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)


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
This may b COPD,it may associates with allergic bronchitis
Very nice description
Thank you doctor

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