Long Lasting Cough

Dr. Parang Mehta, MD.

Running nose, low fever, and cough is a triad that occurs very often in childhood.  Most often, no special treatment is required or given, and the illness passes off in 2-5 days.  These are mostly viral infections, and treatment in neither needed nor effective.

Sometimes, however, a cough goes on and on.  While many cough syrups are freely available, and are even advertised on television and in newspapers, they are not the correct answer.  A cough that lasts for weeks may well be the pointer to a serious illness that needs specific treatment.

Why Do Children Cough?

Cough serves to remove foreign bodies, mucus, etc, that are in the airways

Cough is a defence mechanism of the body.  It protects the lungs and airways from potentially harmful substances.  It also serves to remove the respiratory system's wastes -- the normal mucus produced, the dead cells and bacteria during an infection, pus, and other substances.

Foreign bodies (small objects swallowed by children) can also be expelled by coughing.  Sometimes the object gets stuck, but the cough persists in an effort to get rid of it.

Reasons for long lasting cough

Asthma:-  This is the most common cause of prolonged coughing in children.  A variant of asthma known as cough variant asthma manifests as only cough; other forms of asthma may have other signs like wheezing, chest pain, and breathlessness.  Uncontrolled asthma can cause permanent lung damage, and appropriate therapy is necessary.

Allergic rhinitis:-  Another disease like asthma, with its roots in allergy.  This condition gives rise to excessive secretions in the nasal cavity, which drip into the throat.  This post nasal drip irritates the throat, causing cough.  Allergic rhinitis and asthma sometimes coexist.

Tuberculosis:-  This disease is common in most developing countries, and is becoming more common in developed countries because of the AIDS pandemic. Tuberculosis affects all sections of society, in both rural and urban areas.  The child may be almost normal except for the cough, and the diagnosis is made by laboratory tests and X-rays.  More information

Whooping cough:-  This disease should be rare now, because the DTP vaccine prevents it.  Unfortunately, it still afflicts children.  The vaccine's protection wanes after some years, leaving older children and teens susceptible.  Some children do not receive the vaccine, either because of non availability, or parental beliefs.
The cough of whooping cough can last for weeks, even months.  The cough is so severe that children suffer bleeding into the lungs, brain and other organs.  Several other complications can also occur.  Though it is a bacterial disease, antibiotics do not help much in relieving the cough.  More information

Sinusitis:-  The sinuses are air filled cavities inside the bones surrounding the nose.  Infection of these spaces, sinusitis, causes infected secretions to flow down the throat.  As with any post nasal drip, cough results.  Treatment of sinusitis is best done early; prolonged infection damages the lining of the sinuses, and often requires surgery for treatment.

Pulmonary eosinophilia:-  A type of white blood cell, the eosinophils, are present in high number in this disorder.  The child has cough lasting for weeks.  Investigation and specific treatment are needed for the cure. sfs

Gastroesophageal reflux:-  In this condition, the contents of the stomach flow back up the esophagus (the food pipe).  Sometimes, these liquid, acidic secretions go all the way up the esophagus and spill over into the trachea (the wind pipe).  This gives rise to cough, and since this reflux occurs every day, can be prolonged.  Aspiration of large amounts of stomach contents into the lungs can lead to  pneumonia.

Foreign bodies:-  Children often put small objects into their mouths, and swallow them.  Food items like nuts, sweets, betel nut, etc, may also be swallowed "the wrong way" -- into the windpipe.

A large foreign body that obstructs the windpipe can cause death in minutes.  Smaller foreign bodies can go deeper into the lungs and cause persistent cough for months, even years.  These foreign bodies often cause repeated infections.

Rare causes of long standing cough are bronchiectasis, bronchopneumonia, cystic fibrosis, and certain inherited disorders and birth defects.

A cough that lasts more than a few days should be taken seriously

Considering the diseases that may lie beneath a seemingly simple cough, it is not wise to simply buy a cough syrup at the neighbouring store.  While this may suppress the cough, the underlying disease may get worse.  Any child with a cough that does not get well in a few days should be seen by a doctor.

 

Last Revision: May 22, 2020