Chronic cough causes
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Chronic Cough Causes: An In-Depth Analysis
Introduction to Chronic Cough
Chronic cough, defined as a cough lasting more than eight weeks, is a prevalent condition that significantly impacts the quality of life. It is a complex symptom with multiple potential causes, often requiring a thorough diagnostic approach to identify the underlying etiology .
Common Causes of Chronic Cough
Upper Airway Cough Syndrome (UACS)
Upper airway cough syndrome (UACS), previously known as postnasal drip syndrome, is one of the most frequent causes of chronic cough. It is associated with various rhinosinus conditions and can occur alone or in combination with other conditions .
Asthma and Cough-Variant Asthma (CVA)
Asthma is a well-known cause of chronic cough, particularly in non-smokers. Cough-variant asthma (CVA) is a form of asthma where the cough is the predominant or sole symptom, often presenting without the typical asthmatic symptoms like wheezing or dyspnea. Diagnosis can be challenging and often requires methacholine challenge testing and a positive response to asthma therapy .
Non-Asthmatic Eosinophilic Bronchitis (NAEB)
Non-asthmatic eosinophilic bronchitis (NAEB) is another common cause of chronic cough. It is characterized by eosinophilic inflammation of the airways without the bronchial hyperresponsiveness seen in asthma. Like asthma, it responds well to inhaled corticosteroids .
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a significant contributor to chronic cough. The reflux of stomach acid into the esophagus can trigger a cough reflex, and this condition often coexists with other causes of chronic cough, such as UACS and asthma .
Environmental and Occupational Factors
Exposure to Irritants
Chronic cough can also result from exposure to environmental pollutants, cigarette smoke, and occupational irritants. These exposures can either directly irritate the airways or exacerbate underlying conditions like asthma and chronic obstructive pulmonary disease (COPD) .
Allergic and Non-Allergic Triggers
Both allergic and non-allergic environmental triggers can cause chronic cough. Allergic triggers include pollen and dust mites, while non-allergic triggers encompass smoke and chemical fumes. These factors can lead to conditions like rhinitis and laryngeal syndromes, contributing to chronic cough.
Less Common Causes
Idiopathic Chronic Cough
In some cases, no specific cause for chronic cough can be identified, leading to a diagnosis of idiopathic chronic cough. This condition is often associated with heightened sensitivity of the cough reflex, which can persist even after the initial trigger has been removed.
Protracted Bacterial Bronchitis (PBB)
In children, protracted bacterial bronchitis (PBB) is a notable cause of chronic cough. It is characterized by a wet cough that improves with antibiotic treatment. Misdiagnosis can lead to complications such as bronchiectasis, highlighting the importance of accurate diagnosis and appropriate treatment.
Conclusion
Chronic cough is a multifaceted condition with numerous potential causes, including UACS, asthma, NAEB, GERD, and environmental factors. Accurate diagnosis often requires a comprehensive evaluation to identify and treat the underlying cause effectively. Understanding the diverse etiologies of chronic cough is crucial for developing targeted treatment strategies and improving patient outcomes.
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