Decoding Chronic Cough: Unraveling the Differences Between Asthma and Persistent Cough

When we mention bronchitis, we typically refer to infectious bronchitis caused by bacterial or viral infections. However, bronchial asthma, while sharing an inflammatory response, exhibits subtle distinctions from infectious bronchitis. Unlike infections where neutrophils are primarily activated, bronchial asthma involves eosinophils, a type of white blood cell associated with allergic reactions. This eosinophilic inflammation characterizes bronchial asthma, setting it apart from conventional bronchitis.

While infectious bronchitis manifests with fever and excessive sputum production, asthma-related coughing results in dry, persistent coughs often accompanied by wheezing sounds. Although wheezing can be present, chronic coughing is a prominent feature compared to the breathlessness commonly associated with asthma.

Another condition to consider is eosinophilic bronchitis, which mimics asthma without true airway hyperreactivity. Eosinophilic bronchitis, often labeled as atopic cough, has garnered attention as a significant contributor to chronic coughing.

Understanding the duration of the cough is crucial in pinpointing its origin. A cough lasting less than three weeks falls under acute coughing, often attributed to mild illnesses like the common cold or acute bronchitis. However, if the cough persists beyond three weeks, extending up to eight weeks or even two months, it is categorized as subacute or chronic coughing, respectively.

Decoding Chronic Cough: Unraveling the Differences Between Asthma and Persistent Cough

Within the first three weeks, coughs typically result from conditions like acute respiratory infections or bronchitis. The prevalence of infection-related coughs diminishes beyond three weeks. Instead, post-infectious cough or chronic cough due to persistent hypersensitivity and reactivity of airways may emerge.

Post-infectious coughing, prevalent after severe respiratory infections, indicates heightened sensitivity and irritability of the airways, leading to prolonged coughing. Fortunately, in many cases, post-infectious coughs tend to spontaneously resolve within two months.

When investigating the root cause of chronic coughing, it's essential to scrutinize the medications one may be taking. Certain medications, like angiotensin-converting enzyme (ACE) inhibitors used for hypertension, are known to induce prolonged, dry coughs, particularly among Asian women. While effective for managing high blood pressure, ACE inhibitors may trigger persistent coughing as a side effect.

Managing chronic cough demands patience, especially considering the myriad of potential causes. Diagnosing the exact cause can be challenging due to the coexistence of multiple factors. In such scenarios, a comprehensive approach involving symptomatic relief alongside diagnostic tests helps navigate the complex landscape of chronic coughing.