Inhalations, mustard and oranges: the doctor called the main mistakes in the treatment of cough

Where does the cough come from

SARS is the most common disease in the world - 80% of the population suffers from it annually. Among the pathogens are influenza viruses, coronaviruses, adenoviruses, MS virus, rhinoviruses, parainfluenza viruses and others. Today, the main contribution to the increase in the incidence of SARS in Russia is made by rhinovirus and RSV virus. At the same time, in December and January, a sharp increase in the RSV virus is expected, which means that the flu this season will manifest itself more clearly, says Pavel Berezhansky: The fact is that rhinovirus and influenza are fighting for the same receptors in the respiratory tract. And while a person is sick with rhino, he can not get the flu. So when there is a lot of rhinovirus, the flu is traditionally less and it is milder, as it was last season. But this season everything will change - there will be more RSV, which does not compete with the flu.

Pathogens attack the upper respiratory tract epithelium, which is the first protective barrier to infection. In response to this, an inflammatory process occurs: mucus production increases, the sensitivity of nerve endings increases and mucociliary clearance is disturbed, which is responsible for removing mucus from the respiratory tract. This is how one of the most common symptoms of SARS occurs - cough.

However, the work of the respiratory tract is affected not only by viruses and bacteria, but also by environmental factors, which, according to the expert, determine the condition of a person by 60-70%. For example, malnutrition can increase the risk of contracting SARS. After the summer, many people are vitamin deficient. In summer, water consumption increases, and water-soluble vitamins go away with it. At the same time, the consumption, for example, of vitamin A in the summer increases - to protect the skin from sunlight. In summer, children and adults eat less meat and fish. Therefore, by September-October, many have not only hypovitaminosis, but also hidden iron deficiency. And the return of children in autumn to organized groups further increases the risk of infection with SARS. Lack of protein, vitamins and trace elements weakens the local immunity of the mucous membranes, and an excess of simple carbohydrates and processed foods supports chronic inflammation. When the protective barrier is weakened or damaged, the mucous membrane is irritated or overdried, and the mucociliary clearance is slowed down, a cough appears.

What else makes you more likely to get respiratory viruses? Passive smoking (according to statistics, more than half of children in the world are exposed to passive smoking). The absence of a normal day regime. “Man is the only creature that takes away sleep itself. If an adult does not get enough sleep, somatotropic hormone is released, but in an adult it does not go to growth in height, as in a child, but to growth in width, so a sleep-deprived adult becomes fat, says Berezhansky.

He emphasizes that the respiratory system is literally on the border of the body and the surrounding world: after all, together with oxygen, we daily inhale dust, particles of pollution and irritants. Therefore, lung health is at the same time a question of the quality of the urban environment. Nitric oxide in urban air causes irritation of the mucosa, and this is the entrance gate for infection. In addition, when the mucosa is irritated, goblet cells are formed, which leads to the formation of sputum. Studies of Sechenov University have shown that children living in an urban environment have a higher respiratory morbidity index and a longer period of SARS. In urban children, allergies are more common. And the stress index in children from cities is higher than in children from rural areas. In urban air, there are 5-33 times more bacteria than in rural areas. “Allergies often hide infection, and vice versa. The start of allergic bronchial asthma always begins with a viral infection, so often ill children often become asthmatics, says Professor Berezhansky.

Trees are friends of the lungs

Components of smog in urban air irritate the airway mucosa, damage the ciliated epithelium and slow down mucociliary clearance - a natural mechanism of self-cleaning of the bronchi. As a result, mucus is delayed, and viruses and bacteria easily penetrate deep and cause infection.

But in nature, in the forest, where humidity is stably maintained and the air is saturated with phytoncides, the environment for our respiratory system is the most favorable. Forests have an antimicrobial and ionizing effect, protect against overheating and radiation, act as dust collectors, aerate territories and perform the function of noise reduction. In the shade of trees, the air temperature on a hot day is 7-8 degrees lower. Moderately maintain humidity in the house with the help of indoor plants, but they will not replace ventilation.

More than 500 trees and shrubs emit volatile organic substances with bactericidal and bacteriostatic action. Not surprisingly, there are 5 to 33 times more bacteria in the air than in rural areas. And the air of young pine stands is almost sterile.

There are standards according to which for each person there should be at least 50 square meters. meters of urban green spaces and another 300 square meters. meters of natural plants. Many diseases are associated with the environment. For example, 44% of asthma exacerbations are caused by environmental factors. There is even a separate direction - dendrotherapy. It is proved that a person’s stay in green areas reduces the concentration of adrenaline and increases the concentration of NK cells (innate immunity cells); reduces blood pressure, anxiety, fatigue, increases the level of antitumor proteins, says Pavel Berezhansky.

Not every cough should be treated

Cough is, first of all, the protective mechanism of the body. This reflex symptom is aimed at restoring the patency of the respiratory tract. The purpose of the cough reflex is to protect the mucous membrane of the respiratory tract from the effects of external factors that can cause its damage, as well as remove excess mucus, any pathological discharge and foreign bodies. Muscle and respiratory systems are always involved in coughing.

“Cough is not an enemy that must be fought,” says Dr. Berezhansky. Depending on the causes and type of cough, the approach to therapy can be different. Parents often estimate only the intensity of the symptom, without taking into account its nature, the presence of sputum, the time of intensification. However, it is these details that influence the tactics of treatment.”.

The cough may be dry, wet, unproductive or productive. In this case, the same patient may face several manifestations at once. So, with acute nasopharyngitis, the congestion of the nose makes you breathe with your mouth, the mucous membrane dries up - a dry cough develops, and the flow of mucus along the back wall of the throat provokes a wet one.

At night, the cough intensifies, because in a horizontal position, the person increases swelling and circulation. At the same time, children develop edema more often and stronger than adults. Night cough leads to discomfort and disrupts sleep. It is also interesting that up to 5-6 years old children cannot get rid of sputum on their own due to the anatomical features of the respiratory tract. “The rate of coughing in an adult is 600 km/h, sneezing is 260 km/h. The child has a coughing speed of 50-60 km / h, and the rehabilitation of the respiratory tract is not carried out. The only option here is postural drainage, flipping and tapping, the specialist says. At the same time, children in general have more sputum, so even after clinical recovery, they are contagious up to 2 weeks (and adults - 3-4 days).

Constant coughing, attempts to cough for 2-3 weeks may indicate the carrier of mycoplasma infection (21% of the population are carriers). This year, the expert predicts a surge in mycoplasma pneumonia. For any cough that lasts more than 2-3 weeks, the expert advises to consult a doctor.

“A prolonged cough does not always indicate the chronic form of the disease or the severity of the disease. Prolonged cough can be triggered by postnasal puff syndrome or have a post-infectious nature - persist for 3-7 weeks after recovery. It is wrong to focus only on the duration of the cough, it is important to understand how the disease began, how the cough changed, whether there is sputum, nasal congestion, allergies, temperature. The answers to these questions will help to choose an effective therapy, the expert continues.

Cough therapy: the beginning

Cough therapy should begin with regimen moments, says Professor Berezhansky. It is necessary to observe a drinking regime (warm drinks - water, juice, tea - help to thin sputum and simplify its removal); conduct wet cleaning, do not smoke. With dry air in the room, the mucous membranes dry out, and the cough intensifies. Here help humidifiers and air purifiers for the room, better with HEPA filters. At the same time, it is necessary to wash these devices regularly to avoid accumulation of bacteria and mold formation. In addition, you need to wash your nose with a saline solution: it moisturizes the mucous membranes, helps with congestion and postnasal sedation.

“It is customary to wear oranges to the hospital, but in the acute period of the disease, citrus fruits cannot be used – they irritate the mucosa. If you start drinking vitamin C at the beginning of the disease, it will not affect its course (if a person regularly received it before the disease, this will reduce the period of the disease by 1-3 days). Remember also that all bacteria are sweet tooth, so during the period of SARS it is better to refrain from eating sweets. But if there is no strength, they must be immediately washed down with water. Many believe in the healing power of chicken broth, but remember that you need to cook chicken together with the skin - it contains cysteine, which helps to thin sputum and cleanse the respiratory tract, says Pavel Berezhansky.

There are many reasons for coughing, and you should never treat it yourself. At the same time, urgent treatment to the doctor requires such conditions as fever above 38.5 ° C for more than three days, shortness of breath, whistling, blood in sputum and any cough in a child under the age of one year. If the cough does not weaken for more than 2-3 weeks, you should also consult a doctor. You can not postpone a visit with chest pain, hoarseness of voice or loss of consciousness against a cough.

Keep in mind that the bronchi can clean themselves. When prescribing treatment, the doctor takes into account the nature of the cough and the presence of sputum. If the cough is dry, intrusive, exhausting, and there is no sputum, then it is impossible to stimulate expectoration. With wet cough with viscous and difficult to separate sputum, along with compliance with the drinking regime and humidification of the air, expectorant preparations of plant origin are shown - with lancet thermopsy, extract of the roots of althea medicinal, etc. For example, thermopsy does not thin sputum, but increases the effect on the gastrointestinal tract, where the vomiting center is near the cough, and helps to remove it. And drugs such as mukaltin, including children's syrups, thin sputum and help to evacuate it from the respiratory tract, explains Professor Berezhansky.

What should not be done categorically?

Trying to suppress a wet cough without prescribing a doctor with antitussives - this leads to a violation of the drainage function of the respiratory tract, stagnation of sputum and an increased risk of complications.

In addition, you can not simultaneously take expectorant and antitussive drugs - their action is multidirectional, and therefore the result is unpredictable. For antitussive drugs generally need a strong indication, for example, with cereals.

And, of course, you do not need to take antibiotics without a doctor's prescription for a viral infection.

The most common mistakes in the treatment of cough

“The most common mistake in treating cough is inhalation. People often use medications for inhalers that can not be added there - for example, hormonal drugs that are indicated for COPD, bronchial asthma and croup. Also add permanganate, aloe, chamomile insist. The most terrible case was when a hogweed was added to the inhaler, which burns everything - a person received a burn of the mucous membrane. Children in rural areas often "smoke" plant tubes, including hogweed - we see such patients regularly, says Pavel Berezhansky.

Milk with soda or honey, potato inhalations, mustard, the doctor calls "distraction procedures" that do not have an effect, and sometimes irritate the upper respiratory tract. In any case, you can not breathe mineral water - it enters the lower parts of the lungs, which leads to the appearance of alveolar sacs, cicatricial tissue replacement and their turning off from the act of breathing. Acetylcysteine is rarely used today, and after 6 p.m. it can not be used at all - this leads to a colossal production of sputum, because of which the patient cannot sleep.

To reduce the risk of respiratory diseases, Dr. Berezhansky advises to ventilate the room 2 times a day for 10-15 minutes; clean air conditioning filters every 1-2 months, maintain humidity 40-60% hygrometer. And also walk daily for at least 30 minutes - it is better, of course, in nature.