Chronic cough
Cough is one of the most common symptoms in the clinical picture of diseases of internal organs. Cough is considered chronic, with its duration exceeding 8 weeks.
- Postnasal congestion syndrome is a group of clinical symptoms resulting from irritation of the mucous membrane of the posterior wall of the pharynx and larynx with catarrhal or purulent discharge from the nasal cavity or paranasal sinuses.
In most cases, postnasal congestion syndrome is a manifestation of ENT diseases:
- rhinitis of various etiologies;
- polyps and curvature of the nasal septum;
- bulla and paradoxical bending of the middle nasal concha;
- enlargement of the nasal concha;
- additional fossae of the maxillary sinus, etc.
- Gastroesophageal reflux disease (GERD). GERD is a complex of clinical symptoms and / or morphological changes that occur as a result of throwing stomach contents into the esophagus.
Such a cast can lead to damage to the mucous membrane of the pharynx and the posterior parts of the larynx, followed by the development of chronic pharyngitis, hyperplastic laryngitis, contact ulcers and laryngeal granulomas. The clinical manifestations of GERD vary: less than half of patients may have characteristic symptoms such as heartburn, sour taste in the mouth and belching, while the majority may only have a cough. Cough with GERD is usually dry, long-lasting, occurs mainly when the body position changes, intensifying with inclines and in the horizontal position of the body.
- Taking certain medications: ACE inhibitors (enalapril, lisinopril, captopril, to a lesser extent perindopril and fosinopril), beta-blockers, cytostatics.
- Cough variant of bronchial asthma – characterized by isolated chronic cough as the only symptom of bronchial asthma, responding to inhalation bronchodilator therapy.
In the diagnosis of the cough variant of bronchial asthma, it is necessary to take into account the clinical manifestations of the disease (cough is provoked by inhaling cold air, emotional speech and does not respond to antitussive drugs), as well as laboratory and instrumental diagnostic methods, such as a spirogram with bronchodilation test, increased blood levels of eosinophils, total immunoglobulin E and eosinophilic cationic protein.
- Eosinophilic bronchitis. When examining the general sputum analysis of these patients, eosinophilia is detected (the content of eosinophils is more than 3%).
When conducting a spirogram and a test with a bronchodilator, the test will be negative.
The causes of chronic cough may be other diseases: chronic obstructive pulmonary disease, central bronchial carcinoma, endobronchial tuberculosis; bronchiectasis; heart failure, interstitial lung disease; cystic fibrosis, etc.
Diagnosis of the disease
Diagnosis of chronic cough is based on well-collected complaints and anamnesis of the disease, it is these data that will allow the doctor to determine the further path of diagnosis.
Among the instrumental diagnostic methods used are:
- chest X-ray;
- spirometry with bronchodilation test;
- daily pH monitoring;
- esophageal manometry;
- radiography or CT of the paranasal sinuses;
- fibrobronchoscopy;
- esophagogastroduodenoscopy.
Treatment
Treatment of chronic cough is aimed at the cause of its occurrence.
A multi-profile approach to the diagnosis of chronic cough, includes consultation with a therapist, gastroenterologist, otorhinolaryngologist, pulmonologist, cardiologist.
In the medical scientific center named after A.S.Loginov, it is possible not only to receive narrow-profile specialists, but also to perform all methods of instrumental and laboratory diagnostics of chronic cough.
