Chronic Cough

 

Chronic Localized Cough related to laryngeal irritation may be the sum result of several contributing factors.  There is likely an increase in sensitivity of the cough receptors at the site.  In addition, there is local irritation triggered by the presence of irritating factors.  A non-exhaustive list of irritating factors can include: dry air, cold air, dust, allergens, chemicals, acid reflux, sinus drainage/post nasal drip, asthma, mouth breathing (particularly at night,) chronic infection, protracted irritating cough.  The last factor may become a self-regenerating cough.  Cough causes irritation - causes more coughing - causes more irritation (possibly injury) - causes more coughing = CYCLE.

 

 

Treatment:  Lower the sensitivity and extinguish the irritating factors.

 

  • Sensitivity: Antihistamines, Suppressants, Antibiotics, Locas Steroids, Locas Moisture, Cough Drops, Cough Suppressants.

 

  • Irritating Factors: Rx GERD, Rx Post Nasal Drip (PND), Rx Asthma, Rx Infection, Rx Dryness, Eliminate Triggers.

 

 

A Treatment Strategy: Thorough Evaluation including swallowing and aspiration and treatment trials addressing contributing factors.

 

  • Sensitivity: Anesthetics + Steroids + Moisture (liquids with body) + Cough Suppressants.

 

  • Irritating Factors (Triggers):  Patient keeps trigger records + Rx GERD + Rx PND + Rx Asthma + Rx Allergies Avoid Dusts + Humidify Room + Thickened Liquids.

 

  • Monitor Regularly.

Increased Sensitivity + Irritating Factors = Chronic Cough

Irritated Larynx

Hypersensitivity Cough Map

 

Inflamed Airways

 

Inflamed airways during COPD flare-up

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Connect to us:
Mary Barnett
mbarnett@coh.org
909.732.8281
Brian Tiep, MD
btiep@coh.org
626.359.8104
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