[Cough as a symptom--clarify or treat empirically?]

Cough is one of the most prevalent symptoms for which patients seek the attention of their physicians. Cough may serve as a protective reflex but can also impair social well-being and can profoundly and adversely affect patient's quality of life. Short and self-limited cough often does not require therapy, whereas prolonged cough is bothersome and should prompt further workup. If possible, the underlying cause should be identified and treated accordingly. Often, the patient history helps to establish a working hypothesis, such as possible post-nasal drip syndrome or gastroesophageal reflux as a cause. Asthma, another frequent cause of prolonged cough, is readily diagnosed in most cases. The response to empirical therapy often "confirms" a suspected etiology, if not, extensive workup involving function testing such as bronchoprovocation, radiology, endoscopy, and extended search for exceptional causes is warranted. Productive cough is often related to a bronchopulmonary disease, whereas an irritant cough is often of an extrapulmonary origin.