John Malaty
University of Florida, USA
Title: Chronic cough in adults: Evaluation and management in primary care
Biography
Biography: John Malaty
Abstract
Although chronic cough in adults can be caused by many etiologies, these patients can be effectively evaluated in primary care by considering the most common causes, which alone, or in combination, make up the vast majority of cases: upper airway cough syndrome (UACS), gastroesophageal reflux disease (GERD)/laryngopharyngeal reflux disease (LPR), asthma and non-asthmatic eosinophilic bronchitis (NAEB). These should be evaluated clinically and spirometry performed if indicated. Empiric treatment should be initiated while considering angiotensin converting enzyme inhibitors, environmental triggers, tobacco use, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) as potential causes. Chest X-ray can rule out concerning infectious, inflammatory and malignant thoracic conditions and empiric treatment of the aforementioned etiologies can also be diagnostic. In rare cases, chronic refractory cough may be present and one may then consider referral to pulmonology and/or otolaryngology, in addition to trial with gabapentin, pregabalin and/or speech therapy. In this presentation, the author will discuss how to evaluate and effectively treat these causes of chronic cough in the primary care setting, in addition to discussing when to refer these patients for specialty care.