Chronic cough: a frequent symptom and complex solution

Written by: Dr. Adalberto Pacheco Galván
Edited by: Top Doctors®


Chronic cough (TC) is that cough that persists for more than 8 weeks and affects between 7% and 10% of the population, especially women in the 5th decade. The mechanism of CT is due to a reflex arc where the peripheral receptors are located in the larynx, tracheo-bronchial tree and esophagus and, to a lesser extent, in the middle ear and pericardium.

If we treat the inflammation that originates in those places theoretically we can cancel the afferent path of the reflex arc. International experience maintains that CT scanning is not so easy for three reasons: the level of deepening of the diagnosis of inflammation in the periphery of the reflex arc, the possibility of several simultaneous origins of the start of stimulation and the acquired hypersensitivity at the level of the center of cough in the central nervous system, which can cause even small peripheral stimuli to produce a cough. Several stimuli from different places can develop at the central level a suprastimulation by convergence of the same that, over time, can alter the cough reflex chronically.

CT is usually associated with the diagnostic triad: eosinophilic bronchial inflammation (EIB), gastroesophageal reflux (GER), and upper airway disease, and will usually respond to specific treatment. However, the total cough solution is rare when treated according to this triad, except in the IBE, when corticosteroids are prescribed. Therefore, the Chronic Cough Syndrome is increasingly valued as a Hypersensitivity Syndrome somewhere in the reflex arc. This hypersensitivity can be measured in the laboratory but it has been shown in some tosedores that this test remains abnormal despite the fact that CT improves when treating central hypersensitivity; and this happens with a frequency close to 40% of TC. This type of cough is then called refractory or unexplained, forcing a laryngeal rehabilitation (hence the place with the greatest number of receptors) to begin and using drugs that act at the neurological level.

*Translated with Google translator. We apologize for any imperfection

By Dr. Adalberto Pacheco Galván
Pulmonary Disease

Famous medical specialist pulmonologist asthma and chronic cough. Spanish doctor proposed only as a member to the Committee of Consensus for the Diagnosis and Treatment of Chronic Cough in the ERS (European Respiratory Society). He is the founder and head of the Unit for asthma and cough unwieldy Ramon y Cajal Hospital with more than 400 patients seen notarized.

*Translated with Google translator. We apologize for any imperfection

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