[Chronic cough: a practical approach].

Abstract

Chronic cough (more than 8 weeks) is a frequent symptom (30 millions consultations/ year). The most encountered causes are: asthma, gastro-oesophageal reflux, post nasal drip. Practically we propose the following approach: 1. clinical history, physical examination, chest-X ray, spirometry; 2. to exclude a post infection cough or secondary to an ACEI; 3. in case of high clinical probability of asthma, post-nasal drip, gastro-oesophageal reflux, to treat adequately. In case of negative clinical probability or unsuccessful treatment, metacholine test, oesophageal studies, PEF recording, CT thorax, bronchoscopy, CT sinuses are the most useful tests, using clinical history as guide. Using such an approach, treatment is successful in the vast majority of cases.