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Chronic cough

E B Philp¹

¹Department of Family Medicine, University of Alabama School of Medicine, Tuscaloosa 35401, USA.

American Family Physician

|October 24, 1997

Summary

This summary is machine-generated.

Chronic cough, lasting over three weeks, often stems from common causes like smoking or asthma. A stepwise diagnostic approach helps identify single or multiple contributing factors efficiently.

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Area of Science:

Pulmonology
Internal Medicine

Background:

Chronic cough is defined as a cough persisting for over three weeks.
Common etiologies include smoking, post-nasal drip, asthma, gastroesophageal reflux, and chronic bronchitis, accounting for over 90% of cases.
Multiple underlying disorders can contribute to chronic cough in up to 25% of patients.

Purpose of the Study:

To outline a stepwise evaluation strategy for diagnosing chronic cough.
To emphasize minimizing invasiveness and expense in the diagnostic work-up.
To identify key initial screening parameters and subsequent diagnostic steps.

Main Methods:

Initial screening for smoking, occupational exposures, cough-inducing medications, and post-infectious airway hyperresponsiveness.
Systematic evaluation for chronic bronchitis and suspicious systemic symptoms.

Related Experiment Videos

Stepwise empirical treatment or evaluation for post-nasal drip, asthma, and gastroesophageal reflux in undiagnosed cases.

Bronchoscopy reserved for refractory cases.

Main Results:

A structured, stepwise approach can effectively diagnose the majority of chronic cough cases.
Common causes are identifiable through initial screening and targeted evaluations.
A significant proportion of patients may have multiple contributing factors requiring comprehensive assessment.

Conclusions:

A stepwise diagnostic strategy is effective for managing chronic cough.
Early identification of common causes and consideration of multiple etiologies are crucial.
Minimally invasive methods should be prioritized, with bronchoscopy reserved for complex cases.