Refractory Chronic Cough Clinic
Do you have a nagging, never ending cough?
Does it interfere with your life, lifestyle, and your relationships with others?
Does it drive you crazy because you can’t make it stop?
Have you tried a half a dozen remedies that don’t work?
The providers at Bellingham Asthma, Allergy & Immunology Clinic are experts in evaluating and treating chronic cough. For those patients who can still not find relief, the Clinical Research Center at Bellingham Asthma & Allergy frequently has clinical studies of new medications intended to target chronic cough.
What is a "chronic cough"?
Chronic Cough has historically been considered to be a consequence of some other medical problem, such as bronchitis, sinusitis, allergies, etc. Certain forms of chronic cough are now considered to be a separate defined medical condition. Some recent names for the condition include:
- Cough Hypersensitivity Syndrome
- Throat Hypersensitivity Syndrome
- Unexplained Chronic Cough
- Refractory Chronic Cough – this is the current ‘best’ and official Dx.
At BAAIC, Dr Elkayam and colleagues have developed an evaluation and treatment pathway for Chronic Cough. We have developed a “clinic within a clinic” for our chronic cough patients.
We see this problem in all groups of people, but this type of cough is most typically seen in women > men, and folks over 40 yrs of age. Patients will often have had recurrences and spontaneous remissions over many yrs. I have seen people who have had this for > 35 yrs.
We are uniquely trained and experienced in this condition and can readily identify the associated conditions such as asthma (including Cough Variant Asthma), chronic rhinosinusitis with or without associated allergies, Gastroesophageal Disease (GERD) and Laryngopharyngeal Reflux (LPRD, often called ‘silent reflux’).
We recognize that in many individuals the cough may be due to multiple overlapping issues, and our goal is to tease these apart, understand and treat them individually and then holistically, to achieve the best outcome for the pt.
These are the diagnostic procedures we offer:
Allergy testing
To determine if there are associated inhalant or food allergies.
Rhinolaryngoscopy
To examine the nose and throat.
Imaging studies
Chest and sinus.
Speech Therapy
There is some real science and expertise involved in this, and we partner with an especially effective Speech Therapist.
Lung function testing
To determine whether there is airway inflammation or airflow obstruction (both are commonly seen in asthma and uncommonly seen in RCC).
ENT
There is a novel approach using injection into the area near one of the important throat nerves that provides relief for many.
Clinical Research:
We have had an active cough-related research program here at BAAIC for almost 10 yrs. The focus of this research has been to ‘find a cure’. In this realm, that is defined by research into experimental neuromodulator medications that may block the excess signaling from the nerve receptors in the throat to the cough center in the brain, without the brain dulling effects of centrally acting cough medications such as those containing codeine and other opioid derivatives.
These are some of the treatments we offer:
- We identify and evaluate all associated or underlying conditions that lead to chronic cough. We treat all that we can. What may remain is known as Cough Hypersensitivity Syndrome.
- For Refractory Chronic Cough, we often utilize throat lozenges and behavioral training, such as biofeedback and self-relaxation techniques, to suppress the excess urge to cough.
- Speech therapy has also been shown to have some value. A patient may require several overlapping treatments to achieve relief.
- Neuromodulators represent the future of treatment for chronic cough. Some are currently available and some are still in clinical trials, including here at BAAIC. Help is on the way! See our Clinical Research page for more information.
