Cough
Coughs are among the most common symptoms causing people to seek medical attention. Approximately 20% of all medical visits are due to diseases associated with coughing.[1] Coughing is an innate reflex or response of the body designed to clear airway secretions and prevent foreign materials from entering the lungs.
Naturopathic Assessment
Causal Factors
A cough is a common symptom associated with a number of acute and chronic conditions. A chronic non-productive cough is typically triggered by a specific food or something in the environment. Tracking the food or activities that precede a cough is often valuable in determining the underlying cause(s). Any cough that starts suddenly or gets worse over time needs to investigated further by a trained medical professional.
Lifestyle
- Food reactions, whether they be food allergies, food sensitivities, sensitivities to food additives or reactions to pesticides and herbicides are a common contributing factor to chronic or periodic coughing.
- Hydration
- Dehydration can worsen or trigger a cough.
Social
- Stressful situations can trigger a cough.
Environmental
- Exposure to environmental irritants, pollens, dust, and animal dander can all trigger a cough.[2]
- Weather
- For some underlying medical conditions extreme temperatures, especially the cold, can trigger a coughing episode.
External
- The irritation associated with smoking can trigger a cough. Smoking is also a serious risk factor for developing conditions associated with cough including bronchitis, cancer, and chronic obstructive pulmonary disease (COPD).[3]
Medical Interventions
- Prescription Medications
- An adverse reaction to many medications is a chronic, non-productive cough. It is always advisable to notify your health care provider if experiencing a side effect from a medication. One of the most common types of medication causing a cough as a side effect are Angiotensin-converting enzyme inhibitors.[4]
Physiology
- Breathing pattern disorders such as hyperventilation can lead to a cough or can increase the susceptibility of cough-related conditions.
Genetics
- Family History
- Individuals with a family history of allergic conditions are at greater risk of allergic conditions, asthma, and post nasal drip, which may all precipitate a cough.[2]
Diagnostic Testing
In all individuals with a cough a thorough history and physical exam should be completed, with special attention to the nature and timing of a cough, current medications, and history of allergies, digestive concerns and asthma. Diagnostic testing for coughs include:[3][5]
- Diagnostic Imaging:
- High resolution chest CT, ventilation perfusion scan, rhinopharyngoscopy, and bronchoscopy may be used to evaluate cough in some individuals.
- Laboratory studies:
- Airflow spirometry, methacholine challenge, sputum evaluation, and skin testing (specific IgE) may be used to assess the etiology and progression of a cough.
Related Symptoms and Conditions
The most common conditions presenting with a cough include:[6][3]
Conditions with a acute cough
Conditions with a chronic cough
- Asthma
- GERD
- Upper Airway Cough Syndrome
- Chronic bronchitis
- Bronchiectasis
- Postinfectious Cough
- Cancer
- Psychosomatic Cough
- Congestive Heart Failure
- Postnasal drip syndrome
Rare Conditions Associated with a Cough
- Idiopathic Pulmonary Fibrosis
- Sarcoidosis
- Pulmonary abscess
- Foreign body
Characteristics
A cough is characterized by a deep inhalation followed quickly be contraction of the chest, abdomen, and diaphragm, resulting in a forceful expulsion of air from the lungs. Under normal circumstances, this coughing reflex is a productive defense mechanism for the body to prevent foreign material from remaining in the lungs or to clear mucous from the lungs. The following are the three main classifications of cough:[6]
Acute Cough is defined as a self-limiting cough lasting less than 3 weeks. The most common cause of an acute cough is an upper respiratory infection or common cold.
Subacute Cough can be defined as a cough lasting 3-8 weeks. Most subacute coughs are caused by post-infectious irritation from persistent inflammation.
Chronic Cough is defined as lasting longer than 8 weeks. There are many causes for a chronic cough.
Common Symptoms
Common symptoms associated with cough (other than a cough itself) include:[3][2]
Naturopathic Treatment
The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies.
It is important to treat the underlying cause of a cough. Therapies to treat underlying causes of cough can be found under the corresponding conditions pages. Below find information on treatments to address general cough symptoms.
It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.
Home Care
Home Care strategies include:
- Tracking the food, activity or specific change in health that triggers the cough can assist in determining the causal factors and the changes that have to be made to resolve the situation.
Lifestyle
Lifestyle recommendations include:
- Addressing underlying food allergies, food sensitivities or other food triggers is often a first step especially for chronic and periodic coughs.
- Ensure you drink adequate water.
- Allow exercise can trigger a cough, regular exercise can be beneficial especially in the treatment of chronic cough.
- Addressing postural misalignment issues, especially of the upper back, may decrease the severity and frequency of coughing.
Naturopathic Therapies
The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.
- Nutritional Foods include:[8]
- Herbs and spices that can assist with coughs include: fresh ginger, spearmint, ginseng, licorice,
- Fruits such as grape, grapefruit peel, mango, kumquat, peach, pear, persimmon, sour plum, strawberry, star fruit, loquat, muskmelon.
- Nuts and seeds such as peanut, walnut.
- Vegetables, Roots, Nuts & Gourds such as carrot, white fungus, asparagus, pumpkin, lily flower, mustard leaf, yam.
- Eggs: chicken eggs, chicken egg white.
- Meats such as pork, duck.
- Fish & Shellfish such as common carp, abalone.
- Other foods such as maltose, honey, white sugar, sugarcane.
Naturopathic Therapies for cough include:[9]
- Clinical Nutritional Supplementation includes
- Vitamins such as Vitamin C
- Minerals such as Magnesium
- Other supplements such as Lecithin, Coenzyme Q10, Glutathione, N-acetyl-cysteine (NAC)
- Herbs for a dry cough Garlic (Allium sativum), Marshmallow root (Althea officinalis), Butterfly Weed (Asclepias tuberose), Quebracho (Aspidosperma quebracho), Sundew (Drosera rotundifolia), Echinacea (Echinacea spp), Ephedra {Ephedra spp.), Eucalyptus (Eucalyptus globules), Licorice (Glycyrrhiza glabra), Gumweed (Grindelia robusta), Goldenseal (Hydrastis canadensis), Hyssop (Hyssopus officinalis), Mullein (Inula helenium), Indian Tobacco (Lobelia inflata), White Horehound (Marrubium vulgare), Aniseed (Pimpinella anisum), Black Cherry (Prunus serotina), Butterbur (Petasites hybridus), Lungwort (Pulmonaria officinalis), Golden Rod (Solidago virgaurea), Thyme (Thymus vulgaris), Coltsfoot (Tussilago farfara), Slippery Elm (Ulmus rubra), Old Man's Beard (Usnea barbata), Mullein (Verbascum thapus)
- Herbs for a wet cough Garlic (Allium sativum), Marshmallow root (Althea officinalis), Butterfly Weed (Asclepias tuberose),Quebracho (Aspidosperma quebracho), Wild Indigo (Baptisa spp), Gum myrrh (Commiphora myrrh), Echinacea (Echinacea spp), Ephedra (Ephedra spp.), Eriodictyon californicum, Eucalyptus (Eucalyptus globules), Boneset (Eupatorium perfoliatum), Ground Ivy (Glechoma hederacea), Licorice (Glycyrrhiza glabra), Grindelia robusta (resins), Goldenseal (Hydrastis canadensis), Hyssop (Hyssopus officinalis), Mullein (Inula helenium), Indian Tobacco (Lobelia inflata), White Horehound (Marrubium vulgare), Aniseed (Pimpinella anisum), Balsam poplar (Populus balsamifera), Black Cherry (Prunus serotina), Bloodroot (Sanguinaria canadensis), Skunk Cabbage (Symplocarpus foetidus), Thyme (Thymus vulgaris), Coltsfoot (Tussilago farfara), Tylophora (Tylophora asthmatica), Slippery Elm (Ulmus rubra), Mullein (Verbascum thapus)
- Herbs for a spasmodic cough Garlic (Allium sativum), Marshmallow root (Althea officinalis), Butterfly Weed (Asclepias tuberose), Quebracho (Aspidosperma quebracho), Sundew (Drosera rotundifolia), Ephedra (Ephedra spp.), Boneset (Eupatorium perfoliatum), Licorice (Glycyrrhiza glabra), Grindelia robusta, Goldenseal (Hydrastis canadensis), Hyssop (Hyssopus officinalis), Mullein (Inula helenium), Indian Tobacco (Lobelia inflata), Butterbur (Petasites hybridus), Aniseed (Pimpinella anisum), Black Cherry (Prunus serotina), Skunk Cabbage (Symplocarpus foetidus), Thyme (Thymus vulgaris), Coltsfoot (Tussilago farfara), Mullein (Verbascum thapus)
- Gemmotherapies such as Rosa canina, Sambucus nigra
- Homeopathic Remedies for a dry cough Bryonia, Causticum, Phosphorus, Rumex crispus, Spongia tosta, Sticta pulmonaria.
- Homeopathic remedies for a wet cough Antimonium tart, Hepar sulph, Lycopodium, Pulsatilla, Senega.
- * Homeopathic remedies for a spasmodic cough Drosera, Hyoscyamus, Ignatia, Coccus cacti, Corallium rubrum, Ipeca
- Traditional Chinese Medicine recognizes the varied presentations of cough, and treatment is dependent on detailed assessment. Treatment principles utilized in Traditional Chinese Medicine to address cough include:[13]
- Expel Wind Cold
- Expel Wind Heat
- Clear Lung Heat/Fire
- Clear Phlegm Heat
- Clear Cold Phlegm
- Addressing any structural misalignment, especially related to the upper back, can assist in relieving a cough.
References
- ↑ Pizzorno Joseph, Murray Michael, Joiner-Bey Herb The Clinician's Handbook of Natural Medicine, Churchill Livingstone
- ↑ 2.0 2.1 2.2 2.3 Dains JE, Baumann LC, Scheibel P (2007) Advanced Health Assessment and Clinical Diagnosis in Primary Care third edition Chap 12 Cough Mosby
- ↑ 3.0 3.1 3.2 3.3 Hill DG (2011) Bope and Kellerman: Conn's Current Therapy 2012 1st ed Chap 1 Symptomatic Care Pending Diagnosis- Cough Saunders
- ↑ Maldonado F, Limper A (2010) Mason: Murray and Nadel's Textbook of Respiratory Medicine 5th ed Chap 72 Drug-Induced Pulmonary Disease Saunders
- ↑ Kelkar P, Weldon D (2008) Adkinson: Middleton's Allergy: Principles and Practice 7th ed Chap 79 Approach to the Patient with Chronic Cough Mosby
- ↑ 6.0 6.1 Talierco RM, Cuulver DA (2010) Cleveland Clinic: Current Clinical Medicine 2nd ed Sect 12 Pulmonary - Cough Saunders
- ↑ Kojima H, Yamada T, Takeda M, Itou Y, Yoshida M, Kimura M (2006) Effectiveness of cough exercise and expiratory muscle training: a meta-analysis. Journal of Physical Therapy Science;18(1):5-10.
- ↑ Lu Henry (1986) Chinese System of Food Cures, prevention and remedies Sterling Publishing Co. New York.
- ↑ Prousky Jonathan (2008) Principles and Practices of Naturopathic Clinical Nutrition CCNM Press.
- ↑ Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser (2010) Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto
- ↑ Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
- ↑ Ullman Robert, Reichenberg-Ullman Judyth 1997, Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing
- ↑ Kuoch DJ (2007) Acupuncture Desk Reference 2nd ed Acumedwest.
