Tuesday, February 2, 2010

Introduction

Apart from smoking, most coughs are caused by acute viral upper respiratory tract infections and are self-limiting. (saya tak ambil ubat kerana sebab ini. tambahan pula, ubat batuk sangatlah tidak sedap!). Some coughs persist for weeks to years, and cause patients to go from one physician to another seeking relief from incessant coughing which

1. may rob them of sleep (waktu mula nak tidur sahaja, selepas itu lena sekali)

2. cause urinary incontinence(x)

3. chest pain (yes! i can even feel the retraction of skin at the thorax region.)

4. syncope (x) and

5. interfere with work and life style.(sangat!).

Cough is an important defense mechanism that plays a major role in maintaining the integrity of the airways and can be voluntary or involuntary. The pathophysiology of cough is incompletely understood. Cough is commonly triggered by mechanical or chemical stimulation of receptors in the pharynx, larynx, trachea and bronchi. Cough receptors also exist in the nose, paranasal sinuses, external auditory ear canals, tympanic membranes, parietal pleura, esophagus, stomach, pericardium and diaphragm.

Causes of Chronic Cough

• Cigarette smoking (most common cause) > pasti tidak.
  
  
• Asthma is a disease of airways, resulting in difficulty breathing or wheezing often characterized by abnormal breathing tests. Some asthma sufferers have chronic cough as their only symptom. They may even have normal lung functions tests. This is often referred to as cough-variant asthma. Asthma symptoms can be aggravated by cold air, exposure to air pollutants or pollen, smoke, or perfumes. (waktu kecil pernah ada)
  
  
• Gastroesophageal reflux disease (GERD) refers to reflux, or backward flow, of stomach acid and other contents into the esophagus. If stomach acid moves backward up the esophagus, reflexes result in spasm of the airways that can cause shortness of breath and coughing. In some instances, reflux can be so severe that substances can be aspirated into the lungs and cause similar symptoms as well as damage to lung tissue. In some individuals, no sensation of heartburn is felt and their only symptom may be cough. (this is what my wild imagination thought of)
  
  
• Sinus problems and postnasal drip can also cause chronic cough. This condition can be difficult to detect. Sometimes CT scan of the sinuses is necessary for diagnosis. Patients often complain of a "tickle in their throat" and frequent throat clearing. (macam ya juga)
  
  
• Infections such as bronchitis or pneumonia can cause coughing. These infections can be caused by virus, bacteria or fungus. Viral infections do not respond to antibiotics. In patients with asthma, viral upper respiratory infections often result in a protracted cough even after the infection has cleared. (aigoo..)
  
  
• Certain medications, notably ace inhibitors [enalapril (Vasotec), captopril(Capoten) etc.] used in treating high blood pressure, can cause chronic cough. (tak!)
  
  
• Less common causes can also include tumors, sarcoidosis or other lung disease. (tidak juga!)