Maria Hasan, Fouad Majeed.
Evaluation of chronic cough in adults.
Med Today Jan ;2(3):93-8.

Chronic cough has profound effect on the quality of life making it the fifth most common symptom seen in the outpatient clinic. The cause can be identified in 88-100 percent of the cases and treatment of the underlying cause has the success rate of 84-98 percent. The evaluation of a patient presenting with chronic cough starts with a thorough history and focused examination. This gives the clue in approximately 77 percent of the cases while in the remaining 23 percent of the cases it guides towards the relevant investigations. Patient with chronic cough should avoid exposure to environmental irritants and those who smoke should stop smoking. Any patient having cough for greater than three to six weeks requires a chest radiograph provided the patient is not taking ACE inhibitors and there is no irritant exposure. Postnasal drip syndrome, asthma, and gastroesophageal reflux disease are the most likely causes of chronic cough in adults having a normal chest radiograph. Trial of treatment-empiric therapy for the most likely cause may be preferable to extensive investigation because it may provide relief and diagnosis simultaneously.

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