Respiratory Symptom Evaluation in Adults: Chronic Cough

Area of Science:

• Pulmonology
• Internal Medicine

Background:

• Chronic cough is defined as a cough lasting longer than 8 weeks in adults.
• Persistent coughing can lead to chronic airway irritation and inflammation.
• Most chronic cough cases (90%) have nonmalignant causes, including upper airway cough syndrome, asthma, GERD, and nonasthmatic eosinophilic bronchitis.

Purpose of the Study:

• To outline the diagnostic and management strategies for chronic cough in adults.
• To highlight common etiologies and red flag symptoms requiring advanced investigation.
• To introduce cough hypersensitivity syndrome as a consideration for refractory cases.

Main Methods:

• Initial evaluation involves patient history, physical examination, pulmonary function testing, and chest X-ray.
• Advanced imaging (chest CT scan) is indicated for patients with red flag symptoms or persistent, treatment-resistant cough.
• Management focuses on identifying and treating the underlying cause, guided by established clinical guidelines.

Main Results:

• Common nonmalignant etiologies account for the vast majority of chronic cough diagnoses.
• Specific diagnostic pathways are recommended based on initial findings and the presence of red flag symptoms.
• Refractory chronic cough with uncertain etiology may be attributed to cough hypersensitivity syndrome.

Conclusions:

• A systematic approach to diagnosis and management is crucial for chronic cough.
• Identifying and treating the underlying cause is the cornerstone of effective management.
• Cough hypersensitivity syndrome offers a therapeutic target for refractory chronic cough when other causes are excluded.