Is Your Cough Serious? A Doctor Answers

Inhaling poor quality air during the winter months can increase the risk of respiratory infections, warns Dr Harish Chafle.
Read on to know what precautions you can take to stay cautious and protect your lungs.

Coughing. Sneezing. Watery eyes.

Have you been noticing these symptoms around you?

Everybody seems to be coughing.

You may blame it on the cold weather or poor air quality or the dust caused by the ongoing construction site next to your home, office or school premises.

But how do you know the cough you are ignoring isn't a seasonal reaction and something more serious?

"A common flu or cough does not last more than three to five days. If it carries on for more than that, it could be something serious," Dr Harish Chafle, senior consultant and chest physician, who specialises in bronchoscopy, intensive care and sleep disorders at Gleneagles Hospitals in Parel, Mumbai, tells Divya Nair/Rediff.

Dr Chafle explains how poor air quality during the winter months can trigger viral infections and what precautions you can take to stay cautious and protect your lungs.

Since December, we are seeing an unusual rise in the number of people coughing and falling sick in Mumbai. What could be the reason for this?

During the winter months, the air quality is generally very poor.

In cities like Mumbai and Delhi, construction work is quite rampant. In every area of Mumbai, there's something or the other going on throughout the year.

In winter, the particulate matter in the air settles at the level where we breathe -- it doesn't go high or low; it's at your nose or chest level.

As people cough, they release viruses into the air. And during early mornings, infected particles are also present in the air. These viruses mutate because the air and environment are favourable for them.

Whenever we breathe this polluted air, it irritates the airway which then produces more sputum and more phlegm. It also creates something called hypersensitivity, wherein the airway overreacts.

Usually, the infection will not cause bronchospasm -- the swelling inside the airways because of which the air passage gets limited and breathing becomes difficult.

There is more mucus production because of the increased particulate matter as well as viruses and bacteria in the air which infect the lungs.

All these together cause increased coughing, especially in patients who already have allergic tendencies and particularly in people who have a family history of asthma, allergies or atopy.

Usually, they do not get affected but when they get exposed to such polluted air, particulate matter and an infectious environment, the airways get more inflamed. They develop hypersensitivity, which causes constant coughing.

Since you said it's very common during winter, when should one take a cough seriously? What are the warning signs you should not ignore?

A common flu or cough does not last more than three to five days. If it carries on for more than that, it could be something serious.

Other symptoms would be:

• If the colour of the phlegm changes from a normal whitish to greenish, yellowish or greyish color.
• If the amount of phlegm increases and you find it difficult to breathe.

Normally, people ignore these signs when they go about their daily activities. But if your breathlessness increases and you have fever, irritability and reduced appetite, you must consult an expert, ideally a pulmonologist.

Who needs to be more careful?

These warning signs should be taken more seriously for children as well as by elderly people, especially those above 55 or 60 years of age.

This is even more important for patients who already have comorbidities like diabetes, heart problems or kidney problems. It also applies to those who are on immunosuppressive medication -- cancer patients and individuals who already have respiratory conditions like asthma, COPD (chronic obstructive pulmonary disease), interstitial lung disease or lung fibrosis.

If the cough persists for more than three days, what tests would an expert like you generally recommend?

So the test -- basically, if you want to know which bacteria or organism you are infected with -- is a sputum culture and sensitivity test. But it is not advisable to do a sputum culture for every patient because the test itself takes about three days to give results as the organisms need time to grow before sensitivity is checked.

But if somebody is elderly, diabetic or immunosuppressed, then treatment should definitely be started while the sputum culture is being sent.

By the time the three days pass and the culture report comes, the antibiotic can be reduced, adjusted or changed based on the report.

What is the best and easiest way to treat common cold and cough at home?

I would definitely advise drinking hot milk with turmeric.

But doesn't milk trigger cough?

No, that's a myth. Usually milk contains a good amount of protein. And a protein diet is recommended to fight these infections and get well soon.

If you are allergic to milk or you are lactose intolerant, or someone who has a proven history of cough worsening after consuming milk, you must avoid it.

What are some of the other misleading myths about home remedies for cough that you would like to clear?

Another myth people believe is that lemon and curd (yoghurt) are not good for treating cough.

You have to understand that lemon contains vitamin C. When you have an upper or lower respiratory infection, vitamin C is a good agent. We have witnessed that, during Covid, when the entire world took vitamin C in the form of tablets and injections. Vitamin C is an antioxidant.

Similarly, curd is a probiotic that I would recommend. If you can tolerate it, and there is no proven history of curd aggravating or initiating your cough, you should continue taking it.

What are some of the foods and home remedies you would recommend for treating a cough?

Home-cooked food is always safe to consume. Of course, it should be made with less oil and zero preservatives.

Avoid anything cold or refrigerated.

Avoid deep-fried food because oil may trigger your cough.

Avoid ready-made, ready-to-make or packaged soups.

Avoid foods containing aji-no-moto (may be used to make Chinese store-bought soup) and food colouring agents.

During bedtime, avoid sleeping directly under the fan.

Would you recommend having meat, fish and eggs when you have a cough?

Lean meat and steamed fish are okay because they contain protein. As long as you are not allergic to fish or meat, you can have it.

Post-Covid, people often complain of poor immunity. What are some of the ways to build your immunity?

Eating a high-protein diet, having meals at regular times and consuming fruits and vegetables will definitely have a positive impact on your immunity. It will also protect you against infections.

At the same time, you should be aware of the AQI in your area.

If the air quality is very poor, you should try to avoid going out early in the morning as this is when you are at a higher risk of exposure to polluted air and other harmful elements.

If it is absolutely necessary to go out, you should definitely use a good quality N95 mask to reduce exposure to bad air and pollutants.

Prevention is always better than cure.

*All images used for representational purposes only.

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