WHAT IS CHRONIC COUGH?

Chronic Cough

Definition

• A cough that persists for more than 8 weeks in adults and more than 4 weeks in children is considered chronic.
• A chest x-ray may be normal despite the cough.

Common Causes of Chronic Cough with a Normal Chest X-Ray

• Upper Airway Cough Syndrome (UACS): Caused by nasal disorders leading to nasal drainage and post-nasal drip. Treatments include nasal saline rinses, steroid nasal sprays, and oral antihistamines.
• Asthma: Inflammation of the lower airways, often with a family history of asthma or allergies.
• Chronic Bronchitis: Airway inflammation related to smoking. Quitting smoking is crucial for treatment.
• Gastroesophageal Reflux Disease (GERD) and Laryngopharyngeal Reflux (LPR): Acid reflux leading to chronic cough and post-nasal drip.

Neurogenic or Neuropathic Cough

• A chronic cough caused by overly sensitive nerves in the upper respiratory system.
• Symptoms include coughing triggered by laughing, talking, moving, or cold air.
• Treatments may involve cough retraining therapy, speech language pathology, and medications like gabapentin or amitriptyline.
• In-office procedures using steroids, numbing agents, fillers, or botulinum toxin (Botox) may be considered.

Additional Information

• Chronic cough can have many causes, not all directly related to the lungs.
• It's important to consult a primary care physician and potentially a specialist for diagnosis and treatment.
• The information provided is for educational purposes and does not substitute professional medical advice.

References

• Madison JM, Irwin RS. Approach to the Patient with Chronic Cough. Vol 1-2. Ninth Edit. Elsevier Inc.; 2014.
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• Pawar S, Lim HJ, Gill M, et al. Treatment of postnasal drip with proton pump inhibitors: a prospective, randomized, placebo-controlled study. Am J Rhinol. 2007;21(6):695-701.
• Song WJ, Chang YS, Faruqi S, et al. The global epidemiology of chronic cough in adults: A systematic review and meta-analysis. Eur Respir J. 2015;45(5):1479-1481.
• Giliberto JP, Merati A, Carroll TL. Neurogenic Cough. In: Chronic Cough. ; 2019:97-115.
• Lim K. Neurogenic cough. J Allergy Clin Immunol. 2014;133(6):1779-1779.e3.
• Wamkpah NS, Peterson AM, Lee JJ, et al. Curbing the Cough: Multimodal Treatments for Neurogenic Cough: A Systematic Review and Meta-Analysis . Laryngoscope. 2020:1-17.
• Slinger C, Mehdi SB, Milan SJ, et al. Speech and language therapy for management of chronic cough. Cochrane Database Syst Rev. 2019;2019(7).
• Simpson CB, Tibbetts KM, Loochtan MJ, Dominguez LM. Treatment of chronic neurogenic cough with in-office superior laryngeal nerve block. Laryngoscope. 2018;128(8):1898-1903.