Dr Laurie Slovarp Discusses the Patient Journey for Chronic Cough

Patients with a chronic cough that persists even after treatment usually see a few specialists and have lingering triggers that cause their cough, explained Laurie Slovarp, PhD, CCC-SLP, associate professor in the School of Speech, Language, Hearing, and Occupational Sciences at University of Montana.

How is chronic cough typically diagnosed and evaluated?

The basic definition of a chronic cough is a cough that you've had for over 8 weeks. So, in that regard, it's a really easy diagnosis and primary care physicians diagnose it all the time.

The type of cough that I treat is referred to as a few different names. It's usually called refractory chronic cough or unexplained chronic cough or difficult-to-treat chronic cough. And those all mean pretty similar things. And really, they just have already gone through primary care, and probably seen a few specialists, and they're still coughing, despite assessing for different things like reflux, post-nasal drip, those types of things, and even treating for those things.

And so, once they get to me, as a speech pathologist, they've already gone through a gamut of testing and trials of different medications and treatments that have either helped some but not completely or haven't helped at all.

And most of these patients have what we call cough hypersensitivity syndrome. And so even though the cough started, usually with something else, whether it was a viral upper respiratory infection, or chronic reflux, or just a chronic cough–inducing illness, like bronchitis, those are the things that usually kind of start the cough, but then the hypersensitivity that results from that is prolonged and we believe it's perpetuated by the cough itself.

So, you can treat all the underlying causes, but if you now have increased triggers, other than that cause, every time you cough in response to that trigger, you're just continuing it. So, when I'm diagnosing a patient, I'm really looking for symptoms of cough hypersensitivity because that's specifically what we treat. So, things like do they cough to strong smells like perfumes laundry soaps? Cold air is a common trigger. Talking and laughing are common triggers in patients with cough hypersensitivity. And it's generally a dry cough.

So those are the big things that we're looking at.