Investigations and management of chronic cough: update from the European Respiratory Society Chronic Cough Taskforce 2020

Mohammed A M Farooqi, Vicky Cheng, Mustafaa Wahab, Izza Shahid, Paul M O'Byrne, Imran Satia
Polish Archives of Internal Medicine 2020 July 6
Chronic cough affects approximately 10% of general population, is highest amongst people aged 50-60, and is twice as common in women than men. It is described to last 8 weeks or longer in adults and not treated effectively with most over-the-counter medications. This is a debilitating condition with physical, social, and psychological consequences. The purpose of this review is to highlight the key messages from the task force commissioned by The European Respiratory Society on the management of chronic cough. The assessment of chronic cough should include a thorough detailed history and examination to identify potential causes. The impact and severity can be assessed in clinic using questionnaires. Potential causes of the condition vary; ACE inhibitor induced, smoking, asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airways cough syndrome. In many patients, coughing is persistent despite optimum medical therapy of the underlying medical condition and is hence referred to as refractory chronic cough. In some cases, no cause is found and is classified as unexplained chronic cough. If treatment of any underlying disease is unsuccessful at controlling cough, then neuromodulatory treatment such as low dose opioid, gabapentin, pregabalin or speech and language therapy may be considered. There is no licensed treatment for chronic cough, but a new class of treatment targeting the purinergic P2X3 receptor are currently in phase 2 and phase 3 development.

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