What Causes Severe Coughs And How To Stop Them

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Posted by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital

Paroxysmal cough consists of frequent and severe coughing spells that make breathing difficult. Coughing is an automatic reflex that helps the body get rid of extra mucus, bacteria, and other foreign substances. This article explores what causes a paroxysmal cough, how it's treated, how you can prevent it, and when you should see your doctor.

1. Causes of paroxysmal cough

Paroxysmal cough is usually caused by the bacteria Bordetella pertussis. This bacteria infects your respiratory tract (nose, throat, windpipe, and lungs) and causes whooping cough. This infection is very contagious.
Paroxysmal cough is the second stage of pertussis. This phase occurs about two weeks after infection. A typical case of a paroxysmal cough lasts one to six weeks. In some severe cases, paroxysmal coughs can become so intense that you vomit and your lips or skin may turn blue from lack of oxygen in your blood. Seek emergency medical attention if you experience these symptoms.
Other possible causes of a paroxysmal cough include:
Asthma , a respiratory condition in which your airways swell and fill with excess mucus Bronchiectasis, a condition in which the the tubes in your lungs are permanently enlarged in inner diameter with walls thickened by inflammation, causing a buildup of bacteria or mucus Bronchitis, bronchopneumonia, Gastroesophageal reflux disease (GERD), a condition in which acid from the stomach backs up into the esophagus, throat, and sometimes airways Lung damage from trauma, smoke inhalation, or drug use Pneumonia, a type of lung infection Tuberculosis (TB), a bacterial lung infection that can spread to other organs if left untreated

2. Diagnosis and treatment of cough attacks

If you see your doctor about a cough, they may order one or more of the following tests to diagnose the cause:
Nasal or throat swabs to check for the presence of infectious bacteria Blood tests to check high white blood cell count, which may indicate infection Chest or sinus X-ray or CT scan to look for symptoms of respiratory tract infection, lesions, or abnormalities Spirometry or other lung function tests to evaluate how your body takes in and expels air, to diagnose asthma Bronchoscopy with a thin, lighted tube and camera that can show real-time images of the inside of your lungs Endoscopy to see real-time images of the inside of your nose and nasal passages An upper gastrointestinal endoscopy of your digestive tract to check for GERD (Reflux Esophagitis) After your doctor diagnoses the cause, they can Various treatments may be prescribed depending on the cause. This may include:
Antibiotics, including azithromycin (Z-Pack), to help your immune system fight off infectious bacteria Decongestants, such as pseudoephedrine (Sudafed) or cough suppressants guaifenesin expectorant (Mucinex), to reduce mucus buildup, cough, and other symptoms Antihistamines, such as cetirizine (Zyrtec), to relieve allergy symptoms that may worsen a cough, such such as nasal congestion, sneezing, and itching Treat bronchodilators with an inhaler or aerosol to help open the airways during a cough or asthma attack Antacids for symptoms of GERD Proton pump inhibitors such as omeprazole ( Prilosec), which reduces stomach acid production, to help your esophagus heal from GERD Guided breathing exercises for respiratory therapy for conditions like bronchitis

3. Home remedies for cough

Try the following at home to relieve a cough:
Drink at least 2 liters of water a day to stay hydrated. Shower regularly to keep the body clean and limit the spread of bacteria. Wash your hands often to prevent bacteria from building up and spreading. Use a humidifier to keep your airways moist, which helps loosen mucus and make coughing easier. Do not overuse a humidifier as this can make it easier for bacteria to multiply.

If vomiting occurs, eat small portions at meals to reduce the volume of vomit. Reduce or eliminate your exposure to smoke from tobacco products or fumes from cooking and fireplaces. Stay away from other people as much as possible to prevent the spread of bacteria. This includes five days of isolation while you are taking antibiotics. Wear a mask if you plan to be around other people. Do not use strongly scented products such as air fresheners, candles, perfumes, or perfumes that can irritate your airways. Prevention of paroxysmal coughs
​​Pertussis paroxysmal coughs are common in young children. Get your child vaccinated against diphtheria-tetanus-pertussis (DTaP) or tetanus-diphtheria-pertussis (Tdap) to prevent them from getting pertussis bacteria.
If someone near you has whooping cough, avoid touching or being around them until they have been on antibiotics for at least five days.

Here are some other ways to help prevent a flare-up:
Avoid smoking tobacco products or other inhalers. Sleep with your head up to keep mucus or stomach acid from moving up your airways or throat. Exercise regularly to help breathe easier and prevent weight gain that can contribute to acid reflux and GERD. Eat slowly and chew at least 20 times per piece for easier digestion. Use an essential oil diffuser to help open the airways. Some oils can be stronger than others, so be careful if you try this oil for relief. If this worsens your cough, avoid use. Try relaxation techniques, such as yoga or meditation, to control your breathing, boost your immune system, and prevent acid reflux. When to see the doctor?
See a doctor as soon as possible if a paroxysmal cough persists for more than a week and becomes increasingly frequent or severe.
Some accompanying symptoms could be that you have a serious infection or an underlying medical condition that is causing the coughs. Seek emergency medical help if you experience any of the following:
Coughing up blood Vomiting Inability to breathe or breathe quickly Lips, tongue, face or other skin turn blue Loss of consciousness Fever Chills Conclusion
Paroxysmal cough can have many causes, but is very common due to pertussis infection. In some cases and depending on the cause, the disease resolves on its own, but some causes, such as asthma, whooping cough, and tuberculosis, require immediate treatment or long-term management.
See your doctor if you have a persistent cough that disrupts your life or frequently makes it hard to breathe. Many causes can be treated without the risk of complications if they are diagnosed early.
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References
Geddes JF, et al. (2006). Paroxysmal coughing, subdural and retinal bleeding: A computer modeling approach. DOI: 10.1111/j.1365-2990.00771.x Gladu RH, et al. (2012). Combatting the cough that won't quit. mdedge.com/jfponline/article/64625/asthma/combatting-cough-wont-quit Mayo Clinic Staff. (2018). Asthma. mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 Mayo Clinic Staff. (2018). Gastroesophageal reflux disease (GERD). mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940 Mayo Clinic Staff. (2018). Whooping cough. mayoclinic.org/diseases-conditions/whooping-cough/diagnosis-treatment/drc-20378978 Morice AH, et al. (2006). Recommendations for the management of cough in adults. DOI: 10.1136/thx.2006.065144 Parker D, et al. (two thousand and thirteen). Detecting paroxysmal coughing from pertussis cases using voice recognition technology. DOI: 10.1371/journal.pone.0082971