fever and the common cold to bronchitis and pneumonia — produce recurrent coughs. But the cough that accompanies acute illnesses resolves in a matter of a few days to a few weeks. In contrast, a chronic cough is variously defined as one that lingers for more than three to eight weeks, sometimes lasting for months or even years.
Chronic coughing is common, so frequent that it rates as one of the most common reasons for seeing a doctor. In addition to worry about the cause of the cough, patients experience frustration and anxiety, especially if diagnosis and treatment stretches out over weeks, which is often the case. Coughing interrupts sleep, producing fatigue and impairing concentration and work performance. In this age of scary new viruses, social interactions may suffer. And coughing can also have important physical consequences, ranging from urinary incontinence to fainting and broken ribs. Between medical tests, lost productivity at work, remedies that don’t help, and treatments that do, coughing can become expensive.
What causes chronic coughing?
Smoking is a leading cause. Sooner or later, most cigarette smokers develop a chronic “smoker’s cough.” Chemical irritation is responsible — but the same noxious chemicals that cause the simple smoker’s cough can lead to far more serious conditions, such as bronchitis, emphysema, pneumonia, and lung cancer. The chronic cough is always a cause of concern for smokers.
A lingering cough is also a worry for nonsmokers. Fortunately, benign problems are responsible for most chronic coughs in nonsmokers. Benign or not, persistent coughing can cause worry, embarrassment, exhaustion, and more. That’s why chronic coughs should be diagnosed and treated before they linger too long.
Dozens of conditions can cause a recurrent, lingering cough, but the lion’s share are caused by just five: postnasal drip, asthma, gastroesophageal reflux disease (GERD), chronic bronchitis, and treatment with ACE inhibitors, used for high blood pressure. Many people have several of these conditions, but in nonsmokers, the first three, singly or in combination, account for nearly all chronic coughs. The major causes of long-term coughing are listed below.
Persistent cough: Major causes
Common causes of a nagging cough
Less common causes of a nagging cough
Common in smokers
If you’re like most people with a lingering cough, consider these major causes:
1. Postnasal drip (also called the upper airway cough syndrome). The human nose is more than the organ of smell. It is also the gateway to the lower respiratory tract. As such, its job is to condition the air passing through en route to the lungs. The nose warms air that is cool, adds moisture to air that is dry, and removes particles from air that is dirty. The nasal membranes accomplish all three tasks by producing mucus that is warm, moist, and sticky.
Although the nose is a guardian of the more delicate lungs, it is subject to problems of its own. Viruses, allergies, sinusitis, dust particles, and airborne chemicals can all irritate the nasal membranes. The membranes respond to injury by producing more mucus — and unlike normal mucus, it’s thin, watery, and runny.
All that mucus has to go somewhere. When it drips out the nose, it’s a nuisance. But when it drips down the throat, it tickles the nerves of the nasopharynx, triggering a cough. In some cases, the nose itself is to blame (rhinitis), but in others, a prolonged postnasal drip lingers after a viral upper respiratory infection; some call this variety a post-infectious cough.
In typical cases, patients with postnasal drip cough more at night, and they are often aware of a tickling feeling at the back of their throats. But they can cough during the day, and their throats may be irritated and sore or perfectly fine.
The best way to find out if a chronic cough is the result of postnasal drip is to try treatment. Nonprescription decongestant or antihistamine tablets are the first step. Most contain a decongestant, an antihistamine, or a combination of the two. In one form or another, these medications are generally effective and safe, but some people complain of a racing heart and souped-up feeling (due to the decongestant), while others feel sleepy (due to the antihistamine). Men with benign prostatic hyperplasia (BPH) may have difficulty passing urine while they’re taking decongestants, and antihistamines can occasionally trigger acute glaucoma. As with all medications, read the directions carefully.
Home remedies can help as well. Inhaling steam from a hot shower or kettle is the simplest. Nasal irrigations may also help by cleaning out irritating secretions. You can purchase saline nose sprays at your drugstore or you can do it yourself. First, soak a clean washcloth in a basin containing ⅛ teaspoon of table salt for each cup of water. Next, hold the dripping wet cloth up to your nostrils and sniff in the saline solution. If saline irrigations seem to help, repeat them one to three times per day.
Postnasal drip is the leading cause of the lingering cough. But it’s far from the only cause.
2. Asthma. Wheezing and breathlessness are the usual symptoms of asthma. But not all patients with asthma wheeze. Indeed, some just cough.
Asthma results from bronchospasm, the temporary, reversible narrowing of the medium-sized tubes that carry air into the lungs. In most cases, that air makes a whistling or wheezing sound as it moves through narrowed passages. Excessive mucus production, shortness of breath, and cough are the other classic symptoms of asthma. But in cough-variant asthma, coughing is the only symptom.
In most cases, cough-variant asthma produces a persistent, dry cough that occurs around the clock but may begin at night. Exposure to allergens, dust, or cold air often triggers coughing, as does exercise.
If doctors suspect that asthma is responsible for a chronic cough, they can order pulmonary function tests to confirm the diagnosis; if these tests are inconclusive, patients may be asked to inhale small doses of methacholine, a drug that often triggers wheezing in asthmatics.
Another approach to the diagnosis of cough-variant asthma is to see if the cough responds to anti-asthmatic treatment. Doctors often suggest a bronchodilator spray such as albuterol (Proventil, Ventolin). It’s short acting. So, in addition your doctor might prescribe an inhaled cortico steroid, such as fluticasone (Flovent), triamcinolone (Azmacort) or budesonide (Pulmicort).
If you have a chronic cough that may be due to asthma, ask your doctor to consider testing or treating. But if asthma is not the answer, ask him to think about the third leading cause of the cough that lingers.
3. Gastroesophageal reflux disease. Just as people are surprised to learn that asthma can cause coughing without wheezing; many people are shocked to learn that gastroesophageal reflux disease (GERD) can cause coughing without heartburn.
GERD occurs when stomach contents travel upstream, making their way up into the esophagus instead of down into the intestines. Heartburn is the usual symptom; belching, a sour taste in the mouth, and bad breath are common too. But acid also irritates nerves in the lower esophagus, and these nerves can trigger the cough reflex even without the distress signal of pain. In fact, up to one-third of patients with GERD are pain-free, complaining instead of cough, recurrent laryngitis, or unexplained sore throats.
GERD can be tricky to diagnose when there’s no pain. Barium swallow x-rays and esophagoscopy can help, but the gold standard is esophageal pH monitoring, in which the patient swallows a probe that remains in the lower esophagus for 24 hours to detect the presence of acid. It’s not as uncomfortable as it sounds, but it is expensive and inconvenient.
As with the other causes of chronic cough, a simpler approach to diagnosis is to try treatment. You can begin on your own. Avoid alcohol and foods that often trigger GERD, including those that contain chocolate, peppermint, caffeine, garlic, onions, citrus fruits, tomato sauce, or lots of fat. Eat small meals, and never lie down until two hours after you’ve eaten. Take liquid antacids, particularly at bedtime, and consider elevating the head of your bed or sleeping on a wedge-shaped pillow to keep your stomach’s contents flowing down at night.
If you’re constantly coughing after a week or so, you can add an over-the-counter acid suppressor. Today there are many to choose from, including ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), omeprazole (Prilosec) and lansoprazole (Prevacid). Stronger versions are available by prescription.
It may take three or four weeks of gradually escalating therapy to control GERD. But if your program doesn’t work, you are probably coughing for some other reason.
4. Chronic bronchitis and bronchiectasis. Chronic bronchitis is persistent inflammation of the bronchial tubes causing airway narrowing and production of excess mucus. It usually happens from tobacco use or long-term exposure to high levels of industrial air pollutants. Bronchiectasis is also a result of chronic inflammation that damages the walls of the bronchial tubes. In either variant, the inflammation leads to a chronic cough. The most effective treatment is to quit smoking and avoid air pollutants. In addition, your doctor can prescribe a corticosteroid inhaler, usually with a long-acting bronchodilator. People with chronic bronchitis are prone to flare-ups. Doctors call them COPD exacerbations. The main symptoms are increased coughing, thick dark mucus production, shortness of breath, and fatigue. The treatment includes antibiotics and an oral corticosteroid, usually prednisone.
5. Therapy with angiotensin-converting–enzyme (ACE) inhibitors. ACE inhibitors such as enalapril (Vasotec, generic), lisinopril (Prinivil, Zestril, generic), as well as many others, have assumed a prominent role in the treatment of high blood pressure and heart failure.
ACE inhibitors are favored by many doctors because they produce good results and have few side effects, with one exception — a persistent cough. It occurs in up to 20% of people taking an ACE inhibitor. The first symptom is often just a throat tickle, followed by a dry cough that can begin as soon as three weeks or as late as one year after the medication is started. Once the cough starts, it lingers and lingers.
If the cough is mild, patients may choose to continue their medication, or they may cough less if they change to a different ACE inhibitor. But the only way to eliminate a severe cough induced by an ACE inhibitor is to switch to another type of antihypertensive medication. Fortunately, many are available, including angiotensin-receptor blockers (ARBs) like losartan (Cozaar) and valsartan (Diovan) — drugs that act like ACE inhibitors without causing a cough.
When to worry about a constant cough
Although a chronic cough is usually not serious, warning symptoms call for prompt medical care. The symptoms include:
Less common coughing causes
In nonsmokers, the Big Five account for more than nine of every 10 chronic coughs. But other problems can — and do — cause lingering coughs.
Lung infections make people cough. Most cases of pneumonia are acute infections requiring rapid diagnosis and treatment. However, some lung infections can be more indolent and can cause a persistent cough. Fever is an important clue to infectious causes of persistent coughing.
Pertussis (whooping cough) is a respiratory tract infection that can cause serious problems in children who have not been immunized properly with diphtheria-pertussis-tetanus (DPT) vaccine. Pertussis began to resurface in adolescents and adults because the original tetanus-diphtheria booster shots did not cover pertussis and the vaccine’s effectiveness wears off over time.
Heart disease can masquerade as lung disease if coughing and breathlessness are its main symptoms. It’s a common occurrence in patients with heart failure (HF). Their cough is most pronounced when they’re lying flat, so they often resort to sleeping propped up on pillows. The cough of HF may be dry, or it may produce thin, frothy white sputum. Leg swelling, fatigue, and exercise intolerance are other common symptoms of HF.
Abnormal swallowing can lead to persistent coughing if food triggers the cough reflex by heading down the “windpipe” instead of the “food pipe.” Called aspiration, the problem occurs mainly in people with strokes or other neurologic disorders that hamper normal swallowing.
Environmental irritants can trigger the cough reflex, not just once but with nearly every breath of air laden with chemicals or particles ranging from sulfur dioxide to nitric oxide to dust and molds. Even clean air can trigger coughing if it is too dry or too cold.
Lung cancer certainly belongs on the list of disorders that cause persistent coughing. Fortunately, though, it’s not high on the list, at least in nonsmokers.
Stress. Mental factors can produce many physical symptoms, including cough. Psychogenic coughing increases at times of stress and disappears during sleep.
If you don’t think that coughing is a common complaint, just head to the nearest drugstore. You’ll find a bewildering array of syrups, sprays, tablets, and lozenges designed to control coughing. You’ll also see a steady stream of customers coughing up lots of money to purchase products that may be ineffective.
Many cough remedies contain expectorants, compounds intended to loosen sputum, making it easier to clear. Guaifenesin is the most popular expectorant. Unfortunately, there is little scientific evidence that expectorants are effective. You’ll probably do just as well by using a humidifier and drinking lots of water.
Cough suppressants are also very popular. Nonprescription agents such as dextromethorphan can partially suppress the cough reflex, promoting patient comfort. Prescription cough syrups with codeine tend to be more effective. When used appropriately, cough suppressants can reduce discomfort; remember, though, that because coughing can serve a useful function, it should not always be suppressed.
Medicated lozenges and cough drops are among the most widely sold cough remedies. These products contain various combinations of menthol, camphor, eucalyptus oil, honey, and other ingredients. Like with liquid cough medicines, some also contain topical anesthetics. Despite their popularity, there is no evidence that medicated cough drops are more effective than simple hard candies.
Finding chronic cough causes and cures
Don’t ignore a chronic cough — but don’t panic just because your cough lingers for more than three or four weeks. Most often, the puzzle can be solved without elaborate tests, and the problem can be corrected with simple treatments. In fact, you may be able to diagnose and treat yourself, especially if postnasal drip or gastroesophageal reflux is the culprit. Even so, your doctor can also help. In most cases, it won’t take much more than a stethoscope and a treatment trial or two. But if your cough is accompanied by sputum production, bloody sputum, fever, weight loss, night sweats, breathlessness, undue fatigue, or chest pain, you should consult your doctor without delay.
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Chronic cough – Symptoms and causes
A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children.
A chronic cough is more than just an annoyance. A chronic cough can interrupt your sleep and leave you feeling exhausted. Severe cases of chronic cough can cause vomiting, lightheadedness and even rib fractures.
While it can sometimes be difficult to pinpoint the problem that’s triggering a chronic cough, the most common causes are tobacco use, postnasal drip, asthma and acid reflux. Fortunately, chronic cough typically disappears once the underlying problem is treated.
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A chronic cough can occur with other signs and symptoms, which may include:
- A runny or stuffy nose
- A feeling of liquid running down the back of your throat (postnasal drip)
- Frequent throat clearing and sore throat
- Wheezing and shortness of breath
- Heartburn or a sour taste in your mouth
- In rare cases, coughing up blood
When to see a doctor
See your doctor if you have a cough that lingers for weeks, especially one that brings up sputum or blood, disturbs your sleep, or affects school or work.
An occasional cough is normal — it helps clear irritants and secretions from your lungs and prevents infection.
However, a cough that persists for weeks is usually the result of a medical problem. In many cases, more than one cause is involved.
The following causes, alone or in combination, are responsible for the majority of cases of chronic cough:
- Postnasal drip. When your nose or sinuses produce extra mucus, it can drip down the back of your throat and trigger your cough reflex. This condition is also called upper airway cough syndrome (UACS).
- Asthma. An asthma-related cough may come and go with the seasons, appear after an upper respiratory tract infection, or become worse when you’re exposed to cold air or certain chemicals or fragrances. In one type of asthma (cough-variant asthma), a cough is the main symptom.
- Gastroesophageal reflux disease (GERD). In this common condition, stomach acid flows back into the tube that connects your stomach and throat (esophagus). The constant irritation can lead to chronic coughing. The coughing, in turn, worsens GERD — a vicious cycle.
- Infections. A cough can linger long after other symptoms of pneumonia, flu, a cold or other infection of the upper respiratory tract have gone away. A common but under-recognized cause of a chronic cough in adults is pertussis, also known as whooping cough. Chronic cough can also occur with fungal infections of the lung, tuberculosis (TB) infection or lung infection with nontuberculous mycobacterial organisms.
- Chronic obstructive pulmonary disease (COPD). COPD, a chronic inflammatory lung disease that causes obstructed airflow from the lungs, includes chronic bronchitis and emphysema. Chronic bronchitis can cause a cough that brings up colored sputum. Emphysema causes shortness of breath and damages the air sacs in the lungs (alveoli). Most people with COPD are current or former smokers.
- Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.
Less commonly, chronic cough may be caused by:
- Aspiration (food in adults; foreign bodies in children)
- Bronchiectasis (damaged, dilated airways)
- Bronchiolitis (inflammation of the very small airways of the lung)
- Cystic fibrosis
- Laryngopharyngeal reflux (stomach acid flows up into the throat)
- Lung cancer
- Nonasthmatic eosinophilic bronchitis (airway inflammation not caused by asthma)
- Sarcoidosis (collections of inflammatory cells in different parts of your body, most commonly the lungs)
- Idiopathic pulmonary fibrosis (chronic scarring of the lungs due to an unknown cause)
Being a current or former smoker is one of the leading risk factors for chronic cough. Frequent exposure to secondhand smoke also can lead to coughing and lung damage.
Having a persistent cough can be exhausting. Coughing can cause a variety of problems, including:
- Sleep disruption
- Excessive sweating
- Loss of bladder control (urinary incontinence)
- Fractured ribs
- Passing out (syncope)
July 09, 2019
- Cough. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/cough. Accessed May 8, 2019.
- Kasi AS, et al. Cough. Pediatrics in Review. 2019;40:157.
- Cough in adults. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pulmonary-disorders/symptoms-of-pulmonary-disorders/cough-in-adults?query=cough. Accessed May 8, 2019.
- Cough in children. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/cough-in-children?query=cough. Accessed May 8, 2019.
- When to give kids medicine for coughs and colds. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/when-give-kids-medicine-coughs-and-colds. Accessed May 8, 2019.
- Kellerman RD, et al. Cough. In: Conn’s Current Therapy 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed May 8, 2019.
- Broaddus VC, et al., eds. Cough. In: Murray and Nadel’s Textbook of Respiratory Medicine. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed May 8, 2019.
- AskMayoExpert. Chronic cough. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Use caution when giving cough and cold products to kids. U.S. Food and Drug Administration. https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids. Accessed May 8, 2019.
- Thompson DA. Cough. In: Adult telephone protocols. 4th ed. Itasca, Ill.: American Academy of Pediatrics; 2018.
- Schmitt BD. Cough. In: Pediatric telephone protocols. 16th ed. Itasca, Ill.: American Academy of Pediatrics; 2018.
- Pappas DE. The common cold in children: Management and prevention. https://www.uptodate.com/contents/search. Accessed May 20, 2019.
- Green JL, et al. Safety profile of cough and cold medication use in pediatrics. Pediatrics. 2017;139:1.
- COPD. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/copd. Accessed May 28, 2019.
- Botulism: Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/botulism/prevention.html. Accessed June 4, 2019.
- Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. June 5, 2019.
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Toddler coughs when lying down
Qué hacer con un niño pequeño que tose por la noche
A toddler coughs when lying down? Maybe didn’t cough at all during the day, or not cough much, but started coughing at night?
The reason is that mucus from the sinuses drains into the throat while your toddler is horizontal, triggering the cough. Asthma also can cause a nighttime cough, as airways tend to be more irritable after bedtime.
Contact your pediatrician if your toddler’s cough is on-and-off and gets worse at night and while active.
“While a nighttime cough is typically the result of drainage while lying down, it also could be a sign of asthma. If your child is having trouble breathing or can’t speak, eat or drink, seek emergency help right away,” said April R. Mattingly, M.D., pediatrician with Norton Children’s Medical Group – Crestwood.
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If your toddler is coughing at night and can’t get uninterrupted sleep, here are some ways to help everyone quiet down and get some rest:
A 2007 study found 1 teaspoon buckwheat honey given at bedtime was better than no treatment and just as effective as dextromethorphan for easing a cough and improving a child’s sleep. Over-the-counter cough medicines should be avoided in toddlers. Babies less than 12 months old shouldn’t consume honey because of botulism risk.
Elevate the head
Sleeping slightly upright with a pillow under the head, shoulders and back can make breathing easier for the toddler. If the child is in a crib, try placing a pillow under the head of the crib mattress.
Related: Dry cough in kids and other coughs explained
With the bathroom door closed, run a hot shower and sit with your toddler for 15 minutes. The steam helps break up congestion, making it easier to blow or cough out.
Run a humidifier near the toddler’s bed. The cool, moist air will help clear airways.
A bulb syringe can clear mucus if your toddler hasn’t gotten good at nose-blowing yet.
A spray of saline solution in each nostril during the day loosens mucus.
VapoRub on the feet?
There’s no evidence this home remedy works, but there’s also no harm in rubbing the ointment on the toddler’s feet under a pair of socks. Who knows?
Maybe it’s the steam or warm liquid on the throat, but chicken soup can ease coughs and sore throats.
Norton Children’s Medical Group
Chronic Cough in Kids | Rush System
Chronic cough is one of the five most common reasons children are taken to the doctor, affecting 5 to 10 percent of children in the U.S. every year and accounting for 30 million office visits annually. And that’s not surprising, given that coughing is a symptom of a host of health conditions.
An acute cough due to a cold or respiratory virus usually goes away within a month’s time. When coughing becomes regular and persists longer, however, it may mean there’s a more serious culprit behind it.
When coughing becomes chronic
Coughing is the body’s natural and normal reaction to an irritant in the airway (the nose and nasal passages, pharynx, larynx, trachea and lungs). When the nerves in the airway sense an irritant — for instance, mucus, a foreign particle or even perfume — the nerves send a message to the brain to clear the breathing passages.
Sounds fine, right? But, what if the coughing does not stop after the airway has been cleared?
A daily cough that lasts more than four weeks is considered chronic and should be checked out by a doctor.
The good news is that pediatricians can typically address the common causes of a cough. If the cough persists after traditional treatment or if there are other complicating medical conditions, the pediatrician may refer the child to a specialist — like the multispecialty team at Rush’s Pediatric Aerodigestive Program, one of the first programs of its kind in Illinois.
Here, experts from the program shed light on the causes — both common and rare — of chronic coughing in children.
1. Allergies and sinusitis
Because allergic rhinitis and chronic sinusitis are two of the most common causes of a child’s cough, they are often considered first.
Jill Jeffe, MD, a pediatric ENT specialist asks detailed questions about the patient’s nasal symptoms to help determine whether allergies or a chronic infection may be the source of the problem.
- Children with allergic rhinitis sneeze frequently, tend to have clear mucus drainage from the nose, and may have itchy eyes.
- Chronic sinusitis, by definition, involves more than 12 weeks of symptoms. Children may complain of pain or pressure in the face, and always have thick, yellow-green nasal drainage.
“Both allergic rhinitis and chronic sinusitis often lead to post-nasal drip,” Jeffe explains. “The secretions that drip down the back of the throat as the child changes position can cause a cough. So often parents will describe a cough that is worse when the child first lies down at night.”
Jeffe also listens to the cough for clues. In many cases, a dry cough can suggest that it’s related to an allergy or asthma. A wet or productive (phlegmy) cough can sometimes indicate a problem other than asthma, like pertussis, mycoplasma or pneumonia.
Wheezing, or breathing with a whistling or rattling sound in the chest, it what most people think of when they hear asthma.
Asthma can present with a chronic cough as the only symptom however. When doing diagnostic investigations for a chronic cough reversible airflow obstruction on a pulmonary function test can be used to diagnose asthma that presents with cough as the only symptom.
A cough that is present after a child falls asleep is suggestive of asthma.
With asthma, the body’s levels of cortisol — a key hormone — naturally decrease during the night. This can trigger asthmatic bronchospasm, where the air passages become inflamed and narrow.
3. Whooping cough
Pertussis, better known as whooping cough, is caused by a bacterial infection. Pertussis can cause people to cough so uncontrollably that they have to catch their breath by inhaling so deeply they make a “whooping” sound.
A cough from pertussis could last for months, and complications can be serious, including apnea (not breathing), decreased oxygen, pneumonia, seizures and death. In some cases, complications may require hospitalization for supportive care (possibly including mechanical ventilation in serious cases).
Because complications can be life-threatening in children, it is recommended that adults protect their children by getting vaccinated (in addition, of course, to making sure children get the vaccine as part of the recommended vaccination schedule).
4. Cystic fibrosis
In rare cases, a continued cough may be a sign of a more serious condition such as cystic fibrosis, a progressive genetic disease that causes persistent lung infections.
“A cough that doesn’t go away can be cause for concern especially when a child also is eating voraciously and not gaining weight,” says Jenifer Burke, RN, MSN, a pediatric pulmonary nurse practitioner.
Other symptoms of cystic fibrosis may include loose stools, persistent coughing, recurrent respiratory infections, prolonged symptoms of bronchiolitis (inflammation of the smallest air passages of the lungs), and recurrent/chronic rhinosinusitis (swelling and irritation of the sinus lining).
While acid reflux is typically associated with gastrointestinal symptoms such as stomach aches, heartburn and vomiting, it can also contribute to the development of chronic cough in children.
Coughing that occurs while eating or drinking — especially if the child a history of recurrent pneumonia — could be a sign of aspiration.
Aspiration occurs when swallowed food or liquids pass below the level of the vocal cords and into the lungs. “Aspiration can be due to vocal cord paralysis, or other neurologic conditions that cause decreased sensation in the upper airway,” says Erin Miller, a speech-language pathologist at Rush.
If your doctor suspects aspiration as the cause of chronic cough, your child may be referred to see a speech-language pathologist. The speech-language pathologist will perform an instrumental swallow assessment, such as a video fluoroscopic swallow study (VFSS) or a flexible endoscopic evaluation of swallowing (FEES).
6. Acid reflux
While acid reflux is typically associated with gastrointestinal symptoms such as stomach aches, heartburn and vomiting, it can also contribute to the development of chronic cough in children, according to Anil A. Kesavan, MD, a pediatric gastroenterologist at Rush.
“Acid reflux does not cause chronic cough by itself, but it can exacerbate and worsen cough in patients with underlying respiratory disease,” he says.
Stomach acids are produced to help digest food and are not meant to move upward from the stomach into the esophagus (the canal that connects the throat to the stomach), but when it happens it can trigger a cough reflex.
Reflux-related cough is typically a dry cough that happens more during the daytime when a child is in an upright position. It occurs commonly after eating and with excessive phonation (i.e., laughing, singing, talking).
Certain foods (caffeine, citrus fruits/juices, foods high in fat, tomatoes, pickled vegetables, carbonated beverages) can trigger acid reflux, which can worsen reflux-related cough.
7. A blockage in the airway
In some cases, chronic coughing could be a sign that a foreign object has become stuck in the child’s airway.
After a choking event, there is an asymptomatic period that can last up to two weeks before complications, such as pneumonia, begin to appear. If your child has a chronic cough that develops after a choking event, seek medical care immediately.
8. Habit cough
Sometimes a cough will develop in response to an irritant in the airway, but persist after the original cause has resolved.
Habit coughing is typically “honking” in nature, and it’s distractible — if the child is preoccupied, the cough will disappear. The cough is also not present once the child has fallen asleep.
If other causes of chronic cough have been ruled out and habit cough is suspected, speech and behavioral therapy can be helpful in retraining the child’s abnormal reflex. Giving the child sips of water when he or she feels the urge to cough can also be a helpful therapy.
What to Do with the Patient with Chronic Cough? A Simple Approach to a Difficult Problem
Perm J. 2004 Summer; 8(3): 27–29.
Chronic cough, defined by some authors as lasting longer than eight weeks,1 is a problem frequently seen by primary care providers as well as specialists.2 Although elucidating the cause of a chronic cough can be difficult and frustrating—both for the patient and for the physician—systematic examination leads to successful diagnosis and treatment in nearly 100% of cases.1 In an estimated 95% of patients with a chronic cough and negative results of chest x-ray examination, the cough is caused by postnasal drip, asthma, gastroesophageal reflux, cigarette smoking, chronic bronchitis, eosinophilic bronchitis, or use of an angiotensin-converting enzyme (ACE) inhibitor.1 More than one of these diagnoses is responsible for cough in 18% to 93% of cases.1
A 48-year-old male nonsmoker was seen for four months of intermittent, nonproductive cough that was worse in the evenings after he ate dinner. He denied having any associated symptoms of dyspnea, wheezing, nasal congestion, fever, or chills. The cough was not related to exertion. The patient stated that the cough had become bothersome, often creating embarrassing situations for him at dinner parties. He noted that the cough was worse when standing and seemed to improve when he lay down at night. He tried different over-the-counter cough medications without any relief of symptoms. Results of physical examination were normal except for mild soreness around the ribs with deep palpation. Chest x-ray examination results were normal. The patient’s occupational history was noncontributory.
The clinician should first obtain a thorough medical history and perform a complete physical examination while keeping in mind that the character, quality, and timing of the cough are of little help for determining the diagnosis.1,3 Chest x-ray examination should follow, and a trial of empirical therapy should be begun.1 Because chronic cough often has multiple causes, addition of new empirical therapy while continuing previous treatment is often necessary. Postnasal drip syndrome, asthma, and gastroesophageal reflux are the most common causes of chronic cough and are usually accompanied by normal results of chest x-ray examination (). An abnormal result of chest x-ray examination should prompt the clinician to evaluate less-common causes, including tuberculosis, sarcoidosis, interstitial lung disease, and bronchogenic carcinoma.4 Any of several symptoms—weight loss, hemoptysis, purulent sputum, or night sweats—and risk factors for immunosuppression are indications for additional evaluation, including referral to a specialist.4 An ACE-inhibitor-induced cough should resolve within four weeks after discontinuing the medication.1 Although tobacco use may be the cause of chronic cough in smokers, evaluation of other causes is often necessary in these patients.
|Common causes||Other causes|
|Postnasal drip||Environmental irritants|
|Gastroesophageal reflux||Mycoplasma, pertussis, bordetella|
|ACE inhibitor, beta blocker, NSAID, aspirin||Bronchogenic carcinoma|
|Interstitial lung disease|
|Congestive heart failure|
Postnasal Drip Syndrome
Postnasal drip syndrome, the most common cause of chronic cough, presents a diagnostic dilemma. Lacking any objective criteria for diagnosis, evaluation is based entirely on medical history, results of physical examination, and a trial of empirical therapy.1 A history of frequent throat clearing, nasal congestion, “dripping in the throat,” or cobblestoning (oropharyngeal lymphoid hyperplasia) seen at examination is helpful as a clue for diagnosis, but many patients present with cough as the only symptom.2,5 Postnasal drip syndrome can be caused by sinusitis or rhinitis (including allergic rhinitis), vasomotor irregularity, environmental irritants, recent upper respiratory infection, medication (rhinitis medicamentosa caused by oxymetazoline hydrochloride or cocaine), and pregnancy.1,2 Sinus imaging and allergy testing are of limited help, because a positive test result does not prove that allergy or sinusitis (even if present) is causing the cough.
For most patients with cough resulting from postnasal drip syndrome, the cough improves within days or weeks after beginning an empirical trial of antihistamine medication.1,2,5 Antihistamine medication alone or in combination with scopolamine should help resolve watery postnasal drip, whereas mucolytic agents are more effective for patients with thicker mucus. Although some patients may not show clinically significant response to this therapeutic approach, postnasal drip may nonetheless be causing the cough. Addition of other useful treatments (eg, ipratropium nasal spray for nonallergic rhinitis; decongestants; nasal steroid agents; and high-volume sinus rinsing) should be considered.4
Classic symptoms of asthma—chest tightness, dyspnea, and wheezing—do not always accompany that condition.2 Asthmatic patients seen for cough as the only symptom are defined as having “cough-variant asthma.”2 Unlike postnasal drip syndrome, asthma can be objectively evaluated. Asthma can often be diagnosed by using a beta-agonist to reverse abnormal spirometry results. However, because of the intermittent nature of asthma, many asthmatic patients have normal results of routine spirometry. In some patients with cough-variant asthma, an empirical trial with an inhaled beta-agonist may be beneficial. For patients with normal results of spirometry, a methacholine challenge may be used to help rule out asthma. For patients with a suspected diagnosis of asthma, inhaled corticosteroid agents are indicated as part of an abnormal methacholine challenge or spirometry as well as a possible course of oral corticosteroid agents, depending on severity of symptoms.1 The leukotriene receptor antagonist zafirlukast may be beneficial in cough-variant asthma.6,7
In 10% to 20% of patients with gastroesophageal reflux, this condition causes respiratory symptoms (cough, wheezing, dyspnea, sputum production),2 eustachian tube dysfunction, or nasal congestion; and in nearly 75% of patients with cough induced by gastroesophageal reflux, coughing is the only presenting sign of the gastroesophageal condition.5 The coughing may be associated with eating and may worsen when the patient is in an upright position (ie, when the lower esophageal sphincter relaxes) and improve when the patient is asleep (ie, when transient relaxation of the lower esophageal sphincter is inhibited).3,5 The clinician should elicit the patient’s history of taking medications that lower esophageal sphincter pressure, including theophylline, oral (not inhaled) beta-agonist agents, nonsteroidal antiinflammatory drugs, and ascorbic acid.3 Cough induced by gastroesophageal reflux may be diagnosed indirectly by using a trial of empirical therapy. A proton pump inhibitor taken for at least two months along with appropriate lifestyle changes will successfully treat most cases of cough secondary to gastroesophageal reflux.1,3,5 Conventional antacids and h3 antagonists have little role for these patients. If no difference is seen in symptoms, a higher dose of medication, longer course of treatment (sometimes more than six months), or surgery may be necessary to control symptoms.1 Monitoring of pH should be done only after a failed therapeutic trial of a proton pump inhibitor.
The patient described here typifies many patients who are seen for chronic cough: A detailed medical history showed no specific triggers (eg, ACE inhibitors, environmental irritants, cigarette smoke), no family history of asthma, and no allergies; and results of physical examination and chest x-ray examination were normal. The patient began receiving a trial of antihistamine medication; and after a few weeks without improvement of the cough, a proton pump inhibitor was added. Gastroesophageal reflux-induced cough was diagnosed after symptoms began to improve (within a few weeks after treatment began). The patient successfully discontinued therapy after two months, by which time his cough had completely resolved.
Flow diagram for evaluation of chronic cough. Previous treatment should be continued when new medication is added
ACE: angiotensin-converting enzyme; CXR: chest x-ray film; OTC: over-the-counter
Joseph R Shapiro, MD, is a Fellow in the Department of Allergy and Clinical Immunology Fellowship Training Program, Kaiser Permanente Medical Center, Los Angeles, California. E-mail: [email protected]
1. Irwin RS, Madison JM. The diagnosis and treatment of cough. New Engl J Med. 2000 Dec 7;343(23):1715–21. [PubMed] [Google Scholar]2. Irwin RS, Boulet LP, Cloutier MM, et al. Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians. Chest. 1998 Aug;114(2 Suppl Managing):133S–181S. [PubMed] [Google Scholar]6. Global initiative for asthma: global strategy for asthma management and prevention Updated 2003. Bethesda (MD): National Institutes of Health, National Heart, Lung, and Blood Institute; 2003. (NIH Publication No. 02-3659). Available from: http://ginasthma.com/wr_clean.pdf (accessed April 26, 2004). [Google Scholar]7. Dicpinigaitis PV, Dobkin JB. Effect of zafirlukast on cough reflex sensitivity in asthmatics. J Asthma. 1999 May;36(3):265–70. [PubMed] [Google Scholar]
Acute cough (lasting less than 4 weeks)
At first, symptoms of a cold
Wheezing and, if bronchiolitis is severe, rapid breathing, with flared nostrils, and difficulty breathing
Possibly vomiting after coughing
Typically in infants up to 24 months old, most often in those 3–6 months old
Sometimes a chest x-ray and culture of mucus from the nose (taken with a swab) to identify the virus
Fever, cough, runny nose, rapid breathing, sore throat, shaking chills, headache, loss of taste or smell, vomiting, diarrhea, belly pain, rash, red eyes
Particularly when there are known cases in the community
Sometimes testing with a nasal swab
At first, symptoms of a cold
Then a frequent, barky cough (worse at night) and, when croup is severe, a loud squeaking noise when the child breathes in (stridor) and rapid breathing, with flared nostrils
Typically in children 6 months to 3 years old
Sometimes a neck and chest x-ray
A foreign object in the windpipe (trachea) or larger airways of the lungs (bronchi)
Cough and choking that begin suddenly
Typically in children 6 months to 4 years old
Mild coldlike symptoms for 1–2 weeks, followed by coughing fits
Infants: Coughing fits that may be associated with a blue tint to the lips or skin (cyanosis), vomiting after coughing, or pauses in breathing (apnea)
Older children: Coughing fits that may be followed by a prolonged, high-pitched sound (called the whoop)
Cough that may persist for several weeks
Culture of a sample of mucus taken from the nose
Sometimes wheezing, shortness of breath, and chest pain
Cough that is sometimes productive
Coughing at the beginning of sleep or in the morning with waking
Sometimes chronic discharge from the nose
Sometimes CT of the sinuses
A runny nose and nasal congestion
Possibly fever and sore throat
Possibly small, nontender, swollen lymph nodes in the neck
Chronic cough† (lasting 4 weeks or more)
Periodic attacks of coughing in response to a trigger (such as pollen or other allergens), exposure to cold air, or exercise
Coughing during the night
Sometimes family members who have asthma
Treatment with asthma drugs to see whether symptoms are relieved
Breathing tests to evaluate lung function (pulmonary function tests)
Birth defects affecting the lungs
Several episodes of pneumonia in the same part of the lungs
Birth defects affecting the windpipe (trachea), esophagus, or both
Typically in newborns or infants
If the trachea has not developed normally, possibly a loud squeaking noise when the child breathes in (stridor) or a barky cough and difficulty breathing
If there is an abnormal connection between the trachea and esophagus (tracheoesophageal fistula), a cough or difficulty breathing when the child is fed and frequent bouts of pneumonia
Sometimes bronchoscopy and endoscopy
If an abnormal trachea is suspected, also CT or MRI
A blockage in the intestine by thick secretions (meconium ileus) detected shortly after birth
Frequent bouts of pneumonia, sinusitis, or both
Not growing as expected (failure to thrive)
Enlargement of the fingertips or a change in the angle of the nail bed (clubbing) and nail beds that are tinted blue
Possibly genetic testing to confirm the diagnosis
A foreign object in the lung or airways
Cough and choking that began suddenly
Resolution of choking but cough that persists or progressively worsens over several weeks
Typically in children 6 months to 4 years old
Chest x-rays while breathing out and breathing in
Infants: Fussiness, spitting up after feedings, arching of the back, or crying after feedings and a cough when lying down
Older children and adolescents: Chest pain or heartburn after meals and when lying down and possibly wheezing, hoarseness, nausea, and regurgitation
Cough that is often worse at night
Infants: Sometimes an x-ray of the upper digestive tract after barium is given by mouth to determine whether anatomy is normal
Treatment with histamine-2 (h3) blockers (if symptoms are relieved, the cause is probably gastroesophageal reflux disease)
Sometimes a test to measure acidity or reflux episodes in the esophagus (called a pH probe or an impedance probe) or x-rays taken after formula is given by mouth (gastric emptying scan) to determine the frequency and severity of reflux episodes
Older children: Treatment with h3 blockers or proton pump inhibitors to see whether symptoms are relieved
Headache, itchy eyes, a mild sore throat particularly in the morning, and coughing at night and when waking up
Treatment with an antihistamine or a corticosteroid nasal spray (if symptoms are relieved, the cause is an allergy)
Possibly x-rays or CT of the sinuses
Psychogenic or habit cough
May develop in children after a cold or other airway irritant
Frequent (may be up to every 2–3 seconds), harsh, or honking cough when awake, possibly lasting for weeks to months
Cough that stops completely when the child falls asleep
Lack of fever or other symptoms
Sometimes chest x-rays to look for other causes
Recent contact with an infected person
Usually a weakened immune system (immunocompromise)
Sometimes fever, night sweats, chills, and weight loss
Asthma and your child’s sleep
What do asthma symptoms at night mean?
If your child is coughing or wheezing at night it’s a sign their asthma is not well managed.
It’s important to see your child’s GP or asthma nurse if asthma symptoms are affecting their sleep.
Your GP/asthma nurse can:
- check that your child is taking their asthma medicines as prescribed – sometimes it’s easy to let their routine slip a bit
- consider increasing or changing your child’s asthma medicines
- check your child’s inhaler technique, and that you know how to help them use their inhalers correctly. We have tips for helping your child use their inhalers.
If your child hasn’t yet been diagnosed with asthma, coughing or wheezing at night could be signs of asthma.
Coughing and wheezing can be symptoms of other things too. For example, if your child has a cold it’s very common for them to cough during the night.
Why are asthma symptoms often worse at night?
Asthma symptoms are often worse at night because:
- lying down can trigger a cough, especially if your child also has a blocked nose or sinuses. Or if they have post-nasal drip (mucus that drips from the back of your nose down your throat) due to hay fever, allergies or a cold.
- your child’s body isn’t as good at controlling inflammation – including in their airways – while they’re asleep.
- your child may be exposed to asthma triggers at night such as dust mites in bedding or pets sleeping in their bedroom.
But don’t accept night-time asthma symptoms as normal. Your child’s GP or asthma nurse can help get their asthma under control.
How to reduce the risk of night-time symptoms
Manage your child’s asthma well
- Make sure your child takes their prescribed medicine, even if they’re well: they’re less likely to cough and wheeze, and/or find it hard to breathe at night.
- Use your child’s written asthma action plan to help you recognise if their asthma is getting worse. Find out more about how an asthma action plan can help you manage your child’s asthma.
- Make sure you have regular reviews with your child’s GP or asthma nurse if they’re having night-time symptoms. Your child should have a review at least once a year, but you don’t have to wait that long if you’re concerned.
Try to avoid your child’s triggers
- If your child’s asthma symptoms are triggered by animals, keep pets out of their bedroom, especially at night.
- If your child has hay fever, keep their bedroom window shut at night, and don’t dry their bedding outside to avoid bringing in pollen.
- Make sure your child is not exposed to cigarette smoke. It will make their asthma worse.
Keep your child’s bedroom at the right temperature
Breathing colder air at night or sleeping in an air-conditioned room, such as a hotel room, can trigger asthma symptoms. If possible, keep the temperature in their bedroom steady so it’s not too cold or too warm.
Try propping your child up with pillows
Some parents find their child coughs less and sleeps better if they’re propped up with extra pillows. This can help to keep their airways open.
Keep your child’s asthma action plan to hand
This can help you recognise their triggers and symptoms and decide what medicine to give them. It’ll also tell you what to do if they have an asthma attack, and when to call 999 for an ambulance.
Keep a copy on your phone or by your bed so you don’t struggle to find it in the middle of the night.
Have your child’s reliever inhaler ready
Be prepared to deal with your child’s asthma symptoms quickly during the night.
Make sure your child’s reliever inhaler (usually blue) and their spacer are in a safe place in your bedroom so you can find it quickly, even when you’re tired or its dark.
If it’s a spare inhaler, check it from time to time to make sure it’s not empty and is still in date.
“In my experience, it’s harder to deal with asthma symptoms during the night – I think because you’re tired you’re less able to think clearly. Somehow you feel far more vulnerable. I’d say to anyone who has a child with asthma, don’t hesitate to call 999 – especially if it’s the middle of the night. They’d rather see you than for you to wait until it’s too late.” Anna Bonnett, mum to Gabriel, 10, and Beau, 5
How to get a better night’s sleep
Coping with disturbed nights because of your child’s asthma can be difficult. You might also find it hard to sleep if you’re worrying about their asthma.
Try these tips:
- Read through your child’s written asthma action plan regularly so you’re confident about what to do if they have asthma symptoms at night.
- Jot down any worries and how you’ll deal with them – for example, if you’re worried about your child’s cough at night, make a note that you’ll book an appointment with their GP or asthma nurse in the morning. This can help clear your mind so you feel more able to sleep.
- Share your concerns with other parents on our asthma forum or read parents’ stories to find out how others cope.
- Call our Helpline on 0300 222 5800 (9am – 5pm; Mon – Fri) to speak to an asthma nurse specialist about your child’s night time symptoms. Or you can WhatsApp them on 07378 606 728.
Last updated February 2020
Next review due February 2023
90,000 Cough – causes, types
Cough is a protective response of the body to the effects of irritating factors on the mucous membrane of the airways. It can be mucus, phlegm, blood, pus, pollutants (chemicals), dust, pollen, foreign bodies.
Causes of coughing
The function of the cough is to clear and keep the airway open for air flow.
Sensory receptors are present throughout the respiratory tract: in the nose, sinuses, pharynx, larynx, trachea, bronchi, pleura, therefore, a cough act is possible when the mucous membrane is irritated at all levels of the respiratory tract.When the receptors are excited in the outer ear, pericardium, diaphragm, a reflex cough is possible.
Different diseases can differ in the peculiarities of cough, its character , timbre , volume , duration , daily dynamics .
What types of cough are there?
There are two opposite types of cough: dry and wet .A dry cough is usually accompanied by a sore throat, soreness in the chest, does not bring relief, and may be prolonged. A wet cough, otherwise productive, on the contrary, helps to evacuate phlegm from the bronchi and is easier to tolerate. At the same time, it is important to pay attention to the nature, color, smell, amount of sputum, and the time of its maximum discharge.
Some diseases are characterized only by dry cough. This is laryngitis, dry pleurisy, compression of the bronchus from the outside (enlarged lymph node, tumor).Others, like bronchitis, tuberculosis, lung cancer, can initially cause a dry cough, which later turns into a wet one. With pneumonia, cough is not a necessary symptom, since the parenchymal tissue of the lungs lacks cough receptors.
The timbre and the volume of the cough differ significantly depending on the cause. Loud, “barking” cough will be observed with swelling of the larynx, compression of the trachea, psychogenic cough.A barking cough is a classic symptom of whooping cough.
Inflammation of the vocal cords makes the cough loud, sharp. A quiet, short cough, coughing is possible in the presence of a small amount of discharge in the larynx, trachea, with dry pleurisy, the initial stage of pulmonary tuberculosis.
By duration, there are periodic and constant cough. Periodic cough usually occurs with colds (ARI), bronchitis, it is possible with pneumonia, focal tuberculosis and is represented by single cough shocks.In this case, it can be both short-term, light, in the form of a cough, and strong, paroxysmal, up to the onset of vomiting. With more severe pathologies (pronounced inflammation of the larynx, trachea, bronchi, high stages of lung cancer and tuberculosis), the cough becomes permanent.
Dynamics of cough
The daily dynamics of the cough will differ for different ailments. A cough that begins after waking up and getting out of bed is characteristic of the presence of pathological cavities in the lung tissue (abscess, tuberculous cavity) and bronchiectasis, where sputum accumulates during the night, purulent discharge.When the position of the body changes, the contents of the cavities are displaced, irritating the sensitive receptors.
Tuberculosis and lung tumors are more common at night. This is due to the effect of enlarged mediastinal lymph nodes on reflexogenic zones during the period of maximum activity of the vagus nerve.
With acute respiratory infections, bronchitis, pneumonia, cough is present throughout the day, but usually increases in the evening.
A cough that does not have any regularity and a visible basis, appearing sometimes and suddenly, is often not associated with damage to the respiratory system.An example of this is neurotic cough . At the same time, a cough in a person suffering from diseases of the circulatory system can be a sign of the development of formidable complications from the heart.
Auscultation of the lungs and analysis of cough characteristics are critical steps towards a diagnosis, so if an intruder’s cough interferes with your life, do not postpone a visit to the doctor. A timely diagnosis is the key to effective treatment. Therapists at Avenue Polyclinic are always happy to help you get rid of your illness.You can make an appointment on the website avenumed.ru or by calling the branch closest to you.
90,000 symptoms, remedies, methods, what types of cough are there and how to treat it?
Cough syrups can be recommended for both children and adults. Due to the absence of alcohol in the KODELAK ® BRONCHO elixir, it can be taken by children from 2 years of age, as well as by adults, driving vehicles or performing work that requires concentration of attention and maintaining the speed of reaction.
Learn more about the composition…
There are contraindications. You need to get expert advice.
Dry cough attacks in most cases are caused by inflammation and irritation in the throat. KODELAC ® NEO suppresses the cough reflex at the level of the cough center of the brain and has anti-inflammatory activity.
More about dry cough and its treatment …
There are contraindications. You need to get expert advice.
Ambroxol, which is part of the combined antitussive drugs KODELAC ® BRONCHO, reduces the viscosity of sputum and promotes its excretion from the bronchi.
Get acquainted with the composition of the preparation …
There are contraindications. You need to get expert advice.
When buying antitussives in a pharmacy, pay attention to the active ingredient. Generic drugs can vary in price. KODELAC ® NEO contains butamirate citrate for the suppression of dry cough attacks.
Learn more about KODELAC ® NEO …
Contraindications are present. You need to get expert advice.
KODELAC ® is a modern series of specialized medicines for combating various types of cough in adults and children, which includes preparations:
- KODELAC ® BRONCHO – for cough with phlegm;
- KODELAC ® NEO – for dry cough.
There are contraindications.You need to get expert advice.
Nature has presented a person with internal mechanisms to fight diseases, and one of them is a cough. It is a reaction to inflammation and is designed to protect us from foreign bodies trapped in the respiratory tract. With the help of a cough, phlegm is excreted from the bronchi together with pathogens. The cough can be dry and moist, acute and chronic, paroxysmal and persistent, but all types of cough are formed according to the same mechanism. When the receptors of the respiratory tract or pleura are irritated, the signal goes to the medulla oblongata, where the cough center is located.There a response occurs, in which the muscles of the bronchi and larynx are involved. As a result, we turn to the doctor with the question of how to get rid of a severe cough .
Types of cough and treatment
Complaints about a cough for a doctor are a signal to start a more detailed examination. After all, in order to find an effective way to get rid of a cough, you need to accurately identify its cause. And this is not always as easy as it seems: a cough can appear due to irritation not only of the respiratory tract, but also of the external auditory canal, esophagus, diaphragm, and so on.Among the factors provoking it are inflammation, chemical, mechanical stimuli, exposure to temperature and others .
Studied to the smallest detail
The mechanism of cough formation is known in every detail. Despite its apparent simplicity, this is a rather complicated process. It begins with a deep breath, followed by a tense exhalation with contracted bronchi and a closed glottis. Even the value of intrathoracic pressure at this moment is known – it reaches 140 mm Hg.Art. and more. Due to this, we exhale rapidly: the expiratory flow rate during coughing is 20-30 times higher than usual. It is due to this that sputum is evacuated from the bronchi .
Cough accompanies a variety of diseases: from acute respiratory infections to diabetes mellitus. It can also be a consequence of taking a number of drugs, including antihistamines, which patients often “prescribe” to themselves, and it is from coughing . Therefore, it is impossible to talk about the treatment of “just a cough” and the types of remedies for it: it is always necessary to clarify the nature, features of the cough, to determine the causes of its occurrence – all these factors will determine the effective treatment.
It is also called unproductive, meaning that it does not produce sputum. Most often, a dry cough is associated with uncomfortable sensations such as a sore throat or a sore throat. Some patients report that they feel constant irritation inside the throat. All this leads to more or less regular coughing or coughing fits of varying intensity.
Dry cough is typical for many diseases: influenza, parainfluenza, respiratory chlamydia, measles and others.Most of the causative agents of the listed pathologies penetrate into the epithelial cell or act on its surface, which in this case is equivalent to intracellular penetration. As a result, immunity is formed: the body begins to produce special cells – antigen-specific T-killers. They attack the affected cell and destroy it along with the pathogen. While the cell is not yet destroyed, it can undergo some changes. It is the altered cells that are capable of irritating the receptors of the bronchial tree.This irritation causes a dry cough .
With prolonged inflammation, nerve impulses from the irritated mucous membrane enter the brain constantly, which ultimately leads to overexcitation of the brain center. The cough becomes obsessive, debilitating, does not bring relief. The attacks come one after another, the sound of coughing is barking, abrupt. Such a cough can cause vomiting, spasms, and it is especially hard for children to tolerate.
Preparations for the treatment of dry cough can act in one of three directions:
- Softening the mucous membrane of the throat and reducing the inflammatory process.To achieve this effect, you can use folk remedies – gargle with saline, herbal infusions, eat honey, drink warm milk with butter. To relieve inflammation, “Paracetamol” or “Ibuprofen” is usually used, but you should pay attention to the restrictions indicated in the instructions .
- Decrease in the sensitivity of receptors that transmit a signal to the cough center. Various herbal preparations, teas, cough drops, as well as aerosols and hot inhalation (using steam) have a similar effect .
- Dry cough symptoms can be eliminated by suppressing it at the level of the cough center in the brain. Centrally acting drugs, in turn, are divided into two large groups: narcotic and non-narcotic.
- Narcotic dry cough suppressants contain codeine or dextromethorphan. Currently, such drugs can only be purchased with a doctor’s prescription on a strict accountability form; dispensing is subject to strict quantitative accounting in pharmacies.Most often, narcotic drugs are used for chronic severe dry cough, which cannot be eliminated with the help of cough suppressants from other pharmacotherapeutic groups.
- Non-narcotic drugs central action – more advanced means that are not addictive and do not have a depressing effect on the respiratory center. These include drugs with active ingredients such as butamirate, glaucine, oxeladin. For example, butamirate not only suppresses the cough reflex (Codelac NEO, Sinekod, Omnitus), but also has a number of additional beneficial effects: it expands the bronchi (bronchodilating effect), facilitates breathing, reducing airway resistance, and saturation blood oxygen, which has a beneficial effect on the treatment of diseases of the respiratory tract.
Since dry cough is obsessive and seriously affects the general condition of the patient, the drugs should be fast acting. It is desirable that the symptoms can be relieved after the first dose. The second requirement for funds is safety and, accordingly, the ability to use it for treatment in children. It is optimal if the same drug has different forms of release for adults and children, given that children are often reluctant to take pills. Since dry cough often bothers patients at night, one of the especially relevant properties of a modern drug is its long-term effect (from 6 to 12 hours).During this time, the patient can rest from coughing and get enough sleep.
The second type of cough is wet. It is also called productive: with a wet cough, a “product” – sputum is separated. To understand the mechanism of its formation, let us turn once again to the protective barriers of the organism, provided by nature.
The epithelial cells that line the inside of the airways are of various types. Goblet cells are responsible for secretion (mucus, sputum), on which foreign particles, including microorganisms and other pathogens, settle.Ciliated epithelial cells promote secretion excretion due to the movement of special outgrowths, the so-called cilia . This defense mechanism is called mucociliary clearance.
If the body is attacked by pathogens, the production of mucus increases: this is how the immune system reacts to the development of pathology. But the mechanisms of secretion excretion are disrupted: many cells of the ciliated epithelium die off as a result of inflammation, and those that remain are not enough to remove accumulated mucus from the respiratory tract .The phlegm thickens, irritates the receptors, and as a result, a person begins to cough, thus getting rid of phlegm. We call this type of cough wet.
Wet cough can be unproductive (then it is often confused with dry). In this case, coughing up is difficult if the phlegm is heavily thickened or if the muscle strength is not enough to remove it. The second situation is especially typical for children. According to the descriptions of the sensations of patients, a wet cough seems to come from the chest. Often it is accompanied by bubbling sounds, a feeling of congestion, which decreases after an attack.If the sputum leaves poorly, then it continues to thicken and serves as a breeding ground for bacteria. One of the most dangerous complications provoked by an unproductive cough is secondary bacterial pneumonia.
The types of drugs that are recommended for wet cough differ in several ways:
Mucolytic drugs (effectively thinning phlegm):
- Direct-acting drugs that destroy mucus polymers: cysteine derivatives, acetylcysteine, enzymes (trypsin), …When using these funds without the additional use of expectorant drugs, the risk of “waterlogging” of the lungs with a large volume of the resulting liquefied sputum increases. In children, sputum leaves worse than in adults, for a number of reasons: underdevelopment of the respiratory muscles, weak force of cough impulses, narrow lumen of the bronchi. Therefore, for babies, the danger of “waterlogging” of the lungs is especially great.
- Drugs of indirect action that change the biochemical composition, mucus production, adhesion of the gel-like layer: ambroxol, carbocisteine, bromhexine and others.It should be noted that drugs of indirect mucolytic action, as a rule, should be combined with additional intake of anti-inflammatory and antispasmodic drugs, since mucolytics themselves do not have such activity.
Drugs stimulating expectoration:
- Reflex-acting drugs irritate the gastric mucosa and increase the secretion of the mucous glands of the bronchi: thermopsis, marshmallow, licorice root, terpinhydrate and others.
- Preparations of resorptive action are absorbed in the gastrointestinal tract, secreted by the bronchial mucosa and, increasing bronchial secretion, dilute phlegm, facilitate expectoration: sodium and potassium iodide, ammonium chloride, sodium bicarbonate and others.However, they have a drawback: these funds significantly increase the volume of bronchial mucus, which, if difficult to cough up, worsens the condition and can lead to the development of complications.
These are agents that have a complex effect on the causes of wet cough – respiratory viruses and bacteria, inflammation and phlegm in the bronchi – and have mucolytic, expectorant, anti-inflammatory, antispasmodic, antimicrobial effects.
To relieve a wet cough and transfer it to a more productive state, it is optimal to use complex remedies that act not in one, but in several directions at once.This will allow you to quickly achieve the desired result and improve the patient’s well-being. But there are some limitations here too. First, a combination preparation should contain no more than three active ingredients from different groups. Secondly, each active ingredient must be contained in the drug in a safe dose. And thirdly, a complex drug should not increase the risk of side effects .
Cough itself is not a sign of a specific disease: various types of cough accompany many pathologies.If a patient turns to a doctor with such a complaint, the general condition of the patient, the nature and intensity of the cough should be assessed, factors such as the presence of diseases that provoke coughing, taking medications, the person’s lifestyle and others should be taken into account. Only then can treatment begin: it is better when it is complex and affects different mechanisms of cough formation, as well as symptoms. This is especially true if children complain of coughing.
Dry paroxysmal cough in a child – Med Question and doctor’s consultation
– Cough in a child
Hello, on October 28, a child fell ill, everything was as usual with snot and cough, there was no temperature, they began to do inhalations with saline, the nose was washed with an aqualor.On Monday, a strong dry cough began without fever, they made inhalation with pulmicort it became better, on Tuesday we went to the pediatrician (not our district pediatrician, ours was on vacation), she says that he has laryngitis and also prescribes pulmicort 2 r per day, nose aqualore. On Thursday, they came to see our pediatrician (she came out of vacation), looked at the tests (blood and urine) and said that there is a lot of acetone in the urine, the blood is calm, but looking at his breathing, you will have to drink antibiotics, prescribe summamed, erespal, in the nose polydex, inhalation with pulmikort 1 r per day.We really felt better, the cough subsided, there were snot, they are always lingering, on Tuesday we came to her appointment and sat in line for 2 hours, she looked at us, listened, everything is fine, but continue to drip polydex into the nose until 10 days, and at night a terrible dry cough starts to pound us, I did not wait for anything and did inhalation with Pulmicort, it got a little better, I called her and said that our condition had worsened, but since it was Wednesday (we have day of a healthy child), she tells us to go to another pediatrician with whom we were during her vacation, we came, listened to us, there is no obstruction, no wheezing, most likely while you were sitting for 2 hours waiting for an appointment, then you caught what then the virus.They said to do inhalation nat. r-r and berodual 5 drops, continue to drink erespal, in the nose with polydex. But on Thursday we were again cured by a terrible dry cough, I didn’t do any more inhalations with Berodual, but did it with Pulmicort, but the cough was hammering the child and hammering, in the evening I called an ambulance, because the child was choking with a cough, the ambulance said that the lungs were clean, to save themselves by inhalation 3 r per day Pulmicort, and nat. breathe the solution at least every half hour. The ambulance left, and the child cannot sleep, he is hammered by a dry cough, I cannot understand why Pulmicort does not help, before we had enough 3 inhalations and our dry cough turned into a wet one? Tomorrow we will have an appointment, I expect we will be prescribed antibiotics again, I don’t even know what to do, so I am writing here, I want you to help me.Thank you in advance!
90,000 Child coughs non-stop
Most visits to a pediatric pediatrician are associated with the appearance of a cough. While coughing can be a natural process of getting rid of dust or mucus, it is a very worrying process for many caring parents. Accompanying some diseases with a cough confirms the body’s ability to fight the disease. But when he goes into seizures, it becomes non-stop, you need to think about helping the baby.
A child coughs without stopping: causes of a severe cough
Parents’ desire to alleviate the child’s condition forces them to take rash steps. All methods known to mothers are used at the same time. Rubbing, wrapping, warm teas, vinegar on the forehead, mustard in socks, and some pill just in case. For complete confidence, antibiotics are added, and suddenly an infection. This approach does not help the child get rid of the obsessive cough, but only exacerbates the situation.
Important to remember! Before starting treatment for persistent cough, you need to be sure of the cause of its origin .
Non-stop cough can be triggered by the following diseases:
- If a cough without stopping is accompanied by a runny nose, fever and redness of the throat, then most likely it is a respiratory disease. To fight viruses, antiviral drugs, a large amount of fluid are needed, and an incessant prolonged dry cough is removed by removing irritation of the throat mucosa.
- If the condition worsens with colds, a painful cough with shortness of breath, vomiting and coughing appears, pleurisy or pneumonia is suspected.
- An increase in non-stop coughing fits with bronchitis may indicate inflammation of the bronchioles or bronchoscopic syndrome.
- Bronchial asthma is accompanied by coughing fits without stopping. They are especially intensified in the morning.
- False croup causes a non-stop cough at night for a long time.Other symptoms of this condition are voice changes and shortness of breath.
- Whooping cough. During bouts of coughing, there are several sharp exhalations and a wheezing breath. It intensifies at night, can cause vomiting and short-term breath holding.
- Inflammation of the pharynx, larynx can cause coughing without stopping.
Continuous cough can be caused by causes other than respiratory diseases:
- Allergic reactions.There are many reasons for allergies, and they need to be clarified in order to exclude dangerous manifestations, which can be expressed by a runny nose, severe non-stop cough, rash and even edema.
- A foreign object in the airway also causes a cough that cannot be stopped until the foreign body is removed. If it is impossible to do this on your own, urgent help from specialists is needed.
- Incorrect microclimate in babies provokes coughing attacks, especially in the evening and at night.
- A child’s nervous cough can last for a long time, until it calms down completely. Quarrels in the family, personal experiences, fear can become a reason for an unreasonable long cough.
Child coughs nonstop: dry cough, irritating mucous membranes
With a dry cough, the mucous membrane of the respiratory tract is irritated. This cough is unproductive and does not bring relief. It turns out a vicious circle. Inflamed mucous membranes cause a cough, which is practically useless, since mucus and phlegm do not drain.A strong cough further irritates the mucous membrane, which in turn provokes even larger bouts of non-stop dry cough. Such a process is especially painful at night, the child’s body does not rest, it loses the strength that it needs to fight the disease. To break this connection and alleviate the child’s condition, it is necessary to transfer a dry cough to a wet one. Sputum discharge with a wet cough is not such a dangerous symptom and gives relief to the child. Dry cough is typical for the initial stages of colds and as a residual after illness.
Important to remember! A non-stop dry cough without the appearance of a cold can signal serious illness. The child needs an examination to identify the causes.
Some pathologies that cause dry cough without stopping, not related to colds:
- bronchial asthma;
- stomach diseases;
- problems with the heart and blood vessels;
- psychological state of the child.
With the correct diagnosis, even a dry cough is treatable. But there are situations when you need to urgently consult a doctor, without waiting for the development of events:
- Non-stopping cough accompanied by very high fever or respiratory failure.
- Cyanosis of the face or lips appears during coughing.
- Coughing fits are accompanied by a whistling sound in the chest.
- Purulent thick sputum is coughing up.
- Persistent coughing for more than two weeks.
- Cough without stopping is accompanied by symptoms of intoxication.
Important point! Don’t delay calling an ambulance or seeing a doctor the next morning. Wasted time and assistance not provided on time threatens not only the health of the child, but also his life.
The child coughs without stopping until vomiting
Coughing fits are severe enough to induce vomiting in children.Cough, irritating the pharyngeal mucosa, provokes a gag reflex. The nerve endings responsible for coughing and vomiting are in the immediate vicinity of children, and prolonged bouts of coughing excite the receptors of the vomiting center. Vomiting while coughing for a while brings relief to the child. But later, an attack of coughing without stopping, ending with vomiting, may recur.
Such attacks are especially dangerous at night when the baby is asleep. The child does not control his actions, and vomit can enter the respiratory tract.At these moments, it is important for parents to be close to the baby and control the process.
Tip! Vomiting during coughing is very draining and dehydrating. Increase the amount of fluids your child drinks. Give him a warm drink between attacks. This will not only replenish fluid reserves, but also alleviate the condition of the baby.
Non-stop cough with vomiting can be a symptom of the following diseases:
- whooping cough;
- chronic bronchitis;
- runny nose.
In the supine position, a non-stop cough accompanied by vomiting may worsen. The reason is slow blood circulation and poor absorption of mucus in the nasopharynx and phlegm in the bronchi.
Tip of the Day! Place the child on several pillows, preferably in a semi-seated position. This position will reduce the number and intensity of coughing attacks .
- Vomiting can be provoked by coughing and foreign objects that children like to take in their mouths.If the child chokes on food, the body will react with a prolonged cough, accompanied by vomiting.
- In small children, erupting teeth may cause vomiting during coughing. Saliva accumulates in the larynx, causing coughing and vomiting.
- Nozzles, which the baby is not able to blow their nose independently, flow down the larynx. Thus, irritating her, and causing a continuous cough with vomiting.
- Snot may not come out and accumulate due to ENT diseases, such as sinusitis, sinusitis.Constantly stuffy nose makes the baby breathe through the mouth. Cold air and lack of oxygen causes a violent cough that turns into vomiting.
The child is coughing non-stop: what to do?
Cough treatment is a set of measures aimed at improving the baby’s condition. But what if the child is coughing and needs urgent help?
Urgent non-stop coughing help:
- First you need to calm down the child, and the parents will not hurt to pull themselves together.
- If the baby is coughing while lying down, pick him up or pick him up.
- If a child is choking on a cough, moist, warm air will help. Hot water is taken into the bath and brought into the child’s room for 10-15 minutes. If necessary, after a while, the procedure is repeated.
- Soda inhalation can stop severe coughing without stopping.
- Warmed milk will help soften the throat and stop coughing. You can add soda or honey to it.
- For allergic coughs, spasms and swelling can help relieve antihistamines.
- If a severe, non-stop cough is not accompanied by a fever, a hot hand or foot bath can be used. Blood flow will increase in these areas, causing outflow from the respiratory system. The condition will improve for a while.
- Non-stop cough caused by a foreign body requires urgent removal.
Caring for coughing children
Having stopped a coughing fit, you need to take care of proper childcare. These simple recommendations will greatly facilitate the child’s condition and speed up the healing process:
- Humidify the air in the nursery.Dry air provokes a cough in babies. Daily wet cleaning, a damp towel on a battery, water containers placed in the room, or just a humidifier will help maintain optimal humidity.
- Maintain the temperature at 20-22C. Ventilate the area twice a day.
- Eliminate all irritating odors. Chemical smells, detergents, any smoke can provoke a cough.
- Increase drinking, especially alkaline.Milk, tea, just water, herbal decoctions, teas with jam saturate the body with useful moisture and liquefy phlegm.
- Ample food is not required for a child at such times. Light broths, mashed potatoes, boiled chicken, jelly, jelly are quite suitable for a weakened body.
- Warming compresses, mustard plasters, cans help well with a debilitating cough. But do not forget to wrap up the baby after the procedure.
- Chest massage can help drain mucus and reduce coughing attacks.
Hardening the child
The frequency and intensity of diseases accompanied by non-stop coughing depend on the baby’s immunity. It is important during periods when the child is not sick to devote sufficient time to hardening. Preventive measures for frequent colds with severe cough include:
- Frequent walks in the fresh air;
- physical activity and sports, appropriate to the age and development of the child;
- the child’s clothes must be appropriate for the season, overheating is not beneficial;
- baby’s nutrition should be balanced and contain all the vitamins necessary for a small body;
- daily water treatments with hot water dousing.
The child coughs without ceasing, how to help: Reviews of female readers
Marina Savelyeva, 26 years old, Samara . My daughter, 5 years old, had a terrible cough. It went down during the day, now they did not sleep at night. This went on for five days. We were advised to do cough inhalation. We tried ordinary mineral water, but did not breathe for long. Although 10 minutes was enough for us to reduce the cough. We will continue to do inhalation.
Inna I take it, 30 years old, Magnitogorsk. The cough has worn us out.The son goes into fits, catches his breath, and sometimes vomiting. We’ve probably tried everything already. And cough syrups, and antibiotics, mustard plasters were put, inhalations were done. The cough has not gone away for more than three weeks. Now we have passed the tests, we are waiting for the results. Maybe it’s whooping cough?
Elena Semenchenko, 28 years old, Irkutsk. We were sick all the time. The cough will pass, the snot will appear. Let’s cure snot, cough again. Vitalik coughed without stopping, it was very difficult for him to breathe. Permanent sick leave.We began to temper it a little, we ventilate the room for the night, pour summer water over it, and stopped wrapping it up, as before. Of course, from time to time we still get sick, but we no longer observe such attacks of coughing.
Tatyana Lisovaya, 35 years old, Moscow. My daughter had a severe cough in the evening, they could not stop it. I decided to wait until morning, do nothing, and then call a doctor. Strange, but she coughed up, went to bed, and woke up in the morning and did not have more attacks. We did not call the doctor, and did not understand what caused such a strong cough.
Lyudmila Savicheva, 22 years old, Vologda. I was very scared when my daughter started coughing continuously. I read about whooping cough, croup in babies. Our pediatrician listened to Masha and said that this is how her body tolerates ARVI. We give a lot of warm milk to drink, and the cough becomes less. While the doctor recommended not to give any coughing syrups, the cough is still very dry.
Daria Voronova, 25 years old, Yekaterinburg. For example, I know perfectly well why my son starts to cough.Allergy to wool was discovered 3 years ago. Of course, we have no animals at home. But it happens that coughing attacks begin right on the street. I always have Suprastin with me. Just beginning to cough badly, and even suffocate, I give a pill.
The child coughs without stopping, what to do: Video Doctor Komarovsky
Offers with “non-stop”
We found 80 sentences with “non-stop”. Also see synonyms for non-stop.
Meaning of the word
- Like most of his friends, he smoked continuously, and his non-stop cough while driving worried me.
- Parts of the right flank of the 3rd Army of the Southwestern Front continue non-stop withdrawal in a southeastern direction towards Efremov.
- This does not mean that there was non-stop jitters, that everyone was sitting, walking and looking around.
- At the same time, there is a kind of non-stop search for another actress.
- Finally, one day, in the early morning for one night high-speed non-stop ferry we were taken to the far platform of Ryazan station.
- This does not mean that there was non-stop jitters, that everyone walked and looked around.
- Our echelon went non-stop , roads were open for us everywhere.
- He walked non-stop forward, like a man haunted by terrible visions, until he finally felt that he had gone astray.
- At first “Yermak” went non-stop , but then it stopped and had to work from a raid, each time passing about half the length of the ship.
- Units of group non-stop made their way forward.
- Vitebsk was advancing quickly, non-stop .
- There were more than a hundred of them, and they non-stop fired.
- I didn’t follow any particular diet, but I also didn’t eat non-stop .
- Many and many of them have already fallen, but the mass went non-stop , as in a good teaching.
- Despite the hail of grapeshot, the French non-stop pushed forward.
- However, he reported that he had from me the order to go to Yekaterinodar without stopping .
- I was silent, and it was unthinkable to insert at least one word during the wild cries that she non-stop definitely threw out of herself.
- Non-stop sailed to the Yenisei Big Rapid, where at one time my grandfather and great-grandfather drowned.
- The eyes of non-stop wandered over the ramp and the other side of the ravine.
- Apparently, Yurka Drozdov did his best, who the day before in the battle with Loko beat me non-stop bludgeoning.
- In this hall, traders of bonds were running non-stop billions of dollars.
- And we are already at the start line, the arrow moves non-stop .
- But she was getting worse, she non-stop cried, and towards the end of the ceremony she clutched at her heart.
- All trusts are cracking, and traders are raising foam non-stop .
- Only when most of them started roaring nonstop roaring, did the SS allow them to return to the barrack.
- This is no longer a miserable village of four houses, but a whole store in the open air, where nonstop are trying to get money out of you.
- I was shaking in the bus, wiping the sleeve of my sweater non-stop tears and realized that I had one less problem.
- We drove nonstop until noon, and then settled down to rest on bare ground until three o’clock.
- Repair of fortresses, replenishment of weapons and materiel went non-stop .
- Steamships suffer mainly when the icebreaker cannot follow non-stop .
- Inspiring the army, Trotsky nonstop makes speeches to the soldiers.
- The vehicles of the 3rd Panzer Division non-stop went along a wide road.
- Tickets fell on the table one by one and I answered nonstop .
- I spent four months in Arabia, non-stop moving from place to place.
- The huge propaganda industry non-stop forms the stream of people’s thoughts within certain frameworks and directions.
- And therefore it is necessary non-stop to take care of yourself, so that, accidentally forgetting, you do not die in the face of another and do not transmit the infection to him.
- On the front of the Don and Volunteer Army, our units moved forward non-stop .
- What is Lenin to him, what Trotsky, that the whole line of the Bolsheviks, that the blood spilled in October and non-stop and now is pouring out!
- They stood on the front line without any protection and methodically and non-stop beat on the positions of the Vlasovites.
- Eleven vehicles, moving non-stop and in a straight line, reached the western coast.
- The enemy was informed that he was retreating non-stop .
- Non-stop thundered our heavy 211-mm mortars “18”, unleashing shell after shell at the enemy pillboxes made of steel and concrete.
- Subsequently, non-stop pursuing the enemy and knocking down his screens, continued to advance to Krivosheevo.
- At this time there were no battles, but on both sides non-stop worked on trenches and fortifications.
- Despite the strong fatigue of people and horses, the pursuit was carried out non-stop all night long.
- But soon the foreboding of trouble began to intensify: his body slowly but non-stop began to rotate.
- Everybody’s booing at Bobel, and Doodle roars non-stop .
- We drove nonstop , day and night, and very, very slowly.
- Five hundred meters to our right, assault guns and motorized infantry move non-stop .
- Cassius himself helped to restore justice, who has been shouting non-stop since the birth of .
- Our steamer bristled with a dozen anti-aircraft cannons and machine guns, which non-stop shot arrows of fire into the sky.
- His face was burning with fire, and he non-stop walked back and forth through the audience.
- Grandmother stood, as always, silent, only small tears non-stop poured from her healthy eye.
- We took a break on Thursday morning to cook soup, and at 5 o’clock in the afternoon we set out again, which continued non-stop until nightfall.
- Tears flowed from the corner of his right eye non-stop and, leaving a wet mark on his cheek, rolled down the wrinkle behind the collar.
- We met almost no resistance and attacked all the time non-stop .
- Just because it worked continuously and non-stop .
- Mike non-stop chewed gum, was blessed, you see, took communion in the morning with a port bag.
- And everywhere along the highway they were followed by a “tail”, they were not allowed to stop to rest, they had to go non-stop .
- The new icebreaker is able to go nonstop through the ice that covers the Vladivostok roadstead and the Golden Horn.
- It seemed that we would non-stop move into the unknown under the endless rain that does not subside for a minute.
- Only a Russian soldier is able to walk nonstop forty versts and, without resting, engage in battle.
- Before his death, it was as if non-stop diminishing forces had returned to him a long time ago.
- Our retreat non-stop continued until Schweidnitz.
- The new icebreaker is able to go nonstop through the ice that covers the Vladivostok roadstead and the Golden Horn.
- On the seventh day of the non-stop campaign, forward patrols made it known that Ariovist’s troops were 24 miles from ours.
- They don’t want to have anything to do with the power they used to non-stop ass licking!
- But now the wheels are measured and non-stop knocked, and the city lights were left somewhere behind.
- Listen to yourself, and you will hear the heart beat in your chest non-stop .
- During his landing and disembarkation of soldiers non-stop were firing at enemy guns and machine guns located behind the airfield.
- Fatty rats tore holes in the bodies, which non-stop devoured, and made holes there.
- During our one-hour meeting, he was non-stop smoking .
- But if you saw the Light of Joy, then strive to Him non-stop , so as not to stumble on the Path again.
- In some places we could move non-stop , and in some places the icebreaker stopped, we had to back up and make our way from the raid.
- Gangs replaced each other non-stop .
- Jean-Louis is very productive, he writes nonstop .
- Steamships suffer mainly when the icebreaker cannot follow non-stop .
- Low tide non-stop lasts six hours.
- Speakers non-stop counting down the time, and the tone became more and more shrill.
- In the officers’ club he nonstop bragged about his adventures in the air, but never took part in flights.
Source – introductory fragments of books with liters.
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COVID-19: personal experience of Kuban journalist Rostislav Kutuzov – Society
He was treated in Spain
Well-known journalist Rostislav Kutuzov from Armavir on a page on a social network tells in detail how the coronavirus infection proceeds. He contracted COVID-19 while in Spain, where he is now undergoing treatment.Rostislav published the first message about a possible disease on April 13, 2020.
“Judging by the clinic, I got sick.
Symptoms of bronchitis since yesterday morning. Weakness, malaise, dry, unproductive cough, shortness of breath. I used to often suffer from bronchitis and therefore can diagnose myself with 99% accuracy.
No temperature. But, I believe this is covid-19. In a light form. I am sure that it will continue this way. ”
Later it became known that Kutuzov’s wife also fell ill.Moreover, the woman also had rashes, similar to mosquito bites, as symptoms.
“Today is the 6th day of illness, if you count from the moment the characteristic rash appeared. And the 4th since the beginning of the cough.
Yesterday evening, against the background of a temperature of 36.4, there was again a fever. And it’s time to take paracetamol. I drank a pill and after 15-20 minutes I was in a fever and sweat.
At night – hot milk with baking soda and butter.The cough effect is not great. I don’t write about water in liters, tea with lemon, glasses, yogurt in kilograms, I mean).
As soon as I lay down, I began to choke my cough. I decided to inhale budesonido. This is a glucocorticosteroid, prescribed to my daughter in case of an allergic reaction of the bronchi, to relieve spasm. She is allergic to us and in the first-aid kit, just in case, there is always this drug. ATTENTION! I DO NOT RECOMMEND THIS PREPARATION! I used it myself at my own peril and risk. Consult with doctors, please!
And that’s it, I forgot about coughing for a while and fell asleep.During the night I noticed that the cough appeared when I turned on my side. Any one, right or left. Lying on my back, the cough did not bother me. At night, sputum began to actively withdraw.
In the morning I woke up cheerful. There is no feeling of withdrawal, malaise, muscle pain. You can say I feel like a healthy person. Rare coughing fits are reminiscent of the disease.
My wife: the rash on the back is enlarged and itchy. I think the active symptoms of ARVI will begin tomorrow.Morally ready ” .
The seventh day of illness Rostislav Kutuzov described as follows:
“Yesterday I coughed little all day, I felt good and, in general, thought that everything was over. But, so far in vain. “No need to rush.”
Didn’t indicate another symptom, piquant. But I decided, since “such a booze has gone” … It’s diarrhea. But, not in its classical manifestation. Stool no more than 1-2 times a day, but very bad. And strong flatulence in the intestines.I always watch my stools, as it is an indicator of immunity in the body. And necessarily yoghurts twice a day. Sorry, but for the sake of completeness of the clinical picture, I will be as frank as possible. I don’t think I spoiled my image too much)
In the evening there was a slight feeling of heat, nausea (for the first time) and again weakness. As soon as I lay down, a dry, unproductive cough began. Endless. The phlegm does not go away. All night long. Nothing helped. Even budesanido inhaled, didn’t help. Very strange.
True, yesterday evening the milk ran out, and I did not drink hot with soda and butter.
As a result, I was awake until 4 am, then there were some lapses in sleep, interrupted by a cough. Although, it can be called a dream with a very strong stretch. ”
On the eighth day of treatment, Rostislav spoke about a strong dry, non-stop and debilitating cough against the background of general well-being.
“The doctor is measuring oxygen saturation, everything is fine.Adds mucolytic to treatment.
The cough is of course wild. But, now productive, cleansing. Giving the opportunity to relax. He cleared his throat and for a while you can not cough, but, for example, sleep)
I am stating another strangeness of the course of the disease. Suddenly onset bronchitis, with shortness of breath, dyspnea, severe intoxication of the whole organism, just as suddenly turned into laryngo-tracheitis. And only a cough remained of the symptomatology. But, damn it, what! This is the king-cough!)
So, the general state of health is very good.Now I’m going to hand over blood. They somehow determine by the blood the presence of a secondary infection that could join. If I get you right.
About my wife. Her symptoms: 3-4 days of mild urticaria, sore throat, pain in the eyes – viral conjunctivitis, also a symptom of CV19. And that’s all. Oh yes. Several sleepless nights from my loud cough. ”
On April 18, 2020 Rostislav Kutuzov published the last post on the course of coronavirus infection.
“So, the 9th day of illness.
Although, I am sure that covid-19 itself is already behind me and I still have laryngo-tracheitis as a complication with bacterial etiology, as a secondary infection.
At this stage, you can conduct a resume. I was in a mild form. Most of humanity will get mild CV19 and develop antibodies. The disease is serious, but you should not be afraid. Fear is an extremely negative factor in the course of an illness.Be very responsible about the situation. Remember, the responsibility lies with you for yourself and for your loved ones. Drink more water, hot drinks, citrus fruits, milk, yoghurts.
Spanish doctors immediately prescribed paracetamol for me every 8 hours, regardless of temperature. I also recommend this to everyone at the onset of clinical manifestations.
And one more fact! I will write in capital letters: in case of suspicion of a disease – IMMEDIATELY CONTACT A DOCTOR !!! “.
photo from social network
Komarovsky child has a cough at night. Cough in children at night
Attacks of nocturnal coughing torment the child and interfere with sleep both for him and his parents. When a baby wakes up at night and coughs painfully for a long time, it is impossible to remain calm and wants to help the baby as soon as possible. But for this it is necessary to understand why the cough appears at night and how it is treated.
Cough acts as a protective function designed to rid a person of excess phlegm, bacteria or foreign bodies in the respiratory system.If the baby coughs during the day, as a rule, this symptom intensifies at night, since in the supine position less oxygen enters the lungs, and sputum accumulates.
The main causes of dry cough at night are:
- Consequences of colds and SARS.
A cough with such diseases can last long enough, especially if they are not treated.
This cough often appears suddenly and is not accompanied by any other symptoms.Parents may associate it with exposure to an allergen, such as the flowering season or new household chemicals.
- Whooping cough.
An agonizing cough at night with whistling, facial flushing and vomiting is a characteristic symptom of this disease.
- Bronchial asthma.
Coughing fits with such a disease can torment a child closer to the morning.
- Chronic inflammation of the nasal mucosa or sinuses.
With this type of runny nose or sinusitis, the child is often worried about a prolonged dry cough at night.
- Chronic pharyngitis.
Nocturnal cough with this disease is not the only symptom. The child will also complain of severe sore throat.
- Gastric reflux.
Such a reflex cough is caused by the contents of the stomach entering the esophagus, so it will also have heartburn.
For this reason, a child may cough at night due to excess saliva flow.
- The air in the room is too dry. This situation is especially typical for the heating season. When the air is too dry, it irritates the respiratory tract, resulting in a dry cough.
Cough can appear when infected with those worms, the larvae of which migrate through the lungs.
Cough without fever
The absence of fever during nocturnal coughing fits may indicate the allergic nature of this symptom. In this case, the child may often have symptoms such as a runny nose, sore throat and itching, tearfulness and redness of the mucous membranes of the eyes.As a rule, bouts of dry allergic cough appear due to the presence of an allergen nearby, for example, due to new washing powder with which mother washed the bedding or curtains, due to a down pillow, or due to flying pollen entering the nursery from open window.
How to help with a coughing fit?
First of all, a child with a coughing fit should be reassured, since many babies under 5 years old with such nocturnal attacks develop a strong fear.Also, if a cough occurs at night, the child should be given a warm drink, for example, tea with honey or raspberries. A good effect is the use of alkaline mineral water, from which the gas is released, before bed. Another popular recipe that has been shown to be effective for dry coughs is warmed milk with a little honey and baking soda.
It is also important to humidify and ventilate the room. Sometimes, to eliminate a dry nocturnal cough, it is enough to change the position of the child in a dream – turn him on his side or put a high pillow.If the dry cough recurs and is not eliminated by such measures, be sure to go with your child to the doctor.
In the treatment of dry nocturnal cough, it is important to determine the cause of the symptom, since in each case the treatment will be different. If the cough is allergic, it is important to eliminate the allergen and consult a doctor who will select the appropriate antihistamine. If the cause of the cough is a bacterial infection, the child will need to be given antibiotics, which the pediatrician will prescribe.
Medicines used for coughing at night can affect:
- Cough center in the brain. They block the reflex itself.
- Bronchial muscles. These drugs dilate the bronchi and make breathing easier.
- Bronchial mucous membranes. Such medicines moisturize them, relieve inflammation and promote phlegm production.
- Sputum in the bronchi. These medications make the mucus thinner, which helps you cough up the mucus.
A pediatrician should prescribe such medications, because if the wrong drug is chosen, in many cases they can further worsen the child’s condition, and some drugs are not combined with each other.
A popular doctor calls a cough a protective symptom and calls for treating not it, but the disease that manifests itself in this way. Komarovsky is sure that fresh air and a lot of drink are of great importance in getting rid of a dry cough.With such simple measures, a well-known pediatrician recommends treating coughs to all parents, assuring that the use of medicines has the same effectiveness.
For more details, see Dr. Komarovsky’s program about coughing.
- Do not ignore the attacks of nocturnal coughs in your child. In some cases, this can be a symptom of diseases that need to be treated very urgently. If the cough persists for several nights in a row, be sure to see a doctor.
- Do not buy or give your child cough suppressants without consulting a pediatrician, especially central antitussives and antibiotics. They may be contraindicated for your child or simply not helpful.
- Do not forget about the need for a plentiful warm drink for the child, which will soften the throat and moisturize the mucous membranes. Give the baby tea, milk, herbal teas.
- Inhalation is often used to moisturize the mucous membranes with dry coughs, but parents should remember that immediately after the procedure, the cough, as a rule, intensifies.In addition, there are age restrictions for their implementation.
- Try tucking the baby into bed with the pillow high. This technique will help get rid of a nocturnal cough caused by profuse drooling or a runny nose.
- To make it easier for your baby to breathe through the nose, clean it before bed. To do this, you can use a saline solution by dropping 2-3 drops into each nostril.
Systematic nocturnal cough in a child is a serious reason to find out the causes of this phenomenon.This symptom is defined as a reflex excretion from the body of accumulated mucus or foreign bodies trapped in the children’s respiratory tract. Without understanding the source of the problem, taking antiviral drugs, inhalation and traditional medicine will be powerless.
Dr. Komarovsky calls a cough a symptom, for the treatment of which it is important to understand the reasons that provoked its appearance. He strictly prohibits giving the child medicines that suppress coughs without medical prescription, assuring that there is nothing dangerous in a night cough, and parents need to be patient with active treatment before visiting a pediatrician.
Komarovsky about the causes of night cough
Cough is not always the result of terrible and dangerous processes in the child’s body. You can create a list of the most common situations when a child coughs at night:
- Allergic cough: reaction of the child’s body to down, woolen and synthetic bedding fillers, smells of paints and varnishes.
- Runny nose. Even with minor nasal secretions, the child can overtake a cough during sleep. This is due to the fact that mucus from the nose flows down the back of the throat, tickling and irritating the mucous membrane. With the help of a cough, the body spontaneously tries to bring it out.
- Dry air in the room. With the beginning of the heating season, there is a temperature drop, and parents are extremely concerned about keeping the house warm. However, too hot air dries out the delicate mucous membrane of the child, which is the reason for a dry cough.
- Growing teeth: a common cause of nocturnal coughs in infants.Cough provokes profuse salivation.
- Complex diseases, in particular – respiratory diseases, for the treatment of which a doctor’s consultation is required.
Komarovsky conditionally classifies cough into allergic and viral. If the symptom is accompanied by intense fever, a runny nose, general weakness and poor health, this is a sign of a viral infection. A cough in a child without fever in the absence of additional signs of the disease is defined as allergic.
Treatment of viral cough with antibiotics is prohibited and impractical, since antibacterial drugs are powerless in the fight against viruses.
What to do
First, the parent should determine the nature of the cough, body temperature and check the general condition of the child. Next:
Komarovsky categorically prohibits amateur activities and trying to overcome such serious diseases as bronchitis, pneumonia, rhinitis, etc. without the help of a doctor. There are too many antitussives, and they all have a different focus.
By blocking the cough reflex with a wet cough, and taking remedies for the discharge of sputum with a dry cough, you can earn complications, vomiting and a host of other negative consequences for your child’s health.By acting wisely, you can easily cope with a night cough.
Do I need to give medicine
According to Dr. Komarovsky, it is not a cough that needs to be treated, but the disease that caused it. If the child is dressed for the weather, consumes enough fluids, the air in his room is humid, and in the nursery it is cool – 90% of the actions aimed at treating symptomatic cough have already been done. Do I still need to give medicine?
Any antitussive drugs have nothing to do with independent methods of treatment.Even when it is obvious to the parent that the child is sick with ARVI, medications can be prescribed only after the doctor listens to the child’s lungs and makes sure that they are clean and there is nothing to cough with.
The use of medicines that increase the volume of bronchial secretions is dangerous because their action is aimed at reducing the frequency of cough shocks and mucus accumulation, which significantly increases the risk of complications.
We can summarize:
- for ARVI, in most cases, cough medicines are not needed and are contraindicated;
- the use of medicines that suppress cough is dangerous and useless for children under 2 years of age;
- medical treatment of children over 2 years old is allowed only with the clear recommendations of the doctor and under his watchful supervision;
- it is strictly forbidden to combine antitussives and drugs that increase the volume of sputum in one complex of therapy;
- one should not expect super-efficacy from drugs, ignoring simple treatment conditions: abundant drink, fresh air, humidity in the room, etc.
Since cough is the most common symptom of childhood illnesses, the choice of drugs to treat it is dauntingly overwhelming. The effectiveness of the vast majority of funds has not been proven. This is due to the fact that the nature of the symptom mainly depends on the conditions in which the child is.
A huge arsenal of cough suppressants is a sedative for relatives who need to cure their child. Eliminating the cause of the cough and ensuring a healthy environment are key indicators of a successful and quick recovery.
In therapy, the correct distribution of responsibilities is important: the pediatrician must find and eliminate the cause of the disease, the parents must create conditions under which the prescribed drugs can be most effective, and the body must defeat the disease. Sufficient use of safe and appropriate drugs is the main principle of symptomatic treatment.
Colds, the symptom of which is coughing, are very common among young patients of preschool age.But if the daytime cough is easier for both the child and his parents, then the nighttime cough causes a lot of concern and questions. We will learn about its causes, types, possible therapy.
Cough in children, mainly at night: causes
Young parents are always worried about why their baby’s cough worsens at night. The thing is that the phlegm accumulating in the nasopharynx and lungs of the baby is absorbed slowly. It clogs the airways, causing a reflex cough. And attacks of such a cough are provoked by colder and drier than daytime air.It is he who irritates the mucous membranes of the baby’s larynx.
Regular nocturnal exacerbation of coughs is a sign of such diseases:
- Chronic rhinitis, pharyngitis, sinusitis. In these cases, a constant tickling and tingling sensation is felt in the child’s throat.
- Asthma. It can be mild.
- Gastroesophageal reflux.
When the cough, accompanied by fever, does not go away within a week, the child loses weight, is nervous, then he should definitely be shown to the pediatrician, and not listen to the advice of neighbors and acquaintances.
Dry cough in a child all night, at the same time
If a child coughs only at night, then, most likely, this is evidence of the development of bronchial asthma or whooping cough.
The symptoms of the latter are a painful dry cough. He can reach vomiting, and the baby’s face turns red at the same time, noise and whistling are heard during inhalation. In seizures, the child sticks out his tongue.
If we are talking about bronchial asthma, then the breaths of a sick baby are whistling. In this case, more often than not, attacks worsen closer to the morning.This period is the time of frequent deterioration in asthmatics. In such children, seizures can also be observed during physical exertion, but an exceptionally nocturnal manifestation of the disease is possible. When a child regularly suffers from bronchitis, there are people in the family with asthma, then it is necessary to show the child to an allergist, because such conditions are characterized by rapid progress and can lead to complications in the absence of adequate therapy.
Gastroesophageal reflux often causes a child to cough all night.This is more often observed in preschoolers, who also complain of heartburn.
If we are talking about coughing attacks of a baby at the same time, then the reason for them (in addition to allergies to feather pillows, blankets) may be underdevelopment of the child’s lungs. It happens that the development of this respiratory organ lags behind the development of the child’s body, and the lungs simply cannot cope with the stress, which is manifested by nighttime symptoms. Usually this phenomenon disappears by 4-5 years.
Severe cough in children at night before vomiting, with attacks
Do not worry too much for the dad and mom of the baby, whose coughing attacks at night reach the point of vomiting.There is no threat to life in this, and this is a fairly common occurrence. Pediatricians explain it this way: the emetic and cough centers are located close to each other. They are even interconnected. But you cannot let such a situation take its course, you need to contact your pediatrician in the morning. After all, coughing up to vomiting can be a symptom of a serious illness. And a favorable outcome largely depends on the timeliness of the treatment begun. Therefore, first of all, it is necessary to establish the cause of the problem. And if after an attack the child vomits, then whooping cough should be excluded.A dry, convulsive cough in the form of attacks, ending in vomiting, is a bright symptom of this disease. At the same time, the child almost suffocates. His face turns red from exertion, tears are flowing, that is, the baby is trying to cough with his whole body. Usually, with whooping cough, antitussive drugs are powerless, they do not bring relief to the child. Without error, it is possible to recognize whooping cough in a baby by the specific sound that the patient makes at the end of the attack.
Parents’ personal guesses can only be confirmed by a doctor and mucus culture, which must be passed during the first week of the disease.Next, you will need to take a blood test.
Only after pertussis has been ruled out as the cause of the problem should we look for others. A similar condition in children can occur against the background of colds and SARS. If these diseases have gone far, then most likely the development of bronchitis.
What to do if a child’s cough worsens at night and in the morning
A child who coughs several nights in a row must be examined by a pediatrician. If a serious illness is suspected, he will prescribe additional examinations in order to finally establish a diagnosis.If the pediatrician is convinced that a night cough is a sign of ARVI, then the baby needs to be helped to survive the night with maximum comfort. And for this there are general recommendations:
- Evening airing of the room where a sick child will spend the night.
- Carrying out wet cleaning in it before bedtime.
- Additional room air humidification.
- Increase the dose of drinking throughout the day. It should be warm. Options – vitamin fruit drinks, rosehip decoction, chamomile infusion, milk with butter and honey.
- Cleansing the baby’s nose before going to bed with saline solution. Make the child blow his nose well.
- Ease attacks of dry inhalation cough, which are recommended for children after one year.
Parents should know what to do in such problem situations. It is forbidden to treat cough with antibiotics. When it is wet, you should not give the baby antitussive drugs. A dry cough cannot be treated with expectorants.
How to calm a child’s cough at night: treatment, folk remedies
If a young patient has been coughing for several nights in a row, he should be examined by a pediatrician.If you suspect whooping cough, bronchial asthma, the patient will be prescribed additional examinations. When a pediatrician diagnoses that a cough is a symptom of an acute respiratory viral infection, it will be easier to deal with them. It is necessary to carry out treatment against the background of regular ventilation of the nursery, humidification of the air in it, and abundant warm drinks. As for medications, children’s doctors recommend using antitussives for dry coughs, which affect the cough center in the brain stem.These are glaucine, sinekod, tusuprex, sedotussin. Also prescribed drugs acting on cough receptors: levopront and libexin; antitussives stoptussin and bronchodilator.
If the baby has wet cough attacks, it is recommended to be treated with marshmallow and Doctor Mom syrup, pectusin, bronchicum elixir. Many mothers give preference to the folk elimination of the above problem. And this is their right. If the child is not allergic, then you can offer him to suck on natural buckwheat honey.It has a good effect on the respiratory system, softening the mucous membrane, enveloping it, warm natural milk with butter and honey. Sometimes a quarter teaspoon of baking soda is added to it. Warm raspberry tea and berry fruit drinks also work well.
You can buy ready-made herbal antitussive preparations in pharmacies. This is breast collection number 1, which contains licorice, oregano, coltsfoot. In addition to them, plantain is also present in breast collection No. 2. Components of breast collection No. 3 are licorice, pine buds, anise, marshmallow, fennel, sage.
Another popular option for treating a night cough is a compress of warm potatoes, mustard, alcohol, applied to the back of the child. The duration of this procedure is one and a half to two hours.
Cough in children at night: Komarovsky
The well-known pediatrician Yevgeny Komarovsky has his own view of the treatment of nocturnal children’s cough. In his opinion, many parents simply incorrectly treat upper respiratory tract infections using mucolytics. This is precisely the way to provoke a night cough in a child.ARVI therapy with biseptol is also a good way to cause complications.
Therefore, Dr. Komarovsky strongly recommends that parents stop such treatment, visit their pediatrician and follow his instructions. Evgeny Olegovich advises to rinse a sick baby’s nose with saline and fight not with a cough, but with the disease of which it is a symptom (or consequence). By eliminating the cause of irritation of the mucous membranes of the respiratory tract, you are more likely to cope with a nocturnal cough.
The pediatrician advises to make sure that the child’s nighttime attacks are not a manifestation of allergies.To do this, he first advises to remove flowers, feather pillows, a blanket from the nursery, do wet cleaning before bedtime, ventilate the room and watch the baby sleep. If such measures do not help, then hurry to the pediatrician in the morning.
Especially for – Diana Rudenko
Parents experience any diseases in children very acutely. Anxiety for the child’s condition haunts. Cough is a defense mechanism for removing accumulated mucus, and it can appear for various reasons.Most often, this symptom appears during colds. But the children’s doctor Komarovsky also sees the causes of a night’s cough in a child in other pathologies and conditions. To prescribe an effective treatment, it is important to find out the provoking factor and eliminate it.
Komarovsky’s opinion on the causes of nocturnal cough
If a child has a nocturnal cough reflex, this does not necessarily indicate the development of a serious illness, although such attacks should not be ignored.
The reasons for coughing at night in a child Komarovsky sees in the following:
- Allergic reactions.
- The period of teething in a baby.
- The air in the children’s bedroom is too dry.
- Psychogenic character of cough. In this case, there is psychosomatics, the symptom is caused by nervous disorders. Seizures are not uncommon in such cases.
- Residual phenomenon after an infectious disease.
- Serious pathologies requiring medical attention.
It is possible to make a decision about possible treatment only after finding out the reason, a pediatrician should be engaged in this.
Possible diseases with cough without fever
When the child goes to bed, the horizontal position leads to the accumulation of phlegm in the upper respiratory tract. If a child coughs at night, Komarovsky believes that the absence of a temperature at the same time may indicate the presence of the following pathologies:
- Rhinitis, pharyngitis.With these diseases, the cough is dry and irritating. Between attacks, the baby may cough, a sore throat appears.
- Asthmatic bronchitis. The cough is accompanied by wheezing, the child complains of chest pain, it becomes difficult for him to breathe.
- Whooping cough. A serious illness that manifests itself as a non-stop barking cough. In this case, whistling sounds appear, a large amount of sputum is released, and vomiting may be observed. The strongest cough simply exhausts the baby, disrupting sleep and leading to exhaustion.
- Adenoids. With such a pathology, the cough reflex increases during periods of exacerbation and with a severe degree of pathology. Mucus going down the nasopharynx makes the child cough.
- Gastrointestinal reflux is a dry cough and sore throat. If you cough heavily, you may be vomiting.
- Helminthic invasions. The presence of helminths in a child’s body often causes a dry cough reflex. The child may also have abdominal pain and nausea.
If an unpleasant symptom does not allow the child to fall asleep, torments him at night, then during the day he is sleepy, looks tired. If a child’s cough does not go away during sleep for a long time, then Komarovsky believes that it is time to visit a doctor.
It is not necessary to prescribe medications for the treatment of a child on your own. This could be hazardous to his health.
Child only coughs at night
Parents begin to worry if there is no cough during the day, and at night their child often wakes up due to an obsessive symptom.Komarovsky advises to pay attention to some points if a child coughs while sleeping:
It is important to distinguish an allergic cough from symptoms of a cold. Therapy is meant to be different.
The children’s doctor believes that not the symptom itself should be treated, but the pathology that provoked it. Parents often ask the question, how to stop the attack, what to do in such cases?
- If the cough is allergic, then you should try to eliminate allergens: make bed linen only from natural fabrics, regularly carry out wet cleaning, ventilate the children’s bedroom before going to bed.
- Infectious pathology, as a cause of cough, requires its own drug treatment.
- Maintain air humidity at a normal level, a humidifier is ideal for a children’s room.
- Cutting teeth became the culprit of the cough, there is nothing you can do about it, you have to go through this period.
If the parents are sure that a severe cough is provoked by a cold infection, ARVI, then drug therapy will be needed, but only a doctor should prescribe it.
As for taking medications, Komarovsky has his own opinion on this matter:
- Most often, in the presence of a respiratory infection, cough drugs are not required, and sometimes they are completely prohibited.
- If the baby is less than two years old, then drugs that inhibit the cough reflex are contraindicated. The result can be achieved quickly, but the consequences can be quite serious.
- It is strictly forbidden to combine cough suppressants with sputum augmentation agents.This is fraught with the accumulation of fluid in the lungs and the development of an inflammatory process in them.
- Drug therapy should be combined with humidification of the air, warm and plentiful drinking, compliance with the temperature regime in the room.
According to Komarovsky, if a child coughs during sleep and therapy is prescribed by a doctor, then the parents should have an idea of the mechanism of action of a particular drug. Such funds are divided into several groups:
- Mucolytic.The active ingredients of the drugs dilute phlegm.
- Expectorants. Helps remove mucus from the bronchi.
- Combined products. At the same time, they remove the inflammatory process. They make the phlegm less viscous and facilitate its expectoration.
Depending on the type of cough in the child, the doctor will prescribe a medicine. The following preparations will help calm dry and improve sleep:
- Antitussive medicines: “Stopussin”, “Bronholitin”.
The dosage and treatment regimen is selected individually, taking into account the condition of the baby, age and the presence of concomitant symptoms.
The following medicines will bring relief from a wet cough:
- Doctor Mom.
In addition to drugs to alleviate the cough reflex itself, agents are prescribed to combat the cause of the symptom.If a bacterial infection has joined, then you cannot do without taking antibiotics.
If a viral infection provoked the cough reflex, then antiviral treatment will be added.
Physiotherapy for cough relief
Physiotherapy treatment accelerates recovery and improves the condition of the child. Taking into account the reason, the doctor prescribes a set of procedures during which the following devices are used:
- Magnetotherapy. The action is based on a magnetic field, which eliminates the inflammatory process, improves the condition of the child, and reduces the amount of medications taken.
- Quantum and laser therapy. Procedures using such equipment allow you to increase the body’s immune response, which helps to reduce the amount of drugs consumed.
Among the methods of cough treatment are often used: electrophoresis, UHF therapy, mud, salt treatment. This therapy is especially useful if the cough reflex is caused by bronchitis or other infectious diseases of the respiratory system.
It is not possible to use devices at home, but you can resort to the following procedures:
- Banks and warming plasters.
- Vibration massage of the back and chest.
- Breathing exercises will help to alleviate the baby’s condition.
- Physiotherapy exercises. The specialist will help you choose a set of exercises that will help to strengthen the respiratory system, the discharge of phlegm.
- Steam inhalation. The procedures contribute to the liquefaction of sputum, reducing the inflammatory process. Nebulizers are perfect for inhalation.
In the presence of serious illnesses, physiotherapy treatment will be an excellent addition to speed up the healing process.Even if, according to Komarovsky, the child coughs during the day, but not at night. It doesn’t matter when the symptom appears, physical therapy can help treat any cough.
Many mothers try to avoid taking medications and resort to using traditional medicine recipes. It should be noted that such funds help a lot, but if a serious illness has become a cough provocateur, then they can only complement the main drug treatment.
Effective recipes include the following:
- Mix warmed milk with honey and baking soda.Drink during the day and at night.
- In the pharmacy, buy herbal tea: coltsfoot, oregano and licorice root. This formulation helps to reduce inflammation and improve mucus flow.
- You can use compresses to calm your morning or night cough reflex. Boiled potatoes are suitable for the procedure. Knead it, add internal fat, half a teaspoon of mustard and honey. It is better to do the procedure at night.
- Use badger fat to rub the baby’s breast and back.
- Grate the radish, mix with sugar or honey, squeeze and give a teaspoon several times during the day.
If parents do not regularly engage in prophylaxis and do not monitor the child’s health, then after treatment, the cough may return soon after.
Prevention of cough
Children’s doctor Komarovsky assigns the main role to prevention. It should be as follows:
- Every day, before you send your child to bed, you need to ventilate the bedroom and do some wet cleaning.
- Maintain the optimum level of humidity.
- Avoid contact with any household chemicals, possible allergens, do not allow smoking in the house.
- During the day to ensure drinking, in the season of colds it is better if these are herbal teas, rosehip infusions.
- Legs soar before going to bed.
- In the presence of laryngitis, it will facilitate the inhalation of steam. You need to fill the bath with hot water and have a baby to breathe.
- Inhalation with saline solutions, medicinal herbs is recommended for babies from one year of age.
Inhalation, antihistamines are prohibited for infants, therefore, you can relieve a night cough by changing the position of the child in the crib more often.
Doctors also recommend paying great attention to nutrition. The diet should contain only healthy foods, fresh vegetables, fruits. A balanced diet allows you to strengthen the immune system, increase tone, which will allow the body to quickly get rid of an unpleasant symptom.
Cough is, of course, a problem, but not always serious.It is only important to recognize the culprit of the symptom in time and take the necessary measures to establish a night’s sleep in the child and improve his condition.
A child’s nighttime cough is a fairly common problem. Especially if the cough torments the baby during the day, accompanied by a sore throat, fever, nasal discharge. All this in combination is a clear sign of any disease of the respiratory system. But there are situations in which coughing attacks begin precisely at night.Or during daytime sleep.
Dr. Komarovsky and other specialists have repeatedly encountered this problem. And the cause of the disease was different in each case. Therefore, doctors have outlined a list of the most likely factors that can trigger the onset of nocturnal seizures. And also made recommendations on how to alleviate or eliminate a child’s night cough.
If a child coughs badly when he goes to bed, Komarovsky recommends taking him to the ENT.Since, in his opinion, a child’s nocturnal cough is a sign of a disease called posterior rhinitis. In this case, inflammation occurs in the back of the nose. During the daytime, mucus runs unnoticed down the back of the throat, and the child unconsciously swallows it. But, says Komarovsky, this pathology, which does not bring discomfort to the baby during the day, becomes the cause of coughing at night.
Komarovsky also claims that posterior rhinitis is not the only factor that provokes a sleepy cough, because during sleep a child may simply have an allergic reaction.For example, a toy that is constantly in bed, or rather, the material of its manufacture. Or the laundry detergent that mom uses to wash her baby’s clothes.
Cough after sleep in a child, according to Komarovsky, also indicates a runny nose. After all, as soon as the baby takes an upright position, the mucus accumulated overnight begins to actively flow down and irritate the nasopharynx. The child begins to vigorously cough it up – this is a natural defense mechanism.
Causes of nocturnal attacks
So, with the help of Komarovsky and other doctors, you can roughly imagine the reasons why a child may have a night cough:
- Common rhinitis.It is in a dream that the baby is in such a position that the discharge begins to irritate the nasopharynx. The kid, with the help of a cough, is simply trying to clear the larynx.
- Allergy to materials from which objects, things, furniture in the children’s room are made. A child coughs in his sleep if he has an individual intolerance to fluff, wool, or chemical compounds that are present in the cosmetics used.
- Seasonal colds or viral infections, diseases of the ENT organs (tonsillitis, tonsillitis, pharyngitis, laryngitis, rhinitis, sinusitis and other sinusitis).If there is a lot of mucus, the child may even have a wet cough at night, which is usually a symptom of bronchitis or pneumonia.
- Teething in infants. This process is accompanied by increased salivation. Small children may simply not have time to swallow saliva, being in a horizontal position and, as it were, “cough” with them.
- Retrograde movement of digestive juice from the stomach to the esophagus. This pathology can cause heartburn and sore throat when the child is in a horizontal position.To eliminate the discomfort, the baby is trying to cough.
If the causes of a nocturnal cough are not accompanied by pain and fever, try to exclude all external factors
And in the cold season, one of the main causes of a nocturnal cough is the wrong microclimate in the nursery. Parents keep the air temperature high, but forget about humidity. As a result, the mucous membrane of the nasopharynx dries up at night, and the baby begins to cough. In this case, Dr. Komarovsky suggests how to soften a child’s cough – you just need to maintain optimal humidity in the room at night.
Exposure to allergen as a cause of cough during sleep
Is it possible to distinguish a nocturnal cough caused by a cold from a cough triggered by various allergens? Yes, in case of allergies, the child will have additional symptoms in addition to coughing:
- Profuse runny nose, constant sneezing, itching in the nose, swelling in the sinuses.
- Sore throat due to itching of the mucous membranes.
- Tearing, partial photophobia, reddening of the whites of the eyes.
- Skin manifestations – hyperemia, edema, itching.
All of these symptoms occur unexpectedly after exposure to an allergen. And they are not accompanied by other characteristic signs of a cold or viral illness (fever, pain). For example, a child was bathed at night with a shampoo that contains an allergen, and during sleep he starts to cough. Or they put him to sleep on a down pillow, and during the day the baby does not come into contact with the fluff, and therefore does not cough.
Effects of viruses
If a child starts coughing at night, this may be due to a viral attack.Typically, influenza, parainfluenza, adenovirus viruses are activated and spread in the autumn-winter period. Those kids who attend kindergarten or school are especially at risk of infection.
Also, a variety of viruses, fungi and bacteria live in small numbers on the oral mucosa. If the immunity is in order, it inhibits the activity of pathogens, prevents them from multiplying. If immunity is reduced or severe hypothermia occurs, the vital activity of microorganisms is activated, and the child develops tonsillitis, tonsillitis, pharyngitis, or other diseases of the upper respiratory tract.In this case, the baby is worried about coughing, which intensifies during sleep, since it is much more difficult to cough up phlegm and mucus in a supine position than in an upright position. If a cough prevents a child from falling asleep at night, the only thing that can be done to completely eliminate it is to accurately diagnose and cure the underlying disease.
Diseases causing nocturnal cough
There can be many reasons why a child coughs when he is sleeping. If we ignore causes such as allergies or unfavorable indoor climate, respiratory tract diseases remain:
- Whooping cough.
- Bronchial asthma.
- Pneumonia and others.
In the case of these diseases, coughing fits are disturbed due to the fact that the child lies for a long time. Firstly, he cannot fully cough up or get rid of the itching in the throat. Secondly, at night all biological processes in the body slow down. Resorption of mucus is suspended, blood circulation in the tissues is not as intense as during the day. As a result, the child coughs violently, which prevents him from falling asleep and gaining strength to fight the disease.Therefore, parents should make every effort to alleviate the condition of the baby. The local pediatrician can tell you how to do this. After all, the methods of assistance depend on the reasons that contributed to the onset of the cough.
Only a pediatrician can determine the exact cause and make a diagnosis. Do not try to self-medicate so as not to aggravate the situation. Take your child to a specialist as soon as possible.
There are the following methods with which you can bring down a child’s cough at night:
- Instill a vasoconstrictor drug into the baby’s nose, after rinsing the nasal cavity with saline or salted water.
- Give a warm drink that will soften the mucous membrane of the throat – heated milk, infusion of chamomile or other medicinal herb, tea with raspberry jam.
- Place a damp towel on the battery to increase the humidity in the room.
You can also massage the chest and back, inhale, or give your child a medication to relieve coughing.
Cough without fever
A severe cough in a child without fever, especially at night, is a sign of either an allergy or the unsatisfactory state of the room in which the baby sleeps.In this case, infectious and inflammatory diseases as a cause of cough can be excluded. Since these pathologies are usually accompanied by additional characteristic symptoms, including subfebrile (37-38) or febrile (38.1 and higher) body temperature.
If a child has a cough of any intensity in a dream, you need to pay attention to the following points:
- Are there any additional signs of an allergic reaction – tearing, nasal discharge, sneezing, swelling of mucous membranes or skin.
- Is the air in the room dry? If the room is heated (battery, electric radiator, air conditioner), and the humidity is low, the child’s mucous membranes may dry out and the throat begins to sore.
- Is the room clean (floors washed, dust wiped off, carpets knocked out).
- Are there too many soft toys in the room that can act as dust collectors?
- Maybe your parents use fragrances and air fresheners too much, or does your dad smoke in the kitchen?
Also, the cause of dry cough without fever can be a violation of the drinking regime.That is, the child is active (runs and sweats), eats well, but drinks little. Lack of fluid in the body contributes to the thickening of sputum and secretions, drying out of the mucous membranes of the mouth, nasopharynx, esophagus.
First aid – how to relieve a coughing attack
If a child suddenly has a nocturnal paroxysmal cough, you need to call an ambulance. While the doctors are going to the call, you can try to provide the baby with first aid. How to relieve a child’s cough in the evening and at night:
- Give the baby a warm liquid that envelops, softens and has a beneficial effect on inflamed mucous membranes.This is what is at hand – compote, fruit drink, chamomile decoction or, in extreme cases, weakly brewed black tea. They say that if you give your child milk with honey and butter at night, he will cough much less and sleep better.
- Ventilate the room and try to increase the humidity in the bedroom in any way (wet towel, mug with water on the radiator, spraying water with a spray gun).
- A child who is coughing during sleep can be helped by making him a half-sitting position.Massage the chest and back.
Establish a rule to keep harmless traditional medicines in the first-aid kit, with their help it will be possible to relieve or alleviate symptoms before seeing a doctor. Herbal decoctions, honey and oils for inhalation are the best helpers.
If parents consider calling an ambulance unreasonable, then in the morning they still have to see a pediatrician. And before going to bed on the eve of a visit to the doctor, a warm foot bath with the addition of mustard powder helps to prevent coughing (if there is a temperature, the bath cannot be taken).After the bath, you need to put on warm socks on the baby’s legs, you can put mustard plasters and inhale with a nebulizer.
It should be noted right away that rubbing and inhalation, like most pharmacological preparations, are prohibited for children under 6 months of age. If an older child has a nocturnal cough, he can arrange a kind of inhalation in the bathroom. For this, the patient needs to be seated on a chair in the middle of the bathroom and turn on the pressure of hot water.A couple of drops of any essential oil can be added to a bathtub plugged with a cork, cedar oil is optimal. The child should breathe wet steam for 5-10 minutes, after which he can be put to bed. This advice is given by many doctors if they are asked how to help a child with a cough at night if there is no inhaler at hand.
If the house has a special device for inhalation – an inhaler or nebulizer, then the treatment can be carried out without even lifting the baby out of bed. When choosing a drug for inhalation, you need to focus on the technical characteristics of the device itself.You can use a simple decoction of a medicinal herb, such as thyme. Also, the drug Chlorophyllipt, which is often used for inhalation, has proven its high efficiency and safety.
If a child over 10-12 years of age coughs, hot inhalation can be done over a saucepan of water. Also with the addition of essential oils or herbs. The procedure will help stop a child’s cough at night, as it will help thin sputum, improve blood flow and metabolic processes, and reduce the activity of pathogenic microorganisms.
Rubbing or massaging is one option for calming or stopping a child’s cough at night. You just need to remember that rubbing is prohibited if:
- The child has not reached the age of 6 months.
- The baby has a fever.
- There is a possibility that the child may be allergic to the ointment used for the massage.
It is better not to use ointments and creams with mint and menthol for children under 3 years old.
If a child breathes heavily and / or coughs during sleep, he needs to expose his chest and back, as well as his feet.On the skin, apply a small amount of the preparation for rubbing and rub in circular gentle movements first into the sternum area (avoiding the area where the heart is located), then the back. To dress and wrap up warmly, but so that it is comfortable to sleep. Then rub your feet, put on warm socks and put the baby to bed.
Night cough control
What to do if a child has a severe cough at night:
- Consult a pediatrician.
- Provide ideal room temperature and humidity.
- Make sure the bed and drinking regime is observed.
- Give the drugs prescribed by the doctor strictly on schedule.
Treatment of children under 1 year of age involves the prescription of drugs that promote coughing up and reduce the viscosity of sputum. For this purpose, preparations are purchased based on the juice of plantain, coltsfoot, elecampane, wild rosemary, thyme, marshmallow, anise, licorice.
If the condition can be alleviated by means of traditional medicine, then you can completely get rid of the cause only with medication and inhalations.Strictly follow the recommendations for choosing and taking medication to avoid complications.
How to treat a night cough in a child 1-3 years old:
Also, do not neglect inhalations and do therapeutic massages.
How to stop an attack of nocturnal cough in a child over 3 years old:
- The intensity of a dry cough can be reduced with Glavucin or Levopront.
- Sputum separation can be accelerated with Pectolvan C and Abrol.
Inhalations can be done with baking soda or herbal extracts / infusions. Children at this age can already drink herbal tea. They will not only help get rid of cough, but also saturate the body with vitamins and other biologically active substances.
Traditional medicine provides a wide range of natural preparations that quickly and reliably help to get rid of a child’s night cough:
- Buckwheat (or any other natural) honey.If you let your child suck it before bedtime, the cough will be less intense.
- Warm milk, especially goat milk, mixed with 1 tbsp. honey and 1 tsp. natural butter will perfectly soften mucous membranes and soothe paroxysmal cough.
- It is useful to steam the legs for 15 minutes in warm water with the addition of herbal decoctions.
In the pharmacy, you can buy ready-made herbal preparations specially designed to combat cough in children:
- Breast collection number 1 will help with tracheitis or laryngitis (for children from 6 years old).
- Chest collection number 2 is prescribed for pneumonia and bronchitis (for children from 6 years old).
But breast collection No. 4 can be given (after consulting a doctor) even to children from 2 years old. It contains medicinal herbs such as chamomile, mint, calendula and licorice.
How to relieve a child’s coughing attack at night without even waking him up – put a compress of boiled potatoes on the baby’s back and breast (but not on the heart area). The warmth will relax the muscles of the sternum, dull the cough reflex, and calm the child.Make a compress in this way:
- Boil a few potatoes and crush in mashed potatoes.
- Add 0.5 tsp each to the potatoes. alcohol (vodka) and mustard, as well as 1 tbsp. interior fat and honey.
- On the baby’s skin, put cling film and a layer of cotton wool, then a potato compress.
At the end of the procedure, the child is wrapped in a scarf. Leave the compress until morning or remove after 1.5-2 hours.
Preventive measures taken by parents after recovery from the disease will help prevent the problem from recurring in the future.
Do not forget that preventing a disease is much easier and cheaper than curing it. Keep track of how and where your child spends time, do active sports and do not forget about hardening.
If the cause of the cough is an allergy, you need to:
- Find out what causes the child’s individual intolerance.
- Limit the baby’s contact with a potential allergen as much as possible.
- Consult a specialist for the appointment of antihistamines.
If the cause of the cough is a disease of the respiratory tract, including the ENT organs, you need to:
- In the cold season, dress the child warmly, but do not wrap it up.
- Limit your baby’s stay in crowded places.
- Apply measures to improve immunity (immunostimulants and vitamin-mineral complex).
- Carry out hardening and health improvement of the child.
- Make sure that the baby adheres to the rules of personal hygiene (wash his hands after visiting the street).
Children will not have a cough at night if the bedroom is always warm (20-22 degrees), but not hot, and the air is at optimal humidity. The room should be ventilated before going to bed. During the day, the child should receive the amount of drink recommended by the pediatrician, and preference should be given to plain clean water.
You also need to remember that the occurrence of a cough in a child, especially if its causes are difficult to establish, is a direct indication for seeking medical help.Self-treatment, especially for children under 6, can do more harm than good.
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