Clinic opening

Cough is one of the most common symptoms for visits to hospitals. Viral infectious diseases of the respiratory system, such as colds, are an important cause. Most cases improve within 1 to 2 weeks, and symptomatic treatment is usually sufficient in most cases. However, for so-called ‘chronic cough’ where coughing continues for a long period of time, a different approach is needed as accurate diagnosis of the underlying disease and appropriate treatment are required. Ilsan Paik Hospital Cough Clinic provides highly satisfactory treatment through in-depth examination, systematic cause identification tests, and professional treatment for coughs that have been suffering for a long time.

Cough is one of the most common symptoms that patients present to the hospital, and is experienced by approximately 14-23% of adult non-smokers. Depending on the duration of the cough, a cough lasting less than 3 weeks is classified as an acute cough, a cough lasting from 3 to 8 weeks is classified as a subacute cough, and a cough lasting more than 8 weeks is classified as a chronic cough. Since chronic cough generally does not respond well to cough suppressants used outpatiently, it is most important to find the hidden cause of the disease and provide appropriate treatment rather than simply reducing the symptoms.

In what order is patient care carried out?

Patients who visit outpatient clinics due to severe coughing over a long period of time will first undergo a thorough medical history survey. We thoroughly investigate the patient's medical history, including when it started, the pattern, frequency, and duration of the cough, aggravating factors, presence of sputum, reaction to medications administered prior to visiting Ilsan Paik Hospital, and test results, and conduct a physical examination and imaging such as chest x-ray. The cause of the disease is found through objective diagnostic tests such as examination, sputum test, lung function, and gastrointestinal endoscopy. First, we investigate whether you are taking certain medications along with your smoking history. Smoking often causes a cough, but not many people actually go to the hospital. Among smokers who smoke more than one pack of cigarettes a day, chronic cough may occur in about half of them. It will improve if you quit smoking for about 4 weeks. However, when you stop smoking, you may experience temporary respiratory symptoms. Angiotensin-converting enzyme inhibitors, which are used to treat high blood pressure or diabetes, may cause coughing in some patients. It may occur within hours of taking the drug, or it may occur weeks or months later. If in doubt, stop the drug and the cough will disappear in 1 to 4 weeks. First, if you go through the above process and there are no special abnormalities in the chest will be provided.

What are the symptoms of upper respiratory cough syndrome?

Upper respiratory cough syndrome occurs in association with rhinitis, sinusitis, and nasopharyngitis. Symptoms include secretions going down the back of the throat, a foreign body sensation in the throat, postnasal drip, sucking the nose into the mouth and spitting it out, or, on examination, secretions in the throat. It may be suspected if it has a cobblestone appearance. Once postnasal drip is confirmed, it is important to diagnose the disease causing the postnasal drip. Nasal endoscopy, simple sinus imaging, and allergy skin testing should be performed to accurately diagnose the underlying disease of postnasal drip. For patients who have severe rhinosinusitis that does not respond to medical treatment or who require surgery due to polyps, etc., nasal sinus tomography can be performed to more accurately evaluate the presence of anatomical abnormalities and the degree of sinusitis.

What are the symptoms of cough-type asthma?

The cough is dry, paroxysmal, and usually occurs around the same time, but tends to be particularly severe at night. It gets worse when exposed to colds or causative allergens, when airway inflammation worsens, or when exposed to cigarette smoke, irritating odors, exercise, cold air, etc. It improves with active asthma treatment (steroid inhalation medication).

Cough caused by gastroesophageal reflux

Stomach acid and contents refluxed due to gastroesophageal reflux may stimulate cough receptors in the lower esophagus mucosa or be finely aspirated into the airway, causing coughing. It is often accompanied by other diseases that can cause coughing, and has a prevalence of 5-41% in patients with chronic cough. If you have a typical cough along with symptoms of gastric acid reflux and heartburn, you can immediately suspect a cough caused by gastroesophageal reflux. However, there are many patients who do not have any characteristic symptoms and only complain of a lot of phlegm or a dry cough. . Therefore, when there is no response to various empirical treatments, cough caused by gastroesophageal reflux must be considered. Good treatment results can be achieved by correcting lifestyle habits and appropriately using antacids, H2 receptor blockers, gastrointestinal motility stimulants, and proton pump inhibitors. Since it takes several months for symptoms to improve, it is important to treat for a sufficient period of time, and inform the patient in advance about this so that he or she can follow the drug treatment along with consistent lifestyle changes.

Psychogenic or habitual cough

You should not immediately diagnose a psychogenic cough just because you do not cough at night or have a coughing cough. Occasionally, in cases of problems such as anxiety, depression, domestic violence, or child abuse, patients may complain of chronic coughing due to a somatization reaction, so this should be taken into consideration when dealing with patients. A cough that fails to find the cause of the cough despite various diagnostic tests and does not respond well to empirical treatment may be a psychogenic cough. If psychogenic cough is suspected, improvement can be expected with psychiatric treatment including behavioral therapy.

Use of antitussive expectorants

Even if diagnostic/therapeutic measures are taken according to the approach suggested above, there are cases where the cause of cough cannot be identified. When the cause of the cough is unclear, when time is needed before treatment for the causative disease takes effect, or when treatment for the cause is ineffective, such as inoperable lung cancer, an expectorant is used to improve the patient's symptoms. and can improve the quality of life.