The approach to chronic cough in childhood

Chronic cough is a fairly common pediatric complaint. Usually, it is secondary to irritation of the airways following a respiratory viral infection. In these cases, the cough tends to diminish over time. There may, however, be a subsequent development of bronchial hyperreactivity. Asthma is common in the pediatric population. From 50% to 90% of chronic coughers may have hyperreactive airways. In the absence of a pulmonary function laboratory to test for this, a trial of bronchodilator therapy is warranted. Other conditions discussed may also cause chronic cough and a thorough history and physical examination with some simple radiologic investigations can help pinpoint the cause. Specific therapy can then be used to manage the problem. In addition to specific therapy, care must be taken to explain to the parents and patient the physiology of the cough and why it is present. Anxieties and fears should be dealt with in a caring and direct manner. Occasionally, non-specific therapy is needed to allow the parents and child some rest and relief.