James Digby

A 76-year-old woman presented to specialist cough clinic with a 30-year history of a dry cough. This started with throat irritation, progressing to a worsening cough in the 10 years prior to presentation. The cough was exacerbated by exercise, changes in temperature and strong smells. It was partially relieved by drinking water and sucking sweets. She had a pre-existing diagnosis of asthma, post-nasal drip and had recently undergone a left total hip replacement.

Chronic cough, defined as a cough lasting over 8 weeks, has an estimated global prevalence of 10% and has significant detrimental physical, social and psychological consequences on individuals.1,2 Chronic cough is a complex heterogeneous disease, in which many causative factors need to be explored (Figure 1).3 The three most reported associations are rhinosinusitis, gastro-oesophageal reflux disease and asthma.4 However, up to 59% of patients seen in specialist cough clinics have persistent...