Coughing from Foreign Objects: Risks and Remedies

Q: Coughing from Foreign Objects: Risks and Remedies

Hello： If a foreign body is not coughed out, it may lead to obstructive pneumonia. <br>Chronic coughing may result in the foreign body being swallowed into the stomach, which is generally not a major concern unless it is a hard object. <br>The irritation caused by the foreign bod

Suspected foreign body aspiration?

Hello Doctor: If a foreign object enters the respiratory tract and causes a cough reflex, is it possible to suppress the cough by swallowing if the object is not expelled? If it is suppressed but the object is still not coughed out, will the coughing continue? Does the object move deeper or remain lodged in the same place? Are there any potential complications? What consequences might arise? Additionally, if the object did not enter the airway and it was simply a choking incident, what happens if a forceful swallow is attempted during the coughing process (going against the reflex action)? Should one allow the cough to resolve naturally, or should it be forcibly stopped? What are the consequences of forcibly stopping a reflexive cough? If symptoms are suspected to be caused by the above reasons, what kind of examinations should be conducted? Should an endoscopy, bronchoscopy, X-ray, or CT scan be performed?

Xiao Hao, 20~29 year old female. Ask Date: 2017/04/16

Dr. Wu Yingxun reply Pulmonology

Hello: If a foreign body is not coughed out, it may lead to obstructive pneumonia.
Chronic coughing may result in the foreign body being swallowed into the stomach, which is generally not a major concern unless it is a hard object.
The irritation caused by the foreign body in the throat will trigger a reflex cough as a protective mechanism.
Typically, an X-ray is performed first.
If there is suspicion of a lesion, a CT scan or bronchoscopy may be indicated.

Reply Date: 2017/04/16

More Info

Coughing due to foreign objects in the respiratory tract is a serious concern that requires immediate attention. When a foreign object enters the airway, it can trigger a cough reflex as the body attempts to expel the object. However, if the object is not expelled and is instead swallowed or pushed deeper into the airway, several complications can arise.

Firstly, if a foreign object is pushed down the throat rather than expelled, it may not necessarily stop the coughing reflex. The body may continue to cough in an attempt to clear the airway, even if the object has moved deeper into the respiratory tract. This can lead to persistent coughing, which may cause irritation and inflammation of the airway tissues. If the object becomes lodged in the airway, it can obstruct airflow, leading to difficulty breathing, wheezing, or even respiratory distress.

In terms of the location of the foreign object, if it is pushed down, it may either become lodged in the trachea or bronchial tubes or continue deeper into the lungs. If the object is stuck in the original location, it can cause localized irritation and inflammation, leading to chronic cough or infection. If it travels deeper into the lungs, it can cause more severe complications, such as pneumonia or lung abscess, depending on the nature of the object and the duration of the obstruction.

Regarding potential long-term effects, if a foreign object remains in the airway for an extended period, it can lead to chronic respiratory issues, including recurrent infections, bronchitis, or even lung damage. In some cases, the body may form a granuloma around the foreign object as a protective response, which can also lead to complications.

If a person experiences coughing due to choking or aspiration, it is crucial to allow the cough reflex to occur naturally. Suppressing the cough can lead to further complications, as it may prevent the body from effectively clearing the airway. Forcibly stopping a cough can lead to increased pressure in the airway, potentially causing the object to move further down or lead to aspiration into the lungs.

If there is suspicion of a foreign object in the airway, medical evaluation is essential. The appropriate diagnostic tests may include:
1. Chest X-ray: This can help identify radiopaque objects (those that show up on X-rays) and assess for any signs of obstruction or infection.

2. CT scan: A CT scan of the chest can provide a more detailed view of the airways and help locate the object if it is not visible on an X-ray.

3. Bronchoscopy: This procedure involves inserting a flexible tube with a camera into the airways to directly visualize and potentially remove the foreign object.

4. Esophagogastroduodenoscopy (EGD): If there is a concern that the object has moved into the esophagus or stomach, an EGD may be performed to visualize and remove it.

In conclusion, if you suspect that a foreign object has entered your airway and is causing persistent coughing, it is crucial to seek medical attention immediately. Do not attempt to suppress the cough, as it is a vital reflex that helps protect the airway. Prompt evaluation and intervention can prevent serious complications and ensure proper management of the situation.

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