Cough - an Interdisciplinary Condition: The Pneumologist's Perspective

Abstract

Cough - an Interdisciplinary Condition: The Pneumologist's Perspective Abstract. Cough is one of the most frequent reasons for a medical consultation. Patients mostly suffer from acute cough (< 2 weeks duration) and subacute cough (2 - 8 weeks) during consultation at primary care. Chronic cough (> 8 weeks) is mostly cared for by specialists. Acute and subacute cough is most frequently caused by infections with primarily viral pathogens. Chronic cough is commonly associated with obstructive airway disease (i. e. Asthma, COPD), gastroesophageal reflux and upper airway cough syndrome. Pulmonary causes are investigated by spirometry, bodyplethysmography, blood eosinophil count, exhaled nitric oxide, methacholine challenge test, chest x-rays and computed tomography. Treatment should target underlying diseases, causing cough. Trials of inhaled corticosteroids can be considered if an asthmatic cause is suspected. Secretolytics and cough-suppressing medications should be used only to reduce patient symptoms if there is no alternative causal treatment. Clinical trials show positive results for treatment of chronic refractory (no improvement of symptoms despite adequate treatment of the underlying condition) and chronic idiopathic cough with Gefapixant, a P2X3 purinergic receptor antagonist. If recent trial results are confirmed a first specific cough modulating substance might be available soon.