Chronic Cough
chronic cough

What is chronic cough?

When the cough lasts more than a month in children and couple of months in adults

What are the causes of chronic cough?

  • Acid reflux
  • Laryngopharyngeal reflux
  • Environmental pollution
  • Whooping cough
  • Viral, fungal and bacterial respiratory infections
  • Exposure to irritants
  • Pulmonary emboli
  • Aortic aneurysm
  • Allergies
  • Asthma
  • Tobacco usage
  • Postnasal drip
  • Sinusitis
  • Nasal polyps
  • Upper airway cough syndrome
  • Rhinitis
  • Fibrosing alveolitis
  • Sleep apnoea
  • Vocal cord dysfunction
  • Cough hypersensitivity syndrome
  • Ciliary dyskinesia
  • Chronic bronchitis
  • Emphysema
  • Bronchiectasis
  • Pulmonary fibrosis
  • Cystic fibrosis
  • Certain medications – ACE inhibitors
  • Sarcoidosis
  • Eosinophilic bronchitis
  • Vitamin B12 deficiency
  • Lung cancer
  • Psychogenic

How chronic cough is diagnosed?

  • Physical examination
  • Medical history evaluation
  • Environmental and Occupational assessment
  • Differential diagnosis based on diagnostic outcomes
  • Lab tests – Blood Cultures, Serology, Molecular Tests, Immunoassays, Allergy Tests, Exhaled Nitric Oxide, Autoantibodies, Sweat test, ESR, CRP,
  • Methacholine challenge test
  • Oesophageal pH testing
  • Lung function tests – Spirometry
  • Medical imaging – X-Ray scan of chest, High Resolution CT, Sinus Imaging, Magnetic Resonance Imaging, Angiography, Ultrasound, Echocardiogram, Bronchoscopy, Rhinoscopy, Esophagram, Videomicroscopy, Quantitative transmission electron microscopy, Sinus imaging

How chronic cough is treated?

Treatment is aimed at curing the underlying condition

  • Treatment of asthma – Inhaled Corticosteroids, Glucocorticoids, Adrenocortical steroids, Beta2-agonists, Leukotriene modifiers, Cromones, Bronchodilator, Long-acting beta agonists & Theophylline
  • Treatment of COPD – Beta-agonists, Corticosteroids, Anticholinergics
  • Treatment of GERD – Antihistamines, Histamine-2 blocker, Proton Pump Inhibitors, Alginates, Prokinetic agents
  • Treatment of eosinophilic bronchitis – Glucocorticoids
  • Treatment of hay fever / rhinitis – Antihistamines, Glucocorticoids
  • Bacterial infections – Antibiotics
  • Treating rhinitis – Anti Histamines, Oral Decongestants, Nasal Steroids and Adrenocortical steroids
  • Alternative medication for high blood pressure if the chronic cough is due to ACE inhibitor drugs
  • Other medications – Decongestants, Mucoprotective agents, Codeine, Nasal Spray, Pholcodine, Dextromethorphan, Methadone and Morphine; Gabapentin or Pregabalin, Mucolytics
  • Speech therapy

How to prevent chronic cough?

  • Quitting smoking
  • Eating plenty of fruits and fibre rich foods
  • Having plenty of fluids in the form of water, soups and fresh fruit juices

How to get relief from chronic cough?

  • Wear facial mask when outdoors
  • Use humidifier at home
  • Gargle salt water
  • Use extra pillows on the bed while sleeping
  • Use lozenges or hard candies
  • Use oral decongestants & non-opioid cough suppressants
  • Improve indoor air quality

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