Taming chronic cough.

OBJECTIVE To review the available evidence on treating chronic cough to relay a thoughtful, evidence-based approach for the diagnosis and treatment of chronic cough. DATA SOURCES MEDLINE, PubMed, EMBASE, and CINAHL were searched using the following keywords: cough, asthma, gastroesophageal reflux, sinusitis, rhinitis (allergic, seasonal), postnasal drip, vocal cord dysfunction, lung disease (interstitial), bronchiectasis, and bronchoscopy. STUDY SELECTION Studies were selected based on their relevance to the diagnosis and treatment of chronic cough. Because of a lack of randomized prospective studies, nonrandomized and retrospective studies were considered, with their strengths and limitations noted. RESULTS Few randomized controlled trials have addressed the diagnosis and treatment of chronic cough. There are several prospective noncontrolled trials for adults with chronic cough that found a high percentage of cough resolution when using an approach that focused on the diagnosis and treatment of the most common causes: asthma, gastroesophageal reflux disease, and upper airway cough syndrome. Preliminary studies in children support an approach that distinguishes between a wet and dry cough, as well as an in-depth investigation of any specific symptoms that point to an underlying chronic illness. CONCLUSION Allergists, as experts in treating upper airway and lower airway disorders, are uniquely poised to diagnose and treat chronic cough.