Published 24 April 2009, doi:10.1136/bmj.b1218
Cite this as: BMJ 2009;338:b1218

Practice

Diagnosis in General Practice

Chronic cough in adults

Kevin Barraclough, general practitioner

1 Hoyland House, Painswick, Stroud GL6 6RD

k.barraclough@btinternet.com

This case is an example of how "test of treatment" (doi:10.1136/bmj.b1312) can be used when the diagnosis is uncertain

The first 150 words of the full text of this article appear below.

A 42 year old non-smoking woman presents with a three month history of cough after a coryzal illness. The cough is worse in the morning and rarely produces sputum. She is not short of breath, and she has been taking an angiotensin converting enzyme (ACE) inhibitor for two years for hypertension.

Chronic cough is somewhat arbitrarily defined as any cough with a duration of eight weeks.1 It is common in primary care. In one postal survey of 11 000 patients registered with four general practices, 14% of men and 10% of women reported coughing on more than half the days in the year.2 In practice, smokers rarely consult about their cough because they assume (usually correctly) that smoking is the cause.

The problem in diagnosis is differentiating between the common causes of chronic cough—asthma, chronic obstructive pulmonary disease, postnasal drip, gastro-oesophageal reflux disease (GORD), and drug (ACE inhibitor) induced—and not . . . [Full text of this article]


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Relevant Article

Diagnosis using "test of treatment"
Paul Glasziou, Peter Rose, Carl Heneghan, and John Balla
BMJ 2009 338: b1312. [Extract] [Full Text]

This article has been cited by other articles:

  • Glasziou, P., Rose, P., Heneghan, C., Balla, J. (2009). Diagnosis using "test of treatment". BMJ 338: b1312-b1312 [Full text]  

Rapid Responses:

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Article misses the point about pertussis
Andrew M Ross
bmj.com, 26 May 2009 [Full text]
Chronic cough in adults and the pitfall of postnasal drip.
Thiru M Siva, et al.
bmj.com, 13 Jun 2009 [Full text]
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