Cough is the most common reason to seek primary care with about 30 million clinician visits each year. Chronic cough is defined as a cough that has been present for 8 or more weeks. Cough is produced through triggering of cough receptors in the upper and respiratory tracts, as well as chemical receptors in acid, cold, heat, capsaicin compounds, mechanical cough receptors. Etiologies of cough include underlying pulmonary or cardiac disease, allergies/sinus issues with or without post-nasal drip, reflux, medication side effects, dehydration, habitual, or idiopathic. Cough can be triggered by environmental irritants, weather, exercise, stressful environments, voice use.
Read more about our approach to Chronic Cough here.
Symptoms
Symptoms associated with chronic cough include cough and/or episodes of coughing (we could word this differently but something including coughing fits), post nasal drip or nasal discharge, throat clearing, episodic wheezing, hoarseness, swallowing difficulty, night time coughing. Could we include something about triggers for cough? - strong smells, temperature change, tickle in the throat, talking, laughing, etc.
Evaluation
Evaluation for chronic cough is typically performed by a laryngologist and/or physician assistant. A Speech Language Pathologist (SLP) may be included in the evaluation process based on the person’s specific cough complaints. A typical chronic cough visit includes an evaluation of prior work up, and consideration for additional testing to consider pulmonary disease, asthma, post nasal drip syndrome, and GERD. A comprehensive history intake is taken and a laryngoscopic evaluation is typically completed to assess the structure and function of the throat and voice box (larynx) and identify possible causes or contributions to the chronic cough.
Treatment
Treatments for chronic cough vary based on multiple potential etiologies of cough and are unique to each patient. Treatments range from speech therapy, targeting behavioral modifications to address cough, to trials of corticosteroids, decongestants, acid blockers, antihistamines, to medications or injections for neuropathic disorders that can help reduce the frequency and severity of cough.