Your cough can indicate a variety of things

As a fam­ily medi­cine spe­cial­ist, this is a ques­tion I am fre­quently asked. A cough is an in­vol­un­tary re­flex that comes from our brain when our brain senses that we need to clear out our air­way (the tube that leads from our mouth to our lungs). But still, why? This can be one of many reas­ons. 

First, in­fec­tions are most of­ten the case, es­pe­cially when the cough oc­curs sud­denly. If it oc­curs with fever, runny nose or mu­cus, it is most com­monly be­cause of in­fec­tions.

But what if it is not sud­den and oc­curs for a long peri­od of time? It may be a chron­ic dis­ease, most likely asthma or em­physema. Asthma is a con­di­tion when we have dif­fi­culty get­ting the air out of our lungs due to a nar­row or in­flamed air­way. If you have that con­di­tion, cer­tain causes can trig­ger it, such as ex­er­cise, in­fec­tions, al­ler­gies, cold air, stress, ex­pos­ure to chem­ic­al fumes or second­hand smoke. Of­ten, these pa­tients need treat­ment like a hand-held in­haler to widen the air­way or stop it from nar­row­ing.

Em­physema is when we have dif­fi­culty get­ting the air in­to our lungs. The most com­mon cause is smoking, either first-handedly or second- handedly. Many of us who are of­ten around smokers can de­vel­op em­physema without ever smoking first-handedly. This is be­com­ing a big con­cern for those who work or have worked around smokers. It was not long ago when cus­tom­ers could smoke in res­taur­ants and bars in Phil­adelphia. Also, pol­lu­tion can cause the same ef­fects on us. There are sim­il­ar in­halers for all of these pa­tients to util­ize as a treat­ment op­tion. 

Some pa­tients may be ge­net­ic­ally prone to these dis­eases due to a de­fi­ciency of a cer­tain en­zyme. But, of course, the most im­port­ant cause is smoking to­bacco. What makes this so im­port­ant is that smoking is modi­fi­able. That is, we can stop the be­ha­vi­or. This is easi­er said than done. Bet­ter yet, you should nev­er start smoking. That is why the cam­paign to the young is so im­port­ant and is mak­ing a dif­fer­ence for fu­ture gen­er­a­tions.

No dis­cus­sion about cough­ing would be com­plete without the men­tion of lung can­cer. This is of­ten fatal and, as in all can­cers, early de­tec­tion is a key to sur­viv­al. Any cough that is ac­com­pan­ied by cough­ing up blood must be in­vest­ig­ated with a chest X-ray and of­ten a cat scan of the lungs. So, if you have a cough last­ing longer than the time of a com­mon cold, please see your doc­tor who can in­vest­ig­ate and pre­scribe a re­gi­men ap­pro­pri­ate for you. ••

Jack Tu­masz, D.O., is board cer­ti­fied in fam­ily medi­cine. He prac­tices with EPIC Phys­i­cian Group at 8019 Frank­ford Ave.

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