Dry choking cough as a symptom: What causes it in adults and children?

A dry cough is one of the most common symptoms of a respiratory tract infection. It can be present for a variety of reasons when it is a manifestation of different health problems.

Coughing is also an important defense reflex whose job is to keep the airways clear.

Chronic prolonged cough is usually due to bronchial and pulmonary disease in children or adults. Phlegm leakage syndrome is also common in young children. Another form is psychogenic cough, which is of psychological origin.

Most frequently asked questions:
What is a dry cough, why does it occur and what diseases can it be a symptom of?
Why does it occur in children or young babies?
What about cough during pregnancy?
What medicines and home treatments will help to control it?

Interesting facts about cough

Cough is one of the most important defence reflexes. It is caused by a complex mechanism in which many factors are involved. The second most common reason for its occurrence is respiratory infection.

Respiratory = related to breathing.

Respiratory irritation is caused by chemical (toxins, toxic irritation), thermal (heat) and mechanical irritation. Examples include volatile chemicals, dust, smoke, steam, foreign bodies such as food or a child's toy.

It can also be triggered by irritation of the nerve pathways and cough centers in the medulla oblongata.

We can control coughing partly by will - to suppress it or to induce it.

In terms of reflexes, its role is to keep the airways clear. Here the sensitive mucous membrane of the airways encounters the aforementioned impurities in the inhaled air.

It is of further importance in the removal of mucus. Mucus plays an important role in protecting the mucous membrane of the respiratory system. It is formed under normal conditions, but at an increased rate during infection.

Coughing is caused by irritation of sensitive zones and nerve endings. It may originate from:

• the cerebral cortex
• the medulla oblongata
• receptors of the mucous membranes of the upper and lower respiratory tract, larynx, trachea, bronchi
• vagus nerve endings
  • in the pleura
  • spleen
  • stomach
  • pericardium
  • the skin of the external ear

The cough begins with a short intake of breath, progresses by briefly holding air and exerting pressure against the closed vocal cords.

This is done by muscles such as the diaphragm (the main breathing muscle), the abdominal press muscles, and auxiliary breathing muscles of the chest, such as the intercostals.

This is followed by a sharp exhalation, which is accompanied by a typical sound.

The air flows out of the airways at 120-280 metres per second (m/s).

A pathological type of cough (one that occurs as a symptom of a disease) is a cause of discomfort. It impairs quality of life, interferes with social life, work or children's play.

Cough is classified according to several characteristics

The division is important for several reasons. It is also used to determine the origin and diagnosis, and ultimately treatment.

Cough characteristics in the table

In this symptom, some further information is important. The medical history should include:

• duration - if it persists for more than 3 weeks, the cause should be investigated
• time of occurrence - seasonal, outdoors, in the home
• circumstances of occurrence - sudden onset after eating, in childhood at play
• acute form, attack - aspiration, acute bronchitis, after an accident
• chronic form - asthma, chronic bronchitis, chronic obstructive pulmonary disease
• repeated attacks - asthma, at night
• accompanying symptoms - with or without fever
• expectoration - present, and character of mucus, clear, pale, or green, brown in bacterial infection
• hoarseness - vocal cord involvement
• chest pain - in trauma, pleurisy
• smoking - number of cigarettes per day, as low as 10 in 25% and as high as 50% of smokers at 20 per day
• long-term medication - for example for high blood pressure, e.g. ACE inhibitors

Watch out for complications

Long-term (chronic) coughing impairs quality of life and bothers the sufferer. It is debilitating.

In addition, it is a risk of health complications.

Examples include chest and abdominal pain due to repeated and persistent attacks. Sleep disturbance and waking from sleep, headache, dizziness to vomiting. For this reason, bleeding from the lining of the airways may also occur.

Main causes of cough

The most common cause of cough in children, but also in adults, is an infection of the upper and lower respiratory tract. However, other conditions can also be the underlying cause.

The table below lists the most common causes of cough

Upper respiratory tract

In young children, even common upper respiratory tract infections are quite complicated. Nasal congestion and a full nose cause impaired breathing, children breathe through the mouth. In this case, the typical hoarseness for congestion can also be heard.

Usually the cause is:

• a cold, infectious or allergic
• sinusitis (inflammation of the sinuses)
• tonsillitis
• pharyngitis

On the other hand, severe acute inflammations such as laryngitis and epiglottitis are among the most urgent conditions in childhood, young children and babies, which must be treated professionally without undue delay.

The reason for this is the anatomical arrangement of the airways. Even a small swelling of the mucous membrane in the area in question will produce a big problem.

Read more in articles:
Laryngitis
Epiglottitis

Especially in laryngitis, a dry, choking cough is present. This also has the character of a barking dog = barking cough.

In epiglottitis, the child tries to stifle any movement and cough for pain.

You ask: What causes upper respiratory tract infections?

In this case, it is the dry cough that is present first. Subsequently, it may change to a productive cough. The mucus production increases, but the mucus is not green, yellow or brown in colour.

These colour changes are associated with bacterial superinfection. In this case, the cough is already moist, i.e. with expectoration.

Superinfection = when a viral inflammation is joined by a bacterial one.

At any age, these infections subsequently run together with other health problems.

The onset of influenza is similar. It is characterised by the onset from full health, when the first symptoms are fatigue, weakness, feeling sick, rise in body temperature and even fever. Sore throat, full nose, cough and other common symptoms follow very quickly.

Attention...

Dry cough is also a major symptom of the disease caused by the new SARS-CoV-2 coronavirus, COVID-19.

Read also:

• What is the new coronavirus
• COVID-19 and influenza - similarities and differences
• Influenza and coronavirus - which threatens us more?
• Coronavirus - COVID-19 - article section

Acute respiratory diseases and flu-like illnesses have a broad viral basis. Colds, sniffles and the like are characterised by a relatively rapid onset. However, they usually subside after a few days.

Some discomforts such as weakness, fatigue and increased tiredness, together with coughing, may persist for several weeks to a month.

A complication is the spread of the infection from the upper to the lower respiratory tract.

Lower respiratory tract

In the case of the lower respiratory system, dry cough is commonly manifested by acute and chronic bronchitis, pneumonia.

This is similar to asthma and chronic obstructive pulmonary disease.

In the past, occupational diseases such as asbestosis were common. In people in close contact and those who worked with asbestos, its tiny crystals were deposited on the lungs.

Pneumoconiosis = a group of occupational diseases caused by prolonged inhalation of harmful particles.

An example of pneumoconiosis is:

• asbestosis
• silicosis
• berylliosis
• talcosis
• lung disease in coal miners
• in people working with heavy metals

It can be a symptom of...

Coughing can be the only problem that bothers a person. But sometimes it goes along with a number of other problems.

Sometimes it passes after a few days, sometimes it persists for weeks. It recurs at certain times or in certain environments. It comes on suddenly, in fits or rather slowly.

Summary of common causes:

• respiratory tract infections - viruses, bacteria, fungi, parasites
• post-infectious cough - persists for several weeks after the infection is cured
• mucus leakage from the upper respiratory tract, even in the form of a chronic cough in children
• gastric acid reflux - GERD (gastroesophageal reflux disease), usually as one of the first symptoms
• bronchial asthma
• bronchial hyperresponsiveness - in bronchial asthma, may be the only symptom as an irritating and unproductive cough
• allergies and hay fever - mainly seasonal and possibly after inhalation of other allergens (household, dust, animal, other), atopy
• air pollution - dust, smoke, mould, pollen, etc.
• exposure to and inhalation of irritant chemicals, including in the home - various cleaning products and their inappropriate combinations
• thermal exposure - thermal, cold air irritation, alternating cold and heat
• chronic obstructive pulmonary disease - but more likely with coughing and overproduction of mucus
• pulmonary fibrosis - chronic interstitial lung disease
• tuberculosis, as a specific infectious pneumonia
• bronchiectasis
• lung cancer
• medications - mainly from the group of ACE inhibitors and non-selective beta-blockers
• radiotherapy
• psychogenically induced cough
• asbestosis and similar lung diseases
• pulmonaryembolism - coughing up blood may occur along with other symptoms
• sleep apnoea
• heart failure
• rheumatic diseases
• autoimmune diseases - systemic lupus erythematosus
• effusion - pericardial or fluidothorax (fluid in the pleural cavity)
• anatomical changes such as tracheoesophageal fistula, tracheobronchomegaly. lung cancer, metastases in the lungs, external oppression of enlarged lymph nodes, e.g. in lymphoma, tumours in the mediastinum
• pressure in aneurysms
• and others

A dry, paroxysmal cough, usually present in the evening, at night and early in the morning, which awakens from sleep, may be an independent manifestation of incipient bronchial asthma.

A cough of psychological origin?

Yes.

Particularly in young people, if no other cause is found. The psychological basis must be sought. Mostly affecting women and young adolescents.

It is characterised by not occurring during meals, talking and at night.

On the contrary, the attacks are aggravated and accentuated by psychological stress and the feeling of being watched.

Diagnosis

History is mainly used to determine the cause. The person describes his or her difficulties and the characteristics of the cough.

However, this is not enough to make a diagnosis. It adds a physical examination, a listening examination (auscultatory), an examination of the general condition and blood tests, microbiology (blood, sputum, sputum), CRP and some special methods.

Example:

• Chest X-ray, sinus X-ray
• CT scan of the chest
• examination by a pulmonologist - lung function tests, spirometry
• bronchomotor test - bronchoconstrictor and bronchodilator
• bronchoscopic examination (ENT)
• allergy testing, skin and other immunological tests
• psychological and psychiatric examination
• cardiological examination - ECG, ECHO
• examination by gastroenterologist, for GERD and others
• MRI, PET

Transparent mucus and sputum occur mainly in viral infections, colour changes in mucus indicate mainly bacterial infections, purulent processes in other diseases.

The table lists the cause of infection according to the colour of sputum, sputum

+ It is important to note other accompanying symptoms.

Blood in mucus do not underestimate: coughing up blood or blood with mucus, in cancer and other diseases?

Possible association of symptoms:

• Fever, i.e. body temperature above 38 °C.
• Fatigue
• runny nose
• feeling of swelling in the nasopharynx and throat
• sore throat and sore throat
• hoarseness
• shortness of breath
• wheezing and hoarseness when breathing
• burning in the chest and pyrosis (heartburn), sour and bitter taste in the mouth
• chest pain
• tachycardia
• sweating
• coughing up blood, pink foam
• pain
• weight loss

What helps with a cough?

What will be the treatment for acute or chronic long-lasting cough, you ask?

Therapy depends on the identified cause.

However, if it is an uncomplicated dry cough that accompanies common infections, no treatment is necessary.

Antitussives (cough suppressants) are given if the cough is irritating, suffocating and bothersome. They are divided into codeine and non-codeine antitussives.

On the other hand, in productive coughs, expectorants and mucolytics are chosen to promote expectoration of mucus.

In the case of infection, it is distinguished from viral and bacterial inflammation. Antibiotics have an effect only on the bacterial agent. They do not help on viruses.

In the case of serious diseases, treatment according to the provoking cause and the underlying diagnosis is necessary.

There are many medicines for non-serious illnesses. Over-the-counter medicines, for which no prescription is needed, can be bought at the pharmacy. Various forms are available such as syrups, tinctures, lozenges, candies and others, with a natural base.

People also seek homeopathic and other alternative treatments. Herbs, teas and decoctions are well known, but also various home-made grandmotherly recipes.

It is not always ideal to suppress it.
Why?
Reflex seeks to remove foreign matter or mucus from the airways to maintain their patency.

The effects of various decoctions and combinations of each other are said to be an example:

• Honey
• ginger
• onion and garlic
• lemon
• flaxseed
• Elderberry tea, plantain, motherwort, linden, sage also help
• cloves
• turmeric
• thyme
• marjoram
• anise
• olive oil

Of course, it is important to remember the well-known "Too much of a good thing is bad for you".
Grandmotherly and home recipes also have certain recommended doses.
And everyone is different, and not everyone will be helped by home treatment.

Therefore, especially with a cough that persists for a long time or is accompanied by other problems, choose a professional examination.

+ Lifestyle modification and regimen measures are also important.

How to treat a dry cough without medication:

1. Don't smoke
2. reduce the influence of other irritants
3. Eliminate specific triggers, such as allergens, medicines and others
4. ensuring an optimal environment - temperature and humidity
5. sufficient drinking
6. rest and relaxation, exercise
7. diet - fat restriction, weight reduction
8. semi-sitting position - during sleep
9. vitamins and minerals (C, D, E, zinc, etc.)

Cough and pregnancy FAQs

In this period, the same spectrum of acute infections or long-term problems are behind the emergence.

Treatment is limited due to the safety of the fetus. Therefore, professional examination and treatment is necessary. Think that high temperature, fever above 38 °C are harmful to pregnant women and the fetus.

Some natural preparations are available, but only after consultation with a doctor or pharmacist.

And pregnant women, do not forget about prevention.

Interesting information is also given in the article:

• Is it dangerous and how to treat it?
• Influenza in children: how to prevent it, what is its course and how is it treated?