Cough results from forced expulsion, usually against a closed glottis, creating a characteristic sound. It is a natural reflex and defense mechanism that helps the body clear excessive secretions and prevents foreign material from entering the respiratory tract. At times, cough can become excessive, nonproductive, disturbing to the patient, and potentially harmful. Cough is a complex symptom and often requires a multidisciplinary approach to ascertain its cause and effective treatment. Evaluation should be guided by a thorough history and physical examination, and testing should be individualized for cost effectiveness. Habit cough and unexplained cough are diagnoses of exclusion, and any tendency to underdiagnose or overdiagnose these conditions should be avoided. Most over-the-counter cough suppressants are not as effective as previously thought, and their use in routine practice should be minimized. Future research should be conducted to elucidate the mechanisms of cough production and to develop cough-suppressive pharmacotherapy. Allergists, as experts in the management of upper and lower airway disorders, should play a central role in the diagnosis and management of cough.
COUNTERPOINT: Is the Term Habit Cough an Inaccurate Use of a Term? No
