Cuándo preocuparse por una tos persistente

As many as 1 in 5 of us have a persistent cough, which is not usually serious but can be exhausting - especially if it stops us dormir.

¿Qué es una tos persistente?

Doctors describe a persistent, or 'crónica as one lasting more than 8 weeks. Three to 8 weeks is 'sub-acute' and fewer than 3 weeks is 'acute', meaning short-term.

La duración de su tos es importante porque las tos prolongadas (crónicas) suelen tener causas y tratamientos diferentes a otras. Las tos que duran menos de 3 semanas generalmente son causadas por virus, y los remedios de su farmacéutico pueden ayudarle a superarlas.

See a doctor if your cough persists for more than three weeks or you get other symptoms like shortness of breath, chest pain or coughing up blood. Likewise, if you have a long-term chest condition como asma o EPOC, necesitas contactar a tu médico si la tos ha empeorado estos síntomas.

A cough can be caused by irritation of the airways anywhere from your throat to the bottom of your lungs. Some are obvious, but you might be surprised at the culprits your GP will point the finger at.

EPOC

If you smoke or have smoked, a persistent cough could be due to a enfermedad pulmonar crónica llamada EPOC - sometimes called emphysema or chronic bronchitis. If you're over 35, have ever smoked and have a persistent cough, bring up phlegm regularly, get bronchitis in winter, and get wheezy or out of breath, COPD may be to blame. It can be diagnosed easily by a test called spirometry, which involves blowing into a special machine.

Asma

El asma generalmente comienza en la infancia but can start later in life. Both can be treated with inhalers, but stopping smoking is still essential. If you don't smoke but work in a smoky atmosphere or with chemicals or fumes, they can irritate your upper airways, causing persistent, tickly cough.

Goteo postnasal

Colds, allergies and la sinusitis crónica can cause a drip down the back of your throat which irritates your upper airways, especially when you lie down. It may mean you have a permanently blocked nose and a nasty taste in the back of your throat.

Tratamientos para la sinusitis vary depending on how long you've had it, how severe your symptoms are and whether you have polyps - painless soft growths - in your sinuses.

Allergies like fiebre del heno and persistent rhinitis can be treated with nasal sprays and antihistamine tablets. Persistent rhinitis is a constantly blocked nose caused by allergy to house dust, meaning symptoms are often worse in winter and when you're indoors.

Reflujo ácido

When I talk to people about reflux, they normally think of acidez - that burning pain behind your breastbone that's worse when you lie flat. It can also give rise to an acid taste in your mouth, and this acid can irritate the throat.

It's one of the most common causes of persistent cough. Solutions include medicamentos antiácidos, perder peso, evitar comer tarde en la noche y no usar cinturones o pantalones ajustados. Elevar un poco la cabecera de la cama también puede ayudar.

Problemas del corazón

If your heart isn't pumping blood around your system as efficiently as it should, it can lead to a build-up of fluid in your lungs. Esto se llama insuficiencia cardíaca - although it's not strictly a failure of the heart.

Otros indicios de insuficiencia cardíaca incluyen dificultad para respirar al hacer ejercicio o al estar acostado; tobillos hinchados y despertarse por la noche jadeando por aire. El pronóstico para los pacientes con insuficiencia cardíaca ha mejorado drásticamente en los últimos años con la llegada de nuevos tratamientos médicos.

Algunos medicamentos

A groups of medicines used very commonly to treat high blood pressure can cause dry, irritating cough in up to 1 in 10 men and 2 in 10 women. Se llaman los inhibidores de la ECA and have names ending in '-pril' - for example, enalapril y lisinopril.

Los síntomas pueden comenzar después de haberlos tomado sin problema durante meses o incluso años. Hable con su médico de cabecera si cree que pueden ser los culpables; hay alternativas que no causan tos persistente.

Cáncer de pulmón is also linked with persistent coughing - but other causes are much more likely.

The National Institute for Health and Care Excellence (NICE) has directrices on when cancer should be suspected. They recommend you should have a radiografía de tórax within two weeks if you're over 40 and have two symptoms out of cough, shortness of breath, tiredness, chest pain, weight loss or loss of appetite.

Si tienes más de 40 años y alguna vez has fumado, solo uno de estos síntomas debería desencadenar una derivación para una radiografía de tórax. Sin embargo, esto es solo si los síntomas son inexplicables. Por ejemplo, tener tos durante una o dos semanas acompañada de otros síntomas de infección por un virus, como secreción nasal o fiebre, no genera la misma alarma.

Most coughs that accompany a cold will settle in one to two weeks. It's not uncommon to be infected with more than one virus at the same time, so symptoms may overlap and last longer from start to finish. They're almost all caused by viruses, so los antibióticos no hacen ningún bien en absoluto. De hecho, no podemos curarlos, pero hay muchas cosas que puedes hacer para ayudar a aliviar los síntomas.

Tu farmacéutico puede aconsejarte sobre todo tipo de remedios, dependiendo de la combinación de síntomas que tengas. Por ejemplo, con una tos con flema expulsas flema o moco amarillo o verde, mientras que una tos seca e irritante generalmente no viene acompañada de flema.

Being cold for long periods may increase the chance of illnesses like infecciones respiratorias - so don't sleep with the window open. However, there's no reason to avoid going out entirely if you have a cold, as long as you're well wrapped up.