Dry Cough and Chest Tightness – Possible Causes, Care and Treatment

Coughing is the reflex action to clear the air passage followed by forceful expulsion of air. It helps in clearing the irritants, fluids, microbes, or any other substance that is foreign to the body.  It can happen due to some irritation in throat, smoke, gas, if food is not swallowed properly, infection, etc. The prolong of coughing indicates the presence of some sort in disease or infection.

The infectious pathogens which transmit though air such as bacteria or virus cause the host to cough repeatedly in order to get transmitted from one host to another. It may persist for days to months in severe cases. Symptoms may include pain in throat, chest congestion, pain in chest, fever, body pain and the pain in nose as well.

Dry cough   

There are two types of coughing phenomenon. 

• Productive – in this there is mucus blocking the lungs and hence the coughing results in mucus production in order to clear the lungs. Health experts consider this as productive as during this the removal of mucus clears the air passage and relieves lungs. 
• Non-productive – in this there in no mucus blocking the lungs therefore there is no mucus production. This is known as dry cough. As there is no mucus production the coughing doesn’t lead to clearing the lungs or air passage. Hence, it is considered as non-productive.

Why does dry cough cause chest tightness and pain?

Like every other infection or disease, it also has acute and chronic phase-

• Acute dry cough – the cough that lasts for less than or up to three weeks.
• Chronic dry cough – the cough that lasts for more than three weeks

During dry cough there is just forceful expel of air from lungs as there is no mucus to expel. This vigorous and forceful coughing of air exerts unwanted pressure on muscles and tissues of lungs and air passage, cause minor rupture in some cases. along with the pain in chest during coughing, people may also feel the persistent tightness in chest as there is some weight on your chest. Also there should be the squeezing sensation and burning feeling in the chest.

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Causes of Dry Cough 

There can be multiple causes of a dry cough which include 

1. Asthma – it is a chronic condition in which the air passage or the wind pipes gets inflamed make it difficult for lungs to breathe. It can be productive as well as non- productive but mostly its non- productive. There is also a special category of asthma in which the dry cough is the main symptom known as cough variant asthma. The other symptoms may include wheezing attacks, heavy breathing, shortness of breath, pain and congestion in chest, swelling in chest. It can be treated by certain corticosteroids such as fluticasone, budesonide, etc.
2. GRED – Gastroesophageal reflux disease. In this the acid from the stomach moves to your esophagus due to the dysfunctional sphincter. This can cause the damaged esophagus cells along with cells of pharynx and respiratory tract. They person may feel the burning sensation, chest pain and the cough refluxes. The other symptoms may include the vomiting of the food and drinks, hoarseness, chronic soreness in throat, hard to swallow food or even drink something.   
3. Post-nasal drip – it refers to the dripping cough beneath the throat. When the person is suffering from any infection or allergy causing cold, then there is more production of mucus then before by nose which is too watery and dripseasily. The symptoms may include sore throat, itching and tickling in throat, stucked lump, difficulty in swallowing.
4. Pathogenic infection – during an infection by any bacteria or virus, there is coughing with mucus in it that lasts up to two weeks. During this time the sore throat and swelling is common complain. Due to this after the infection the throat still feel itching and soreness causing dry cough. To treat this patience is required and the reoccurrence of any infection should also be taken care of.
5. Allergies – allergies generates when your immune response mistakes a harmless foreign substance for harm to the body. The body generates immune response against that foreign particle such as coughing, sneezing, fever. These symptoms occur more when the allergy is related to respiratory system and the entering foreign body’s passage is also respiratory system. Other symptoms may include watery-red eyes, running nose, itchy throat, etc. 
6. Covid-19 – in this the infected people develop early symptoms as dry cough as well as mucus cough. Other symptoms may include fever, body ache, heavy breathing, chest tightness, and even death in severe cases and in people with older age. 
7. Environmental factors –factors such as smoke, fog, dust, mold, Sulphur dioxide, nitric oxide, are some common irritants that can either stuck in our airways or can cause an immune response against themselves causing dry cough, heavy breathing, sore throat, red eyes, etc. some people have sensitive system therefore caught cough if the wind is too dry or cold.
8. ACE inhibitors – these are prescribed to people suffering from high blood pressure. Few examples include enalapril, lisinopril. Patients who are suffering from high blood pressure after complain about prolong cough due to the ingestion of these medicines as they make the throat dry and create the urge of thirst.
9. Pertussis – it is the condition of uncontrolled cough with a whooping sound due to bacterial infection. It is also known as a 100-day cough. In the early days it is often confused with the common cold, but later it gets worse as the soreness in throat increases and often create bruises in the inner muscles and tissues to the air passage. Usually occur in children or young people with compromised immunity. It however, can be prevented by vaccination. 
10. Lung’s cancer –cough can be a sign of a lung cancer which persist for a long time. It only gets worse with time and may produce different heavy sound than earlier. If the person smokes for over a long period and have cough then it may be a sign of lung cancer. Other symptoms may include coughing blood, soreness in throat, unexplained weight loss, hoarseness, heavy breathing, pain in lungs especially during heavy breathing and coughing.
11. Collapsed lungs – the deflated lungs cause pneumothorax, due to sudden pressure applied on the chest region or due to some injury. It is common in people with some ongoing lung disease or childs with poor development of lungs. Due to this one may also feel shortness of breath and severe pain in chest.
12. Idiopathic pulmonary fibrosis – it is characterized by the scars and damaged tissues of your lungs, making the breathing process difficult. Along with heavy breathing, chronic dry cough, pain in lungs, weakness and random loss in weight are other common symptoms. 
13. Vocal cord dysfunctional – the congested vocal cord doesn’t leave plenty of passage of air to pass away leading to forceful breathing and hence coughing. It is often mistaken as asthma but in this there is a band occurs in the vocal cords so when you breathe, they will move accordingly but the occurred band in then will cause a hindrance for air to pass. Feeling of choaking, suffocating, tightness in throat, difficulty in swallowing, high pitched whooping are the other symptoms.

Complications due to dry cough

The complications may vary from person to person, due to difference in anatomy and also depends on the severity of the cough. If a person is suffering from a co-infection or disease the complications can be interlinked or the coughing can be due to already existing disease. This may include the following-

1. Fever – during any infection, it’s the body’s normal mechanism to activate an immune response and fever is the usual during this reaction. If a person’s body temperature rises above 37-38 degree Celsius then the person is said to have fever.
2. Runny nose – it is caused when there is inflammation in the nasal area or the tissues. To stop this a person has to take medicines to reduce the inflammation.
3. Sore throat – a person with sore throat may fell itching or irritation in the throat. There may be even pain that can get worse during eating or swallowing something. 
4. Body ache – when the body encounter the pathogens, it send white blood cells to fight that infection. Due to this there is swelling and tiredness in the cells and tissues therefore make the person feel aches in common body areas such as brain, back, legs, etc.
5. Upper and lower respiratory tract infections – this is most common effect during cough as coughing cause the air to exert a greater pressure on the walls of lung’s cells and tissues causing them to rupture. This open the passage for pathogens such as bacteria and viruses to penetrate deep into the upper and lower respiratory tract and cause several secondary infections. 
6. Collapsed lungs – due to the vigorous and forceful coughing the tissues and cells of the lungs experience a great pressure that leads to collapsed lungs during chronic coughing.
7. Red eyes – vigorous coughing also cause sub-conjunctival bleeding causing redness in eyes.  
8. Cough urination – due to the pressure exertion on the body during coughing, that the person urinates. During this the person is not able to control the urination due to the experienced pressure.
9. Cough defecation – it’s the same phenomena as that of cough urination. The exerted pressure is with such as force, that the person defecate unwillingly irrespective of the location, he/she is in. The cough urination and defecation cannot be controlled by the person willingly as this happens with uncertainty along with coughing.
10. Pelvic hernias – it’s the bulb like appearance on the either side of the pelvic bone. This is caused due to forceful coughing. In this, there is a burning sensation and pain in the pelvic region while coughing, sneezing, bending. 
11. Costochondritis – it is the pain and swelling in the joins between rib to cartilage (costochondral) and cartilage to sternum (sternocostal). It either affects the one side of the ribs or can affect both sides and characterized by the persistent pain in the ribs and chest muscles.
12. Fatigue fractures – in some severe cases the ribs became tired due to consistent pressure and swelling that leads to the fracture in the ribs.
13. Cystocele – due to chronic cough the urinary bladder of the women bulges out of vagina, also known prolapsed bladder. In this the suffering woman will feel something is falling out of vagina, heaviness around vaginal area and difficulty on urination. 

Treatment of Dry Cough

In mild cases it can easily be treated with some medicines and home remedies. However, if it is associated with some other serious medical infestation or causing some serious medical condition, its treatment will be done according to the identified condition. In most of the severe cases, dry cough happens due to other secondary medical condition and can only be manages not cured.

Its treatment may include – 

1. Taking some medicines such as dextromethorphan, which may help with cough refluxes. Other medicines include nasal sprays, decongestants, paracetamol to relief fever, painkillers to relief pain.
2. In case of lung cancer, chemotherapy, radiotherapy, radiofrequency ablation and immunotherapy can be used under the supervision of oncologist. 
3. In case of collapsed lungs or idiopathic pulmonary fibrosis- lung transplant, oxygen therapy, pulmonary rehabilitation, and medication can be helpful. 
4. Doctors’ advice to take honey as it can better cure dry cough than any medicines. It soothes the throat and suppress the coughing. Although it is not advisable to give honey to baby under one year of age as it can cause botulism. 
5. Hard cough drops and candies can also be taken as it increases the saliva production and therefore soothes the throat and moisturizes the air passage, so that air can pass easily without any irritation.
6. Drinking plenty of water helps to stay hydrated and relaxes the throat muscles. The water should generally be lukewarm, not too cold and not too hot. If one fide it difficult or tasteless to drink pale water then it can also be infused with honey or some other liquid smoothers for the same.
7. One can also refer respiratory therapist for ACTs, i.e., airways clearing therapies. There are employed to clear the airway tracts and get relieved of the coughing and itchiness in the throat. 
8. In some other serious conditions, one is advised to refer doctor immediately for the diagnosis. 

Prevention of Dry Cough

1. In order to prevent the dryness, humidifiers can be installed at home.
2. Air purifies can be used to get rid of environmental irritants and pathogens present in the environment.
3. Avoid acidic food in order to avoid GRED.
4. If you have some sort of allergies from molds, pollens or fragrances, then always cover your face with a face-mask and avoid using perfumes.
5. Maintain good hygiene around you.
6. Quit smoking, especially second-hand smoking. 
7. Consuming a balance-diet, rich in high fibers, protein, low trans-fat. And manage a healthy weight.
8. Watch your blood pressure and cholesterol. In this way you can avoid dry cough due to consuming Ace inhibitors.
9. Go for a regular body check up to prevent the occurrence of any other medical conditions.

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