Understanding Refractory Chronic Cough: What You Need to Know Have you ever faced a cough that simply refuses to subside? While most coughs resolve independently, some persist for an unacceptable length of time—weeks, months, or even years. This condition is known as refractory chronic cough (RCC), and it is a significant issue that demands attention in the medical community, especially among specialists in ear, nose, and throat (ENT) care. In this blog post, we will clearly outline what RCC is, why it occurs, and the most promising treatments available to those suffering from relentless coughing. What is Refractory Chronic Cough? A chronic cough is defined as one that lasts longer than eight weeks in adults. For many individuals, it is associated with conditions such as asthma, allergies, acid reflux, or certain medications. However, there are instances where the cough continues even after these underlying causes have been effectively ad...
What causes a cough in children?
Coughing is a protective reflex of the body due to irritation of the airway. If the cough lasts more than 4-8 weeks or if after four weeks the cough is becoming worse, then it can be worrying. A persistent cough can affect the quality of the life of a child, including, schooling, sleep and appetite. Common causes of persistent cough could be allergy/hay fever, postnasal drip, large tonsil, gastro-oesophageal reflux or asthma. Rare causes include foreign body inhalation or psychogenic. Evolving evidence is dry cough on its own is rarely a symptom of asthma.
What are two essential things to understand about chronic cough in a child?
- Causes of chronic cough are different from adults
- Management of chough in children if different from adults and parents and clinician need to understand this.
What should I write down when we make an appointment for my child with ENT?
It is important to note, when did the cough start? What is the frequency of cough, hourly or daily? Did the child have a cold before symptoms start? Does your child have a temperature with shortness of breath? Shortness of breath with a cough will trigger urgent attendance to accident and emergency. Is the cough wet with phlegm or dry? Is the cough worse at night? Does sleeping make it better? What are the aggravating and relieving factors for your child's cough?
How do I suspect if my child's cough is due to allergy?
- If the child is having hay fever symptoms and the coughing is seasonal.
- If your child is coughing mainly at night and it gets better when you are away on holiday. In these cases, getting allergy skin prick or RAST blood can help make the diagnosis.
How do I suspect that it could be inhaled foreign body?
Sudden onset coughing with a choking episode could be due to inhaled foreign body. In many of these cases, a choking attack may not be witnessed.
How do I know if an enlarged tonsil is contributing to coughing?
An enlarged tonsil can hold thick secretions in the oral cavity and can make a child cough to clear these secretions. Quite often, these children have associated symptoms of sleep apnoea.
Is the management of the chronic cough multidisciplinary?
A chronic cough is managed multidisciplinary working together with your primary care physician, paediatrician and ENT surgeon.
What investigations might an ENT surgeon request?
A detailed history is a crucial part of managing a child with a chronic cough. Depending on their history, the child may need an allergy test, blood test, chest x-ray, barium swallow or a CT scan. It is essential to note that not every child will need all these investigations.
Helping Patients with Specialist Expertise and Kindness
Mr Gaurav Kumar
Consultant Ear Nose Throat Surgeon
To make an appointment
info@entsurgeonclinic.co.uk
07494914140
Disclaimer: For general information only, always seek medical advice from your treating consultant.
