Coughing Fits and Fainting: Respiratory Issues in Smokers

Q: Coughing Fits and Fainting: Respiratory Issues in Smokers

Hello： Please first consult a pulmonologist to check for any lung issues. <br>Additionally, visit an otolaryngologist to evaluate the reasons for your choking episodes and to assess for any swallowing problems. <br>Difficulty in swallowing could also be related to neurological is

Coughing after choking and then falling?

Hello, doctor.
I would like to ask about my father, who has been coughing for a long time, possibly due to smoking.
He is currently 56 years old and has been smoking for over 30 years.
He used to feel like there was phlegm in his throat, which caused him to cough.
He previously consulted a doctor who advised him not to cough so hard, but he feels that if he doesn't cough hard, he can't clear the phlegm.
Recently, when he smokes or sometimes when he eats, he seems to choke and cough until his face turns red.
Sometimes he coughs and feels fine, but other times he coughs to the point where he feels like he can't breathe and even faints.
Could you please advise if there might be any underlying issues or symptoms related to his condition? Thank you, doctor.

poyu, 20~29 year old female. Ask Date: 2021/04/22

Dr. Jian Shuntian reply Pulmonology

Hello: Please first consult a pulmonologist to check for any lung issues.
Additionally, visit an otolaryngologist to evaluate the reasons for your choking episodes and to assess for any swallowing problems.
Difficulty in swallowing could also be related to neurological issues, so please consider seeing a neurologist as well.
Thank you.

Reply Date: 2021/04/22

More Info

Coughing fits and fainting can be concerning symptoms, especially in a long-term smoker like your father. Given his history of smoking for over 30 years and his current symptoms, it is essential to consider several potential underlying issues related to his respiratory health.

Firstly, chronic cough in smokers is often associated with chronic bronchitis, a condition characterized by inflammation of the airways and increased mucus production. This can lead to persistent coughing as the body attempts to clear the excess mucus. The fact that your father feels the need to cough forcefully to expel phlegm suggests that he may be experiencing airway obstruction or irritation, which is common in smokers. Over time, smoking can damage the cilia in the respiratory tract, which are responsible for clearing mucus and debris, making it harder for him to clear his throat effectively.

The episodes of coughing that lead to facial flushing and fainting could indicate a more severe issue, such as a significant airway obstruction or even a reactive airway disease. When a person coughs forcefully, it can cause a temporary drop in blood flow to the brain, leading to fainting or near-fainting episodes. This is known as a cough syncope. Additionally, if he is experiencing wheezing or a sensation of tightness in the chest, it could suggest that he is developing asthma or chronic obstructive pulmonary disease (COPD), both of which are exacerbated by smoking.

Moreover, the choking sensation while eating could indicate that his airways are compromised, possibly due to chronic inflammation or structural changes in the airways from long-term smoking. This can lead to dysphagia (difficulty swallowing) or aspiration, where food or liquid enters the airway instead of the esophagus, which can cause coughing fits and even choking.

Given these symptoms, it is crucial for your father to seek medical attention. A healthcare provider can perform a thorough evaluation, including a physical examination, lung function tests (such as spirometry), and possibly imaging studies like a chest X-ray or CT scan. These tests can help determine the extent of any damage to his lungs and airways, assess for conditions like COPD or lung cancer, and rule out other potential causes of his symptoms.

In the meantime, encouraging your father to quit smoking is vital. Smoking cessation can significantly improve respiratory health and reduce the risk of developing severe complications. There are various resources available, including counseling and medications that can assist with quitting smoking.
In summary, your father's symptoms of persistent coughing, difficulty expelling phlegm, and episodes of fainting are concerning and warrant a medical evaluation. Early intervention can lead to better management of his symptoms and overall health.

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