REVIEW – February 2019

Chronic cough

Authors: Mare Pauklin, Marget Savisaar

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Abstract

According to the American Chest Physician Association (CHEST) guidelines Publisher in January 2018, cough is divided into three categories: acute, subacute, and chronic. Chronic cough is defined as a cough that persist longer than eight weeks. The most important etiologies of persistent cough in non-smokers and in persons who do not take ACE-inhibitors, are most probably upper airway cough syndrome, asthma, and gastroesophageal reflux disease. Chronic cough should be managed systematically, sometimes trial therapy is effective. The management of chronic cough should first concentrate on the most common causes, while unnecessary tests should be avoided. However, in presence of the signs of danger („red flags“), the patient should receive immediate medical attention. The therapy involves two options: specific therapy against the etiology or mechanism of cough, or non-specific symptom-oriented therapy.