Chronic cough in adults: when to worry?

Definition: when do we speak of chronic cough?

Cough is defined as a “abrupt and sonorous exhalation of the air contained in the lungs, which may be intended to rid the bronchi, trachea, larynx, and pharynx of mucus and noxious agents which encumber it; She can be a reflex response to irritation of the mucosa of the ENT or tracheobronchial airways ; It can also be used to clear the voice or attract attention.“. Chronic cough is defined by a duration that exceeds 8 weeks. “There cough is a symptom, not a disease. It is above all a defense reflex of the body which aims to prevent the penetration of elements which can be dangerous, foreign bodies such as microbes or fungi.“, would like to remind Dr. Jean-Philippe Santoni, pulmonologist.

What are the causes of a chronic cough in adults?

Chronic cough in adults may be related to irritations as in the case of gastroesophageal reflux disease or chronic postnasal drip (in case of allergic rhinitis in particular) or allergic or inflammatory phenomena such as asthma. More rarely, it can be linked to a disease such as tuberculosis. In smokers, chronic cough may be a symptom of chronic obstructive pulmonary disease. “ISmoking, taking certain medications such as aspirin, certain contraceptives, certain antihypertensives and antidiabetics are also common causes“, adds the pulmonologist. In all cases, a chronic cough requires medical monitoring.

When to worry?

“Any chronic cough should be investigated consultation with the attending physician, particularly when it affects quality of life and sleep and occurs in the form of fits, whether or not associated with bloody sputum“informs the specialist.

A cough is called chronic when its duration is more than eight weeks. The presence of warning signs should lead to a specialized examination depending on the symptoms, in particular deterioration of general condition, infectious syndrome, exertional dyspnoea, hemoptysisthe appearance or modification of cough in a smoker, dysphonia, dysphagia or aspiration or even suspicious cervical lymphadenopathy towards the ENT.

Cough suppressants are not recommended. They can only be useful in disabling, non-productive coughs of an etiology not easily accessible to a curative treatment. Several treatments exist, the choice will be made according to the patient’s treatments, the physiopathological state of the patient, the presence of pregnancy or breastfeeding, if the patient has diabetes. The treatments are to be adapted according to the context of the cough. “For example, inhaled corticosteroids and bronchodilators will be administered for the treatment of asthma, antacids for GERD, stopping smoking, particularly in the case of COPD and possibly bronchodilators“, specifies the pulmonologist. And to specify: “For refractory coughs, management can be based on non-drug treatments: speech therapy, meditation techniques and sophrology“, adds the pulmonologist.

Thank you to Dr Jean-Philippe Santoni, primary prevention pulmonologist at the Fondation du Souffle.