Chronic Cough: New Approaches

Having a cough that will not go away can be maddening and exhausting. While an occasional cough is normal, a cough that persists for more than eight weeks is termed a chronic cough and can have a massive impact on day-to-day life.

While managing a chronic cough can be challenging for both doctors and patients, Royal Brompton & Harefield Hospitals Specialist Care have experts on hand who can identify the triggers and provide treatment to lessen and even eliminate symptoms.

 

 

Some of the most common problems that trigger a chronic cough include nasal problems, untreated infection, acid reflux or asthma. Treatment targeting these problems doesn’t always help the cough go away. This can lead to patients being treated unsuccessfully again and again, resulting in frustration with the lack of progress.

Patients who come to Royal Brompton & Harefield Hospitals will meet with a specialist who will examine them, and where necessary. recommend diagnostic tests to confirm or help with a diagnosis and treatment plan. These could include lung function tests, x-ray, computerised tomography (CT) scan, or fractional exhaled nitric oxide (FeNO) testing.


A new diagnostic tool, fractional exhaled nitric oxide (FeNO) testing is available at the Royal Brompton Hospital and RB&HH Specialist Care Outpatients and Diagnostics, at 77 Wimpole Street. FeNO testing involves the patient breathing in to a hand-held device used to measure the levels of nitric oxide in their breath, providing physicians with a better diagnostic tool for respiratory conditions. During inflammation, the levels of nitric oxide (NO) released from the epithelial cells of the bronchial walls are higher than normal. The concentration of nitric oxide in exhaled breath is known as fractional exhaled nitric oxide (FeNO), and can help to identify airway inflammation.

 

Some of the new pharmacological developments for testing chronic cough include drugs which target nerve sensation. These drugs can be particularly effective as people suffering with chronic cough often report uncomfortable nerve type sensations in the throat and upper chest.

Neuromodulators such as gabapentin can be effective in treating chronic cough, significantly improving cough-specific quality of life.

Speech language pathology is also an effective management intervention for chronic cough that persists despite medical treatment. This can aid in the improvement of symptoms by suppressing the cough and increasing the cough threshold.

Consultants work to find the best approach for the patient to improve quality of life and help the patient get back to normal.


 

Dr James Hull
Consultant respiratory physician

Dr James Hull is a Consultant Respiratory Physician with expertise in asthma, cough and shortness of breath.