Clinical assessment and current treatment of refractory chronic cough

Chronic cough is a cough that occurs for more than 2 months. Chronic cough is a health problem that can cause physical complications, psychology problem, dan impact on quality of life. The common causes of chronic cough are asthma, eosinophilic bronchitis, gastroesophageal reflux disease, angiotensin-converting enzyme inhibitor use, smoking, and upper airway cough syndrome. Refractory chronic cough is a cough that is persistent after optimal therapy of underlying diseases. Recent theory regarding the neural system contributes to the pathophysiology of refractory chronic cough known as cough hypersensitivity syndrome. Treatment of refractory chronic cough needs comprehensive evaluation of cough severity, trigger of cough, and underlying diseases. Neuromodulators can be used as pharmacology treatment of refractory chronic cough but still need more research to define standard dose and safety.