Korean J Med.  2019 Dec;94(6):471-484. 10.3904/kjm.2019.94.6.471.

New Approach to Chronic Cough: An Introductory Guide Based on Recent Clinical Practice Guidelines

Affiliations
  • 1Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea. ksh1134@eulji.ac.kr

Abstract

The cough reflex is a vital protective mechanism for the lower airways against aspiration, but when dysregulated, it becomes a clinical problem. Indeed, chronic cough is an important clinical issue as it is common in the general population and causes considerable morbidity. Anatomic diagnostic protocols were the first breakthrough in the management of patients with chronic cough; however, as systematic approaches are not always successful, a new paradigm of cough hypersensitivity syndrome has been proposed. The introduction of this paradigm has provided new opportunities for managing chronic cough, including development of new cough assessment tools and effective cough control therapies. However, it also warranted re-appraisal of existing clinical evidence and refinement of our clinical pathways. Against this background, international and domestic evidence-based practice guidelines based on a strict methodology have been published recently. In this review, we introduce clinical approaches based on the concept of cough hypersensitivity syndrome and discuss key aspects of recently published guidelines for chronic cough in adults.

Keyword

Cough; Guideline

MeSH Terms

Adult
Cough*
Critical Pathways
Evidence-Based Practice
Humans
Hypersensitivity
Reflex
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