J Korean Med Assoc.
2002 Nov;45(11):1331-1342. 10.5124/jkma.2002.45.11.1331.
Chronic Cough
- KMID: 2347509
- DOI: http://doi.org/10.5124/jkma.2002.45.11.1331
Abstract
- Cough is one of the most common symptoms that can be occasionally very distressful and persistently troublesome. Chronic cough is usually defined as a cough persisting for three weeks or longer. The most common etiologies of chronic cough are postnasal drip, asthma, and gastroesophageal reflux, and more than one causes can be identified. Therapeutic trial with decongestants/first-generation antihistamines is usually effective in the diagnosis and management of postnasal drip syndrome. Even cough without postnasal drip can be improved with decongestant/antihistamine. Methacholline challenge bronchoprovocation test is indicated for the exclusion of asthma. The 24-hour esophageal pH monitoring is usually not indicated unless the symptoms are not improving despite the medical management and lifestyle modification for gastroesophageal reflux. Cough may be caused by gastroesophageal reflux in cases not complaining of heartburn or a sour taste in the mouth. Korean patients frequently confuse postnasal drip or throat clearing with sputum from the lower respiratory tract. There is an increasing attention to the pertussis in adults. The laryngeal spasm, that can cause a brief episode of choking sense with cough, is still not well recognized even among physicians. The bronchodilators are to frequently prescribed because many patients and physicians confuse throat clearing with cough or sputum. On the contrary, codein is too much reserved in the management of cough.
