Many pulmonary and some extrapulmonary diseases and disorders can present with chronic cough, making diagnosis and treatment challenging. In practice, chronic cough is often a long-lasting and burdensome condition, persisting for several years and sometimes decades for a substantial number of patients, despite exhaustive medical intervention 7– 9. The definition of chronic cough is guided by expert opinion, as definitive clinical criteria to distinguish acute cough from chronic cough are lacking. The definition of chronic cough in clinical guidelines is cough persisting for >8 weeks in adults and >4 weeks in children 3– 5 however, in many epidemiological studies, chronic cough is defined as cough that lasts >3 months 6. Owing to differences in the pathology, the organs involved and individual patient factors, treatment of chronic cough is progressing towards a personalized approach, and, in the future, novel ways to endotype patients with cough may prove valuable in management.Ĭough is one of the most common symptoms for which people present to primary care and is a chief complaint for patients seeking medical attention in respiratory or allergy specialist clinics 1, 2. Understanding of the mechanisms that contribute to cough hypersensitivity and excessive coughing in different patient populations and across the lifespan is advancing and has contributed to the development of new therapies for chronic cough in adults.
Cough hypersensitivity presents as excessive coughing often in response to relatively innocuous stimuli, causing significant psychophysical morbidity and affecting patients’ quality of life. Most patients with chronic cough have cough hypersensitivity, which is characterized by increased neural responsivity to a range of stimuli that affect the airways and lungs, and other tissues innervated by common nerve supplies. This disorder is challenging to treat because many pulmonary and extrapulmonary conditions can present with chronic cough, and cough can also be present without any identifiable underlying cause or be refractory to therapies that improve associated conditions. Chronic cough is globally prevalent across all age groups.
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