Chronic dry cough: Diagnostic and management approaches

Abstract

Cough is the most common symptom for which medical treatment is sought in the outpatient setting. Chronic dry cough poses a great diagnostic and management challenge due to myriad etiologies. Chronic cough has been commonly considered to be caused by gastroesophageal reflux, post-nasal drip or asthma. However, recent evidences suggest that many patients with these conditions do not have cough, and in those with cough, the response to specific treatments is unpredictable at best. This raises questions about the concept of a triad of treatable causes for chronic cough. This article discusses the mechanism and etiology of cough, along with recent advances in the field of cough, highlighting some of the diagnostic and management challenges.

A Case Report of Recurrent Foreign Body Sensation in Throat-Unusal Long Uvula

“…An elongated uvula can flop down and touch various structures in the upper airway including the posterior pharyngeal wall,base of tongue, epiglottis and sometimes to vocal cords. Irritation of these structures can lead to recurrent foreign body sensation followed by chronic cough 1 .…”

Research Progress on Main Symptoms of Novel Coronavirus Pneumonia Improved by Traditional Chinese Medicine

“…In general, cough is characterized by changes in the normal respiratory pattern caused by reflex, which is mediated by stimulation of extrapulmonary vagal afferent nerves and the brainstem (Mahashur, 2015). The pathophysiological mechanism of a cough may be related to the following two aspects: sensitizing cough receptors by increasing inflammatory mediators, such as bradykinin, tachykinin or prostaglandin, these sensitive cough receptors will cause an increase in the cough reflex; inducing or enhancing cough sensitivity by contraction of bronchial smooth muscle.…”

When a cough persists

“…1,2 It may also be an indication of an underlying disease, either respiratory or non-respiratory in origin. 2 Based on the duration of the cough, the cough may be classified as acute, subacute or chronic. 3 Classifying the cough helps the clinician identify likely diagnostic possibilities.…”