What to Do with the Patient with Chronic Cough? A Simple Approach to a Difficult Problem.

Introduction Chronic cough, defined by some authors as lasting longer than eight weeks, is a problem frequently seen by primary care providers as well as specialists. Although elucidating the cause of a chronic cough can be difficult and frustrating—both for the patient and for the physician—systematic examination leads to successful diagnosis and treatment in nearly 100% of cases. In an estimated 95% of patients with a chronic cough and negative results of chest x-ray examination, the cough is caused by postnasal drip, asthma, gastroesophageal reflux, cigarette smoking, chronic bronchitis, eosinophilic bronchitis, or use of an angiotensin-converting enzyme (ACE) inhibitor. More than one of these diagnoses is responsible for cough in 18% to 93% of cases.