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Chronic Cough: Common and Often Vexing

Solving the Problem Can Take Time, Doctor Notes

Setting Expectations

Lim advises patients to understand that finding a solution may take time. He suggests that patients find a nearby doctor since repeated appointments will likely be needed.

"It's just the nature of the diagnostic process. It's not that the doctor isn't doing his best," he says.

Lim adds that doctors should quickly be able to rule out the conditions patients fear most, like cancer.

Patients should "work with somebody they trust, who's accessible [and] willing to see them back," says Lim. "You need somebody who's interested in the subject, interested in people."

Doctors should give patients start-and-stop dates for each approach they try, says Lim.

Scanning the Sinuses

Lim and colleagues also checked CT sinus scans of 132 chronic cough patients.

Those patients had already failed treatment for rhinitis, reflux, and asthma. Nearly three-quarters of patients who were clinically suspected of having a sinus problem had abnormal CT sinus scans, and about a third had acute sinusitis, the researchers report.

The researchers aren't recommending CT scans for most people with chronic cough. The patients they scanned had already tried other approaches. Having a history of sinus problems or sinus surgery may also push sinus problems higher on the list of possibilities, says Lim.


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