Chronic cough: diagnosis, treatment and psychological consequences

Abstract

Educational aims Summary Chronic cough is a common and disabling symptom leading to a marked decrement in a patient's quality of life. The vast majority of patients with chronic cough can be helped by making an accurate diagnosis, usually of either reflux disease or asthma. Reflux cough presents in a fashion markedly different from the classic symptoms of gastro-oesophageal reflux, such as heartburn. Indeed, <50% of patients with reflux cough suffer from heartburn. The correct diagnosis and correct treatment modality leads to amelioration of cough in the majority of cases. Where no diagnosis is obtained or there is a failure of therapy, non-specific cough suppression can dramatically improve the patient's quality of life. This overview provides information on the pathophysiology of the causes of chronic cough, hence enabling the reader to make an accurate clinical diagnosis and suggest therapy to improve even those with apparently intractable symptoms.