Dr Roxana Siles: Multispecialty Management of Chronic Cough Maximizes Patient Benefits

Roxana Siles, MD, FAAAAI, staff in the Department of Allergy and Immunology at Cleveland Clinic and codirector of the Asthma Center at Cleveland Clinic, addresses the factors that contribute to necessitating multispecialty management of patients with chronic cough.

Transcript

Why is a multidisciplinary approach to management of chronic cough beneficial?

The management involves a lot of lifestyle changes, specifically when we think of reflux, for example. Proper diet, weight loss can make a big difference, but also there is medical management for that condition. One of the challenges we have is sometimes a laryngeal-pharyngeal cough; reflux is a big trigger, where patients may not necessarily have the typical symptoms of what we think of acid reflux. And then, of course, we have asthma.

Certainly there are patients who have just cough or asthma—they may not wheeze or feel short of breath—and this is where we follow guidelines for management of asthma. But also objective testing is important. And, again, a lot of times it [coughing] comes from the back of the throat, so upper airway and evaluation by ear, nose, and throat to make sure there’s no mass, there’re no nodules in the back of the vocal cords affecting this. Again, it’s very important to approach this in a multispecialty fashion to really maximize the benefit and take care of these patients.