Taming chronic cough

Objective: To review the available evidence on treating chronic cough to relay a thoughtful, evidence-based approach for the diagnosis and treatment of chronic cough. Data Sources: MEDLINE, PubMed, EMBASE, and CINAHL were searched using the following keywords: cough, asthma, gastroesophageal reflux, sinusitis, rhinitis (allergic, seasonal), postnasal drip, vocal cord dysfunction, lung disease (interstitial), bronchiectasis, and bronchoscopy. Study Selection: Studies were selected based on their relevance to the diagnosis and treatment of chronic cough. Because of a lack of randomized prospective studies, nonrandomized and retrospective studies were considered, with their strengths and limitations noted. Results: Few randomized controlled trials have addressed the diagnosis and treatment of chronic cough. There are several prospective noncontrolled trials for adults with chronic cough that found a high percentage of cough resolution when using an approach that focused on the diagnosis and treatment of the most common causes: asthma, gastroesophageal reflux disease, and upper airway cough syndrome. Preliminary studies in children support an approach that distinguishes between a wet and dry cough, as well as an in-depth investigation of any specific symptoms that point to an underlying chronic illness. Conclusion: Allergists, as experts in treating upper airway and lower airway disorders, are uniquely poised to diagnose and treat chronic cough.