What is a cough?
A cough is a critical reflex action designed to promote clearing of the upper airways. The material being coughed up may be as a consequence of many conditions - from a lung or sinus infection to an accidentally inhaled foreign object (for example, food or small toy). A cough may also be a symptom of compromised lung function (for example, wheezing) or reflect rare conditions (for example, anatomical malformations).
All children will cough occasionally but recurrent cough, difficulty breathing with cough or coughing up purulent or bloody material warrant a thorough and timely evaluation. A "wet" or "mucousy" cough will sound different than a "dry" or "scratchy" cough or a "barky" ("sounds like a seal") cough. It may be helpful to record the cough prior to an appointment with a child's doctor since a "picture" may be worth a thousand words.
Most pulmonary specialists will categorize cough symptoms as "acute" - those lasting less than four weeks vs. "chronic" - those lasting longer than four weeks.
What are the common causes of acute cough in children?
Since children's cough may be associated with a broad array of situations, it is helpful to consider possible causes under various categories. These would include:
InfectionThe amount of watery nasal drainage produced as a consequence of nasal allergy may be considerable. The material may commonly drain down the back of the throat ("post nasal drainage") and trigger the cough center in the rear of the throat.
Foreign bodyAny object that does not pass from the back of the mouth into the esophagus runs the risk of aspiration into the windpipe (trachea). This is most common in young toddlers due to their infatuation with smaller objects and their intense oral fixation. Any object that can pass through the opening of a vertically oriented toilet paper cardboard tube is considered a risk object. Older children or adults who incompletely chew food prior to swallowing may also aspirate material. Effective emergency treatment of such a situation may be learned in CPR classes commonly taught by either the Red Cross or your local hospital.
WheezingNarrowing the functional diameter of the smaller airways make it difficult to breath (exhalation worse than inhalation) and can cause a characteristic sound during respiration. Wheezing is a consequence of two phenomena - narrowing the airway secondary to tightening of the muscles that wrap around this lung region, as well as thickening of the lining of the airway as a consequence of inflammation. In children the most common trigger to produce these reactions is the virus that causes the common cold (URI). Certain viruses (for example, respiratory syncytial virus ) are notorious in this regard. The environment (grasses, dust, mold) may also trigger such a reaction. In older children intense physical activity or cold air may also trigger a wheezing episode.
Gastroesophageal reflux disease (GERD)Regurgitation of stomach contents and/or acid may trigger a reflex cough and should be considered when the more common causes of cough have been eliminated. This is more common in infants and young children. These young children and infants may not have obvious spitting up of liquids or solids during such episodes; however, they become very irritable during such events.
Benign motor ticChildren may occasionally have repetitive throat clearing as manifestation of a tic. They do not seem to be in any distress during these episodes and the child may stop them voluntarily and they do not occur during sleep. Parents will often describe such cough as "she has a tickle in her throat".
Rare causesVarious rare causes of cough need to be considered when the more obvious or routine mechanisms have been eliminated. A partial listing includes: cystic fibrosis, congenital heart disease, heart failure, congenital malformations of the airway, lungs or major blood vessels of the chest, etc.
What are the common causes of chronic cough in children?
Many of the causes (etiologies) of acute cough discussed above may also persist greater than four weeks and thus be classified as chronic cough. Two causes of acute cough which generally have a shorter than four week lifespan include: upper repsiratory infections (generally a maximum of 2 week duration) and croup (generally 4 to 6 day duration). Some studies have estimated that 5% to 7 % of preschoolers and 12 to 15 percent of older children may have chronic cough. Males are more likely to have chronic cough than female,s and chronic cough is more likely in underdeveloped countries than in those more affluent.
Causes of chronic cough (in addition to those listed above for acute cough) include:
How is the cause of childhood cough diagnosed?
As in most medical evaluations taking a thorough history and conducting a comprehensive physical examination generally leads to a narrow list of diagnostic possibilities. Laboratory studies, X-ray studies and specialized testing by allergists or pulmonary specialists may occasionally be necessary to establish or confirm the cause of childhood cough.
Issues to be evaluated while taking a history of childhood cough include:
Testing may include:
What are the common causes of chronic cough in children?
Many of the causes (etiologies) of acute cough discussed above may also persist greater than four weeks and thus be classified as chronic cough. Two causes of acute cough which generally have a shorter than four week lifespan include: upper repsiratory infections (generally a maximum of 2 week duration) and croup (generally 4 to 6 day duration). Some studies have estimated that 5% to 7 % of preschoolers and 12 to 15 percent of older children may have chronic cough. Males are more likely to have chronic cough than female,s and chronic cough is more likely in underdeveloped countries than in those more affluent.
Causes of chronic cough (in addition to those listed above for acute cough) include:
How is the cause of childhood cough diagnosed?
As in most medical evaluations taking a thorough history and conducting a comprehensive physical examination generally leads to a narrow list of diagnostic possibilities. Laboratory studies, X-ray studies and specialized testing by allergists or pulmonary specialists may occasionally be necessary to establish or confirm the cause of childhood cough.
Issues to be evaluated while taking a history of childhood cough include:
Testing may include:
Source: http://www.rxlist.com
Causes of chronic cough (in addition to those listed above for acute cough) include:
Source: http://www.rxlist.com
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