Wednesday 15 October is World Chronic Cough Day. What are the traits of chronic cough and why is it important to raise awareness?
Chronic cough is common, it probably affects around 5% of people, is seen worldwide and has a big impact on sufferers. It can be a symptom of other conditions or a disease in itself due to hypersensitivity of the nerves that cause cough.
Most people with chronic cough suffer unpleasant symptoms. They often go back and forward to GP’s and various hospital specialists and have lots of investigations and medication trials but don’t get helpful explanations or effective treatment. This is due to a lack of awareness of recent advances in how we manage cough. This is a shame as the correct treatment and advice can make a big difference to people and increase their quality of life and managing cough is not complicated.
Common things to look out for when patients have a chronic cough are:
- making sure patients don’t have anything serious (red flags…)
- if they are smoking then stopping will usually make things better
- stopping ACE inhibitor drugs (used for heart disease and blood pressure) will also help and should always happen
- treating any underlying lung disease eg asthma should be a priority
- some people have a cough due to a sensitive cough reflex, this needs specific treatment.
More detailed management protocols are in the BTS Clinical Statement on Chronic Cough in Adults.
What is the impact of chronic cough on patients?
Chronic cough really impacts on people’s lives. Sufferers experience unpleasant physical symptoms due to the cough with other symptoms such as throat discomfort, chest pain, breathlessness, fatigue and voice problems being common.
Sometimes people can pass out due to coughing (cough syncope) and this can be dangerous and patients who suffer this cannot drive. A lot of female patients suffer urinary incontinence due to cough and that can be embarrassing. People who suffer from cough often worry a lot about the cough and report low mood, probably an impact of having to live with this unpleasant symptom all the time, some people have reported feeling suicidal. You can’t hide a cough and people often expend a lot of energy dealing with the reactions of other people, this can be exhausting and embarrassing.
What resources would you recommend for the monitoring and treatment of chronic cough?
The BTS Clinical Statement on Chronic Cough in Adults is the most up to date guidance out there. It provides information for primary and secondary care and was developed with input from a broad range of professionals.
These resources may be helpful for patients:
- RCSLT Giving Voice
- Respiratory speech and language therapy: Northumbria Healthcare NHS Foundation Trust
- Cough Sway: Developed by Respiratory speech and language therapists using NHS & British Thoracic Society guidance
What advice would you give to healthcare colleagues who are looking to specialise in chronic cough?
Get involved, cough is a small area and is friendly and accessible. We are happy to help people who want to develop or improve services - get in touch. I’ve found working in the area over the last 15 years very rewarding. You can make a big difference to people.