Asthma, postnasal drainage and GERD are the most common causes of cough.1,2 Spirometry and a chest x-ray have been suggested as the minimum investigations required in the evaluation of chronic cough.2-4 Allergists have extensive training to evaluate the upper as well as lower airway in a patient with chronic cough5.
Diagnostic evidence
Cough occurs in all asthmatics.1 However, cough alone is a poor marker of asthma and asthma may be overdiagnosed in children with cough alone.3 The allergist can both provide expert consultation to ensure the diagnosis of asthma is correct and maximize therapy in the asthmatic (see asthma section)
Diagnostic evidence, Indirect outcome evidence (avoidance, pharmacologic, and immunologic therapy)
Postnasal drip is the single most common cause of chronic cough.1 Allergy skin testing and history-testing correlation can differentiate allergic from non-allergic rhinitis (see rhinitis section). Treatment of rhinitis can improve the cough.1 Treatment of rhinitis by allergists improves patient outcomes (see rhinitis section)
Diagnostic evidence, Indirect outcome evidence (avoidance, pharmacologic, and immunologic therapy)
Tobacco smoke exposure clearly increases cough prevalence and exacerbates any pulmonary condition.3 Chronic cough in cigarette smokers is dose-related.4 Allergists can assist with active steps to minimize and/or eliminate tobacco smoke exposure.5
Indirect outcome evidence (smoking cessation)
