COUGH is a SYMPTOM with a protective function that occurs as a reflex to upper or lower respiratory tract stimuli. It can generally be of two types: Mucus secretion can be present in either WET COUGH or DRY COUGH.
A dry cough, also called non-productive cough, is not accompanied by mucous discharge and can have many causes.
If the duration of the cough extends to several weeks, it can affect the person’s quality of life. In this scenario, it is crucial to determine the root cause of the dry cough to find effective treatment options.
What causes DRY COUGH?
The mechanisms that trigger coughing obey different possible response paths:
- Immunological such as dry cough from allergic processes
- Mechanical: the presence of foreign bodies (thorns, toys, food)
- Gastroesophageal reflux
- Infectious: the most common are viruses.
- OTHERS: Medications such as some antihypertensives and environmental factors.
WHAT SPECIFIC ELEMENTS CAUSE THE DRY COUGH?
In the next section, we will review the most frequent causes of dry cough in more detail.
A dry cough often responds to allergens such as house dust mites, animal hair (dogs or cats), and flower or tree pollens. Chemical substances act on receptors in the respiratory tract, triggering a cough that is often dry.
This type of cough occurs more intensely at night. Other symptoms such as tearing, itching eyes, clear nasal discharge, or postnatal drip are often present. Exposure to allergens in patients with asthma and chronic bronchitis (irritating perfumes, cigarette smoke, detergents) can trigger a dry cough as the only initial symptom of the attacks.
In gastroesophageal reflux, coughing occurs in response to gastric contents or gastric fluid in the upper airway from the esophagus. This content stimulates the cough receptors, stimulating the protective cough reflex to prevent fluid from passing through the bronchi and lungs.
The cough symptoms manifest themselves even more at night and affect the quality of people’s sleep, affecting their quality of life.
Other symptoms that might suggest gastroesophageal reflux as a cause of cough are:
- The intake of highly seasoned, spicy foods and copious meals triggers the cough.
- A sensation of heartburn and retrosternal burning pain is often present.
Any microorganism capable of colonizing the respiratory tract can trigger a dry cough.
This dry cough often begins with a mucous secretion that can last for weeks or even months, resulting in a cough (because the respiratory bronchial tree remains sensitive to any stimulus).
Viruses are the pathogens that most frequently cause respiratory infections at any age (rhinovirus, influenza, parainfluenza, covid 19, and others). The most frequent symptoms accompanying a cough are fever, malaise, runny nose, sore throat, and loss of smell and taste.
LESS COMMON CAUSES OF DRY COUGH
FOREIGN BODIES IN THE RESPIRATORY TRACT
(food, coins, small toys)
It is a rare cause; however, it is crucial to remember and pay attention to it, especially in pediatric patients whose only symptom may be a dry cough. The presence of a bronchial foreign body also manifests with dyspnea or difficulty breathing, nausea, vomiting, and difficulty swallowing, depending on the level of its location.
RESPIRATORY TRACT CANCER
Tumor formation can originate in any area of the respiratory tree. Due to the presence of cough receptors in the respiratory tree, the appearance of tumor lesions can excite the cough receptors resulting in DRY COUGH.
Other symptoms such as weight loss, loss of appetite, weakness, dyspnea, hemoptysis (cough with expectoration bloody), and chest pain may be present with this dry cough.
Lung cancer can be primary or metastatic, and although it is a rare cause of dry cough, in association with the symptoms described above, it is a symptom that, when prolonged over time, requires pertinent studies to rule it out.
Dry cough is a possible side effect in patients taking ANGIOTENSIN CONVERTING ENZYME INHIBITORS known as ACE inhibitors (lisinopril, enalapril, captopril, others); these drugs are common medications for high blood pressure.
The symptom occurs in approximately one-third of patients, primarily women. Coughing may persist for a few weeks after stopping treatment; When considering stopping the treatment, please seek advice from your doctor as this requires strict medical supervision to avoid complications related to high blood pressure levels. During the medical consultation, it is crucial that you discuss with your physician whether the consumption of these medications could be the cause of the dry cough.
DRUGS related to this group are listed below:
DRY COUGH DUE TO ENVIRONMENTAL IRRITANTS
The dry, irritative cough is within the clinical manifestations of rare diseases of an occupational nature where the constant entry of particles from the environment produces the cough.
When inhaled by the exposed individual, the defense mechanisms of the respiratory tree are triggered: the production of mucus, the sweeping of cilia from the pulmonary epithelium, and the activation of cells that phagocytose and destroy particles (macrophages).
Along with these mechanisms, the cough appears. This type of cough is sometimes a cough with secretions, which becomes chronic and dry, lasting over time as a symptom of chronic lung disease. Among the substances that cause cough, we can mention:
Asbestos-related lung disease: asbestosis, mesothelioma.
Beryllium-related lung disease (space aerospace workers): berylliosis.
Lung disease related to cotton, flax, hemp: Byssinosis
Silica-Related Lung Disease: Silicosis
Coal-related lung disease: coal miners’ disease.
WHAT TO DO IF DRY COUGH PERSISTS?
The ideal situation is to work with your physician to evaluate the possible causes triggering the symptom. The evaluation of the other symptoms that accompany the cough, in case they exist, will give an approach to the likely cause of the cough. In general, some measures can alleviate the symptom:
Use substances that improve the Ph of the rhinopharyngeal mucosa and clean the upper respiratory tract. For example, using bicarbonate solution in the form of washes or gargles contributes not only to the Ph of the medium but also avoids the proliferation of microorganisms like viruses.
Using saline solutions in sprite in the nostrils, the exact function of clearing and cleaning the area, as well as a nasal decongestant, helps to improve postnasal drip.
Antitussive medicines such as dextromethorphan. Antihistamines can help; always consult your doctor. This article is a guide for educational purposes; this article cannot and does not contain medical/health advice.
Hydration of the respiratory tract is also important; an individual with dry cough symptoms may consider an intake of 2 to 3 liters of water a day to adequately hydrate the respiratory tract.
The ideal scenario is to conduct studies that allow your physician to evaluate the symptoms and triggers and reach a conclusion or probable diagnosis.
Dry cough is part of the defense mechanisms of the respiratory tree.
When a dry cough lasts for several weeks, the patient’s quality of life suffers.
In some cases, your physician might recommend the use of prescriptions or medications, but in some cases, your physician might recommend more conservative treatment measures such as a higher intake of liquids, washing the respiratory tract with bicarbonate water, and rubbing with honey. Remember that coughing is one of the first symptoms of respiratory infection. Therefore your physician may want to rule out the presence of a virus.