Chronic Cough

■ Essentials of Diagnosis:- • One of the most common reasons for seeking medical attention • Defined as a cough persisting for at least 4 weeks • Nasal and oral examination for signs of postnasal drip (eg, cob- blestone appearance or erythema of mucosa), chest auscultation for wheezing • Chest x-ray to exclude specific parenchymal lung diseases • Consider spirometry before and after bronchodilator, methacholine challenge, sinus CT scan, and 24-hour esophageal pH monitoring • Bronchoscopy in selected cases ■ Differential Diagnosis:- • Bronchitis • Respiratory bronchiolitis (smoking-related) • Angiotensin-converting enzyme (ACE) inhibitor • Postnasal drip • Sinusitis • Asthma • Gastroesophageal reflux • Postinfectious cough • Chronic obstructive pulmonary disease • Congestive heart failure • Interstitial lung disease • Bronchogenic carcinoma • Psychogenic cough ■ Treatment:- • Smoking cessation • Treat underlying condition if present • Trial of inhaled β-agonist (eg, albuterol) • For postnasal drip: Antihistamines (H1-antagonists or may add nasal ipratropium bromide) • For suspected gastroesophageal reflux disease, proton pump inhibitors (eg, omeprazole)

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Well updated article Sir plz comment on nasal ipratropium bromide, which can be different therapy in treating post nasal drip. Is it available in spray form?
Sure sir.. & thank you
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This may b COPD,it may associates with allergic bronchitis
Very nice description
Thank you doctor
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