The management of chronic cough

Area of Science:

• Pulmonology
• Neurology

Background:

• Chronic cough is a prevalent condition in primary and secondary care, affecting approximately 10% of adults.
• It significantly impacts patient quality of life and can stem from diverse respiratory and non-respiratory origins.
• While some cases have identifiable causes, others remain unexplained even after specialized investigations.

Purpose of the Study:

• To provide an evidence-based review of the diagnostic and management strategies for adult patients presenting with chronic cough.
• To focus on current management approaches for chronic idiopathic cough (CIC).
• To explore emerging concepts of CIC as a neuropathic disorder and its specific treatment modalities.

Main Methods:

• Literature review of evidence-based guidelines and clinical trials.
• Analysis of diagnostic pathways for chronic cough.
• Evaluation of management strategies, including speech and language therapy and neuromodulatory agents for CIC.

Main Results:

• Identifies common causes of chronic cough amenable to basic investigations.
• Highlights the challenges in diagnosing and managing chronic idiopathic cough.
• Presents findings from speech and language therapy trials and discusses neuromodulatory treatments for neuropathic CIC.

Conclusions:

• A systematic approach to chronic cough diagnosis is crucial for effective management.
• Chronic idiopathic cough may represent a neuropathic condition requiring specialized therapeutic interventions.
• Neuromodulatory agents show promise in managing refractory chronic idiopathic cough.