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[Chronic cough: a practical approach]
1Centre valaisan de pneumologie. jean-georges.frey@admin.vs.ch
Revue Medicale Suisse
|July 28, 2005
Summary
Chronic cough, lasting over 8 weeks, is common. This approach effectively diagnoses and treats causes like asthma, reflux, and post-nasal drip, leading to successful outcomes.
Area of Science:
- Pulmonology
- Gastroenterology
- Otolaryngology
Context:
- Chronic cough (lasting >8 weeks) affects millions annually, with asthma, gastro-oesophageal reflux, and post-nasal drip as primary causes.
- Accurate diagnosis is crucial for effective management of this frequent respiratory symptom.
Purpose:
- To outline a practical, stepwise diagnostic and treatment approach for chronic cough.
- To guide clinicians in identifying and managing common causes of persistent cough.
Summary:
- The proposed strategy involves initial clinical assessment (history, exam, chest X-ray, spirometry), exclusion of post-infectious or ACE inhibitor-induced cough.
- High clinical probability of asthma, reflux, or post-nasal drip warrants targeted treatment.
- Further investigations including methacholine challenge, oesophageal studies, and imaging are indicated for refractory cases or diagnostic uncertainty.
Impact:
- This systematic approach facilitates successful treatment in the majority of chronic cough cases.
- Improves patient outcomes by addressing the underlying etiology of persistent cough.