Chronic Cough

A chronic cough is one of the most common reasons patients seek medical care, but this issue can prove to be a challenging problem to solve for many providers.  Treatment of chronic cough often requires a stepwise approach to help discover the root cause of the cough, and allow patients to get back to full enjoyment of their lives.

Cough is classified into three main categories:

• Acute cough: An acute cough is usually caused by a virus and will resolve within three weeks with use of over-the-counter medications. A patient with an acute cough does not necessarily need to be seen by a health care provider
• Subacute cough: This is defined by a persistent cough lasting 3- 8 weeks. A subacute cough is usually evaluated by primary care providers who may recommend short courses of antibiotics or anti-inflammatory therapies, including the use of inhalers.
• Chronic cough: A chronic cough lasts longer than 8 weeks and frequently leads to evaluation by specialists. A chronic cough sometimes lasts for months to years (called a "refractory cough"), and affects women more than it does men. Someone with a chronic cough may or may not be producing sputum, and this issue can be associated with many other pulmonary conditions. We find that a chronic cough is frequently caused by more than one problem occurring at the same time, or that it is triggered by one problem (a virus or an allergy) but fueled by a second issue (such as a sinus infection or gastrointestinal reflux).

Here at LeBauer Pulmonary, when we encounter cough that doesn't resolve with over-the-counter medications, we can offer interventions such as the following:

• Personalized targeted workup and management using a step wise approach pioneered by Dr. Richard Irwin at University of Massachusetts. Dr. Irwin has demonstrated and published a success rate of up to 95%, which does not typically require high-tech or costly procedures.
• We recognize that a persistent cough can cause as much distress in patients as more severe and life-threatening lung diseases, and we therefore approach each case as thoroughly and professionally as possible. We start with a detailed history and exam, just like a fire marshal who is asked to find the cause of a fire.
• Signs of underlying diseases which do require more high-tech evaluation include associated shortness of breath, coughing up blood, weight loss or loss of voice, and we provide work ups and appropriate, timely referral for further evaluation/testing if any of these problems are present.