All about Coughs and their Causes

Cough is a reaction of the human body to clear the throat which may be obstructed by irritating substances. These substances   may be foreign particles, microbes, fluids, pollens or mucus which irritate the body cells. They prevent   clear passage of air from nose or mouth to the lungs during breathing. The result is the rapid expulsion of air from the lungs due to high pressure which manifests as Cough (also called Tussis). Cough may be voluntary or involuntary.

What causes Coughing?

Acute Cough lasts for durations less than three weeks. It occurs due to

• Infectious causes  like common cold and flu, sinus infections and respiratory infections including bronchitis and pneumonia
• Non-infectious reasons as existence of chronic ailments like asthma, emphysema and also because of allergic environmental factors.

Sub-Acute Cough lasts anywhere between three and eight weeks and improves subsequently.

Chronic Coughs are persistent episodes of cough that last for more than eight weeks. It is caused due to

• Throat Infections caused by sore throats including Laryngitis, Tonsillitis and Pharyngitis
• Throat Diseases resulting in damage of  vocal chords
• Post nasal drips where there is excessive mucus dripping down the throat from the back of the nose
• Gastro Esophageal Reflux Disease(GERD)
• Asthma
• Certain medications like ACE inhibitors(ACE -Angiotensin Converting Enzyme)used for primarily treating hypertension and heart problems
• Severe ailments in adults like tuberculosis, fungal infection of lungs, oral cancer and lung cancer

When to seek medical attention?

Generally coughs subside on their own. But it is advisable to seek medical attention by consulting the ENT (Ear Nose Throat) Specialist if it lasts for more than three weeks.

It is also important to visit the ENT hospital for check-up if following symptoms prevail-

• Coughing increases or there is no relief in prevailing symptoms
• Swelling or lumps are seen in the neck area
• Weight loss is experienced
• There is difficulty in swallowing or in breathing
• Permanent changes  occur in the voice
• Chest pain or discomfort is experienced
• Bouts  of fever continue
• Blood is expelled when coughing

Cough Treatment

There are a variety of ways for treating cough based on its cause.

Home Remedies

• Keeping yourself well hydrated
• Doing hot salt water  gargling
• Using nose decongestant sprays or cough drops for soothening the throat
• Avoiding pollutants like smoke, dust or other allergic substances and alcohol
• Consuming natural antidotes  like ginger, honey with lemon, pepper and hot tea

Medications

• Coughs occurring due to bacterial infections need throat treatment with antibiotics. However antibiotics are not effective for viral infections which need symptomatic treatment.
• Expectorant cough syrups (for wet cough) and cough suppressants containing codeine (for dry cough) may be prescribed for reducing coughs.

Diagnostic Tests

• Additional tests like Chest X-Ray (to ensure lungs are clear) and mucus/phlegm analysis (for signs of tuberculosis) may be done if no evident cough causes are found.
• Rarely, if a heart disorder is suspected as the cause of cough, an Echocardiogram is done to investigate the possibility.
• For more complicated and persistent cases, CT scan may be recommended for in depth view of chest and airways and checking for possibility of cancer. Appropriate treatment follows thereof.
• Further, if CT scan results do not portray the cause, the patient may be referred to Gastroenterologist or Pulmonary Specialist for investigating evidence of GERD.

Prognosis

Coughs are uncomfortable and annoying ailments which usually resolve quickly with simple remedies and medications. However if symptoms persist, it is important to take ENT treatment through physician consultation. 

Light - a Modern Sleep Problem

From childhood, we have been hearing our moms say "close your eyes and go to sleep!"  Why do we exactly close our eyes? Because darkness is essential for sleep as the absence of light signals the brain that it is time to rest by secreting a sleep hormone called Melatonin. Melatonin is secreted by the pineal gland only in darkness and this hormone is vital for relaxing the body.

After the advent of electricity, light has become a modern sleep problem as natural darkness has been replaced at night by artificial light, hampering sleep. Sleep deprivation increases the risk of diabetes, hypertension, depression and even cancer.

Causes of sleep deprivation can include high stress, poor diet, alcoholism or even a sleep disorder like acid reflux, sleep apnea etc. Of these Sleep apneas is most prevalent with over 100 million people suffering from it worldwide! Sleep apnea treatment is vital for maintaining good health and should be treated by consulting a good ENT hospital.

Sleep apnea and snoring

Sleep apnea is a sleep disorder with a fitful breathing which starts and stops often. Obstructive sleep apnea(OSA) is a condition where the throat muscles relax and cause a partial or complete obstruction of airways.

Obstructive sleep apnea is often accompanied by snoring. Snoring is caused due to the vibratory movement of the throat muscles due to the obstruction of air while breathing in sleep.

Snoring Treatment

45% of normal adults snore occasionally and 25% are habitual snorers. Snoring problem is frequent in males and obese people and often worsens with age. A cure for snoring can be found by

1. Lifestyle changes like reduction of weight, abstinence from alcohol and cigarettes, changing sleep position to sideways etc.
2. Orthopaedic Pillows to support head and neck and prevent jaw opening.
3. Dental appliances like Mandibular advancement splits for lowering the jaw and pulling the tongue forward to prevent snoring
4. CPAP - a Continuous Positive Airway Pressure mask placed over the nose or mouth to keep the airway open by pumping a controlled stream of air.
5. Surgery-UPPP-Uvulopalatopharyngoplasty to widen the airway by removing tissue at the back of the throat.

All such corrective measures can be taken only after analyzing the quality of the patient's sleep in a sleep laboratory.

Sleep Laboratory

An expert ENT hospital will have a well -equipped Sleep Laboratory with investigative tools and diagnostic equipment to identify the causes of sleep deprivation. The patient is asked to sleep in a pre-arranged, normally looking bedroom set up with all the diagnostic equipment within. Then polysomnography is conducted to analyze the sleep pattern of the patient. This is a specialized test to identify the sleep disorders like sleep apnea, narcolepsy, seizures, parasomnia etc.

Only very few professional ENT hospitals in India have Watchpat Polysomnography.

Watchpat Polysomnography

Watchpat Polysomnography is the latest medical equipment used to analyze the quality of sleep. This portable diagnostic device uses the tension of the tangential arteries to identify whether there is a blockage or shortness of breath even while the patient is asleep. It is much preferred for its infallible accuracy in its readings and extreme user-friendliness and ease of operation. Since Watchpat testing can be done in the convenience of the patient's own bedrooms, this device has proved to be a blessing in disguise for those patients who are unwilling to spend a night at the hospital. It is however advised to use the Watchpat Polysomnography device after a consultation with the ENT specialist.

"Sleep is nature's own medication to relax and rejuvenate our body. Silence your sleep problems by consulting the best ENT hospital in India and sleep well!"

5 Best Foods for Sore Throat

Sore throat (throat pain) is a common symptom characterized by ache, dryness or an itchy feeling in the throat region. It gives an uncomfortable feeling and may be contagious. Common symptoms of sore throat include throat discomfort, inflammation or ache, pain in the body, ear or head, fever, chills, cold, cough or sneezing, hoarseness in voice and difficulty in swallowing.

Based on the part affected, sore throat may be classified as:

• Pharyngitis (affects throat area behind the mouth)
• Tonsillitis (inflammation and redness of tonsils)
• Laryngitis (swelling and redness of the voice box)
• Epiglottis (causes blockage of air passage)

Causes of Sore Throat

• Throat infections caused by viruses including common cold and influenza
• Bacterial infections like strep throat
• Allergies triggered by immune systems as response to irritants like pollens and grass
• Dry air particularly in winter season
• Pollutants like smoke, alcohol and chemicals
• Any physical injury or trauma in throat/neck area
• Throat problems like straining of vocal chords or sticking of food during swallowing
• Throat Diseases including presence of tumour, cancer or Gastro- Oesophageal Reflux Disease (GERD) resulting in regurgitation of intestinal acid in throat

Sore Throat Treatment

Usually sore throat and associated symptom are treatable at home. However, it is important for patients to consult a physician in following scenarios-

1. Increased risk of developing complications due to weakening of immune system

2. Self-care measures don’t work and symptoms persist (especially in pregnant ladies)

3. Medical emergencies with severity of symptoms like

• Difficulty in swallowing or breathing
• Muffling in the voice
• Severe throat pain
• Drooling sensation
• Stridor (high-pitched sounds when breathing)
• Heart palpitations
• High fever
• Blood in the saliva
• Ear Ache

There are specialised treatments for Ear, Neck and Throat (ENT) problems. Therefore, it is crucial to consult the ENT doctors or visit the ENT hospital under above circumstances.

Home Remedies

• Doing warm water gargling with salt
• Consuming warm beverages (such as herbal tea, water with honey, warm soup broth) or eating a popsicle or an ice-cream
• Using a cool mist humidifier to moisten dry air
• Sucking a hard candy or lozenge
• Resting the throat till voice gets better
• For throat infections, it is important to drink plenty of fluids for avoiding dehydration and take sufficient rest for complete recovery.

Medication and Surgery

Analgesics provide pain relief and reduce fever. Throat lozenges and analgesic throat sprays also soothe sore throats. Antibiotics must be used only for throat infections caused by bacteria.

ENT doctors may recommend further diagnostic tests after doing physical examination. These include throat swab (for strep throat), throat culture and blood tests or CT scan for evaluating other causes like abscess, tumor or injury. Subsequently, surgical drainage of abscess or tonsillectomy (removal of tonsils) may be done for frequent infections, breathing difficulties and sleeping problems.

Foods for Sore Throat

1. Fruits 

• Bananas - Easily ingestible fruit that can be consumed directly or combined in smoothies with vitamin rich fruits like strawberries and blueberries.
• Pomegranate - An astringent with high anti-oxidant and immunity boosting properties.

2. Vegetables

• Cabbage - Has powerful anti-inflammatory and anti-oxidants properties. Is also rich in Sulphur, Vitamin C and Vitamin K and relieves headaches.
• Garlic - Potent immune booster with anti-viral and anti-bacterial properties
• Ginger - Immunity booster with surplus anti-oxidants
• Lemon - Rich in vitamin, has bacteria fighting properties

3. Spices

• Cinnamon -Wards off early signs of sore throats and evades cough
• Cloves-Fights respiratory infection and functions as a cough expectorant

4. Eggs – High protein soft foods containing omega-3s that prevent throat irritation

5. Soft foods with surplus of fibres, omegas and vitamins like Oat Meals and Cooked Pasta

5 Do’s and Don’ts of Cleaning Ears

At one point in time, every one of us is an archaeologist. Puzzled? Don't be, for I am not joking. Each and every one of us becomes an archaeologist when we clean our ears. We become so engrossed in ear cleaning that one would think we are excavating the tombs of Egypt. Yes, give us a pencil, bobby pin or even car keys! And we go digging deeper and deeper into the ear until we almost rip the ear drum apart!

Yes, I do admit that the circulatory motion of rotating the pointed object in your ear can have a pleasurable effect, but cleaning ears can become dangerous if done wrongly. So, let us pick up a few tips on cleaning ears.

5 Do's of Cleaning Ears

1. Know when to clean

The ear by itself, has a mechanism of filtering the dust and dirt by secreting earwax or cerumen and bringing it up to the surface. So most often just wiping the ears after a shower will do. Clean the ears only when you need to as in these cases when

 . Your hearing is dull
 . Your ears itch

Understand that ear wax is actually good for your ears. So, remove it only when you feel there is an earwax buildup or earwax blockages.

2. Wet your ears while showering

Wetting your ears while showering is a good thing as the hot water melts the ear wax and dissolves it right away. So, wiping your ears with a damp cloth is a must after a shower. This is natural cleaning, isn't it?

3. Use softening oils

If you are desperate to clean your ears at home, do it gently using softening oils like baby oil or mineral oil. Add few drops of oil into your ear with the ear canal facing the ceiling. After 5 minutes. tilt your head to drain it off and wipe out the excess oil. Repeat the same procedure for the other ear. Use warm water to flush out ear wax and excess oil.

4. Use ear-wax softening medication

Use medication available over-the-counter for softening ear wax. A few drops of this would be enough to dissolve the earwax blockages.

5. Consult an ENT specialist

Go for an ear check-up periodically and get your ears cleaned at an ENT hospital. Do not hesitate to contact an ENT specialist immediately in case of ear discharge, ear fullness or shooting pain in the ear.

5 Don'ts of Cleaning Ears

1. Don't clean your ears often

Cleaning ears once a month will suffice. Do not clean your ears frequently or rigorously as this will rid them of lubricating oils causing ear damage.

2. Do not put sharp objects in the ear

Do not use pens, pencils, car keys, bob pins or other sharp objects and damage your ears. 

3. Do not use ear buds or cotton swabs

Ear buds are long and your ear canal is short. So by pushing your ear buds in, you might be damaging your eardrum or pushing the earwax deeper and making it solidify. Use wax softening medication instead.

4. Do not use hydrogen peroxide

Some believe that hydrogen peroxide dilutes earwax buildup. On the contrary, it is a harmful chemical that may harm your ears.

5. Do not do ear-candling

Ear-candling is the process where a hot candle is taken near the ear to melt out the wax. Please do not follow this primitive and harmful method that might damage your ear.

Your ears are your only sound receivers that keep you connected with the vibrations of the outside world. Ears are small, sensitive and precious. Guard them with life by following these tips and always seek ENT treatment for ear cleaning and other ear problems.

5 Reasons of Neck Pain and Treatments to Overcome

The neck is an integral part of the spine. It has a rare yet complicated structure that is constituted by vertebrae between the head and upper body. The neck robustly supports the head carrying its weight and allows it to move in several directions. This unique capability in freedom of movement, however, makes the neck prone to pain and injury.

Usually neck pain or cervical pain is not a serious medical condition. It subsides within a couple of days. But if it persists or is accompanied by other related symptoms, it is advisable to consult the physician.

Symptoms of Neck Pain

• Neck stiffness hampering  neck movements

• Sharp localized pain (commonly in the lower neck)

• Radiating pain along a nerve in the neck

• General soreness/pain in neck area

• Feeling of numbness,  weakness  or tingling sensation

• Difficulties in  lifting objects or getting a firm grip

• Episodes of headaches.

Causes of Neck Pain

• Injury or strain in the neck region

• Bad body  postures including incorrect sleeping positions or  hunched sitting during long work hours

• Inflamed lymph nodes triggered by  common infections or viruses or Pinched Nerves

• Existence of  Fibromyalgia(musculoskeletal pain) or Degenerative Diseases  like Cervical Osteoarthritis and  Rheumatoid Arthritis, Spinal Stenosis or Metabolic Bone Disorders in the spinal column

• Mental Stress

Treatment for Neck Pain

Usually neck pain may be treated with non-surgical interventions either by adopting self -care measures at home or seeking medical help from professional therapists. 

Home Remedies

• Taking sufficient rest can heal simple neck strains and sprains. Any strenuous activity or neck movement must be avoided.

• Application of cold packs initially for reducing inflammation. This may be alternated with application of controlled heat packs.

• Massages which reduce neck muscle spasms and tension

• Making lifestyle changes including correcting sitting postures and avoiding activities that aggravate neck pain like continuous talking or texting over smart phones.

• Consuming over the counter medications like pain relievers.

Non- Surgical Care with Professional Help

• Using the soft cervical collar (or neck brace) as recommended by the physician. It is a medical device that supports the neck and keeps it in a neutral position to limit head movements.

• Physiotherapy is one of the common treatment routes for neck pain. It involves doing neck muscle strengthening exercises under the supervision of a trained therapist for multiple sessions. Subsequently these exercises may be done at home for improving neck strength and flexibility.

• Prescribed medications and injections may be used strictly under medical supervision for chronic conditions. Opioids are prescribed for neck pain but should be avoided in long term due to risk of complication and addiction. Cervical epidural steroid injections, cervical facet injections and trigger point injections may be given for reducing neck inflammation and providing relief. However these injections may not give long term cure.

• Manual Manipulation is done to improve neck mobility and reduce pain. Here, health professionals/chiropractors make manual adjustments to the patient’s spine.

• Acupuncture techniques which must be done by licensed professionals. It is well tolerated and considered patient-safe.

Surgical Treatment
Surgical intervention may be considered in cases of compression in nerve roots or spinal cord. Some common neck surgery techniques include

• Anterior Cervical Discectomy and Fusion (ACDF) which involves removal of problematic disc and subsequent cervical spine fusion for stability.

• Cervical Artificial Disk Replacement wherein an artificial disc replaces the damaged disc.

• Spinal Decompression used to increase the spinal canal space.

• Posterior Cervical Foraminotomy where the herniated disc or bone spur causing the nerve irritation is removed.

Summarizing, neck pain can be easily prevented by following healthy habits like maintaining right postures and abdominal muscle tone, exercising , controlling stress and preventing obesity.

Vertigo - Causes and Treatment

Vertigo is a common medical ailment that gives the feeling of being rocked, whirled or objects moving around when actually they are still. It usually occurs due to inflammation of the inner ear or problems in its balancing function. Sometimes, it may also arise due to issues in certain brain areas. Symptoms of Vertigo include dizziness, disorientation issues, a feeling of being in spin and giddiness. The continued symptoms sometimes result in vomiting and tinnitus (ringing sound in the ears).

Causes of Vertigo

• Labyrinthitis - Viral or bacterial infections in the inner ear which may also result in hearing loss.
• Head injury that is either ignored or inappropriately addressed.
• Vestibular Neuronitis- Inflammation of vestibular nerve which connects the inner ear to the brain. This nerve transmits messages and controls the balancing function.
• Benign Paroxysmal Positional Vertigo (BPPV)  which is triggered by certain head movements.
• Meniere’s disease – A rare condition that affects the inner ears resulting in hearing loss, tinnitus and a high pressure feeling in the ear(also called aural fullness).
• Side effects caused due to certain medications.

Vertigo Treatment

A plethora of treatments are available for Vertigo and the precision of the cure is being enhanced day by day, thanks to the new inventions in modern medical science.

1. Medications

• During the initial stages, the Vertigo symptoms can be treated with a variety of medications like oral medicines, patches placed on the skin, intravenous (IV) drugs and suppository.
• Specific remedies like
• Antibiotics for infection of middle or inner ear.
• Giving low salt diets and medications for increasing urinary output for Meniere’s Disease patients.
• Surgical remedies are suggested by ENT (Ear Nose Throat) specialists for recurring/persistent infections due to holes in the inner ear.

2. Certain Physical Therapies are recommended mostly for BPPV patients like

• ‘Epley maneuver’ which is a vestibular rehabilitation therapy .This is an exercise wherein the patient is required to sit on the table edge and then lie down to one side. This step is repeated multiple times on the same and opposite sides until the vertigo symptoms diminish.
• Particle repositioning in which the head is repositioned to ensure the restoration of tiny displaced stones in the vestibular system of inner ear to normal position. This repetitive exercise is done until abnormal eye movements’ stop.

3. Self-Care Measures and Remedies at home
(To be adopted at home after appropriate diagnosis of vertigo and under adequate medical supervision.)

• Doing a modified version of ‘Epley maneuver’ at home after receiving proper instructions from therapists.
• Taking vitamin D supplements (specifically for BPPV patients).
• Consuming plenty of fluids daily.
• Using natural herbal remedies like ginger and coriander.
• Undergoing Acupuncture Therapy for some types of vertigo.
• Avoiding substances that adversely affect blood circulation like tobacco, alcohol and caffeine.
• Additionally, some essential oils like ginger, peppermint, lavender and frankincense may relieve vertigo symptoms.

Lump in the throat

Have you ever suffered from an unusual feeling or sensation of lump in your throat that might have subsided on its own? Let’s find out in this blog what that unusual feeling is!

The sensation of lump in the throat is a common problem people complain about. This feeling is often described as irritating but is not associated with any pain or physical discomfort. Sometimes people also experience a feeling of a lump or swelling without the presence of any lump or swelling in the throat. This condition is known as “Globus Sensation”.

What causes the lump sensation?

The exact cause for this condition is still not clear and remains questionable. However studies have associated this condition with many factors outlined below:

Aberrant Muscle coordination

Any abnormality or in coordination in the functioning of the throat muscles may induce a feeling of muscle tightness in the throat.

Gastric Reflex

Stomach acid entering your oesophagus is also capable of giving rise to muscle tension or swelling in the tissue surrounding the throat. This eventually may feel like a lump or tissue in the throat.

Stress and Anxiety

Many studies based largely on women, have also suggested that a persistent feeling of stress, depression or anxiety may trigger globus sensation. Studies have also confirmed that globus sensation in men is associated with psychopathology like depression and somatic disorders.

Mucosal Lesion and underlying pathological mass

A mucosal lesion which often occurs as a result of trauma or an ulcer can also induce the lump sensation in an individual. A mucosal lesion is a result of trauma or an ulcer. Certain kind of mass like tumor, cysts, granuloma, or enlarged thyroid may predispose to this feeling.

So, is this lump serious?

This lump is a benign condition and do not involve any severe complication. However, some other conditions may present initially as globus sensation so it is important to seek medical care when globus sensation is associated with other symptoms like pain, dysphagia (difficulty in swallowing), lump mass, fever, or weight loss to rule out any other clinical condition.

What are the symptoms of the globus sensation?

The usual symptom is the sensation of a lump in the throat which can come and go. It is usually felt in the front of the neck and can move around, usually up or down. It does not affect eating or drinking and, in fact, in some people, symptoms can be relieved by eating or drinking. There is not usually any pain present in the throat. Many people with globus sensation notice the symptoms most when they are swallowing their saliva.

How is the lump in the throat detected or diagnosed?

An ENT specialist should be consulted in case you have a persistent feeling. A diagnosis for exclusion of any underlying condition is must. A special equipment known as nasolaryngoscopy is placed through the nose to carefully examine the mouth, nose and throat. Sometimes, if the diagnosis of globus sensation is not clear, various other investigations like chest x-ray, oesophageal manometry, videofluoroscopy or barium swallow test may be employed to rule out other pathology.

How is globus sensation treated?

As such there is no definite treatment for globus sensation due to the idiopathic nature of the disease.Some of the recommended treatments include:

Muscle Therapy

Depending upon the cause, an ENT specialist or speech therapist may be required for appropriate physiotherapy to improve the muscle movement.

Treatment for gastric reflux

Patients with the gastric refluxes are likely to have a treatment with antacids and acid regulators to eliminate the acid regurgitation in the throat.

Treatment for reducing stress and anxiety

In people suffering from stress and anxiety: psychological counselling or medical management with antidepressants is undertaken.

Quit Smoking

Smoking is associated with many health hazards, quitting this habit is also one of the preventive approach for the globus sensation.