A cough is a protective reflex that we all have. You might cough because you need to clear your throat, like when it's been irritated by smoke inhalation. Your automatic (reflex) muscle action forces air up and out of your lower airways (lungs) into your upper airways (windpipe, nose and mouth).
A short term (acute) cough last longer, anything up to three weeks, and is usually caused by a viral infection. Acute coughs often run their course, with no need for treatment.
A chronic cough is a long term cough. It can feel like you need to cough all the time, or like a tickling sensation which leads to an uncontrollable urge to cough. Chronic coughing often lasts more than eight weeks.
A chronic cough can be caused, or aggravated, by one or a combination of factors, including:
- asthma - undiagnosed or under-treated asthma
- postnasal drip - mucus in the nose drips down the back of the throat
- stomach acid reflux - stomach acid washes up the food pipe and spills into the lungs
- lung diseases
- chronic obstructive pulmonary disease (COPD), which usually affects smokers
- lung fibrosis (scarring of the lungs)
- lung infections (such as tuberculosis and whooping cough)
- medication such as angiotensin-converting enzyme (ACE) inhibitor medicines. These treat high blood pressure. Read more information on ACE inhibitors or on high blood pressure.
If we can't find a cause for your chronic cough, we call this idiopathic, or a refractory chronic cough. We see many patients in our clinic with this type of cough.
What happens at the chronic cough clinic
When you arrive
When you arrive for your appointment at the clinic, you will meet one of our clinic nurses. They will get you to do an initial breathing assessment. This will involve some simple blowing tests and filling in a brief questionnaire for background information related to your cough. You may also have a chest X-ray.
Who you see
After your initial assessment, you will then see one of our specialist cough team. Our team includes specialist respiratory doctors, speech and language therapists, and ear, nose and throat doctors. Every member of our team has expertise in assessing managing coughs. Our team works very closely together, so even if you don't see the doctor you were referred to or the same one at each visit, there is no need to worry. The team will discuss cases so that everyone is aware of your case and treatment plan.
What happens during the consultation
During your consultation, we will discuss your cough with you. We want to understand how it affects you, what investigations you have had and what treatments, if any, you have tried. Usually, we will have this information from your referral letter from your GP. We will talk with you about what may be causing your cough and how we are going to try to help you. This may involve some more tests and investigations.
What happens next
If you need some tests or investigations, we will arrange these for you. Depending on what tests you need, you may just need to come in for the day, or for an overnight stay,
What happens after the investigations
If you are staying overnight for your tests, one of the team will see you and explain your results to you. They will then decide with you on your treatment. If your tests have been booked in with a day visit, we will discuss your results and treatment with you at your next clinic appointment.
What happens in the long term
The team will discuss the results of any investigations with you and start a treatment plan to help with your cough. The service is set up to provide a specialist opinion to your local GP or specialist. This helps them establish a long-term plan of care to help manage your cough.
Some of our patients need follow-up appointments with us, which means they need to travel periodically. If you are one of these patients, we will discuss this with you.
Participating in research
We are working on a number of research projects to bring benefits to patients in the form of new, more effective and efficient treatments for heart and lung disease. We are also responsible for medical advances taken up across the NHS and beyond.
Our main research partner is the National Heart and Lung Institute at Imperial College, London. We are happy to discuss any potential research projects with you at any of your visits to the hospitals.
If you have any questions regarding your appointment, call us on 020 7351 8011.