Chronic Cough Despite Normal Workup
Researchers describe diagnostic evaluation and management considerations when standard testing fails to identify the cause of persistent cough.
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By
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Kathryn Wighton
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February 13, 2026
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Clinical Scorecard: Chronic Cough Despite Normal Workup
At a Glance
| Category | Detail |
|---|
| Condition | Cough-predominant laryngeal hypersensitivity syndrome |
| Key Mechanisms | Heightened responsiveness of the laryngeal cough reflex triggered by minimal stimuli |
| Target Population | Middle-aged individuals with unexplained chronic cough |
| Care Setting | Outpatient respiratory and otolaryngology clinics |
Key Highlights
- Normal routine imaging and pulmonary tests do not rule out laryngeal hypersensitivity syndrome
- Flexible bronchoscopy can identify exaggerated laryngeal sensitivity
- Management includes conservative, multidisciplinary strategies
- Symptoms may include chronic cough, throat irritation, and globus sensation
- Patient education and behavioral techniques are crucial for management
Guideline-Based Recommendations
Diagnosis
- Consider laryngeal hypersensitivity syndrome in patients with unexplained chronic cough
- Use flexible bronchoscopy when standard investigations fail
Management
- Implement conservative strategies including patient education and hydration
- Encourage behavioral cough suppression techniques and psychosocial support
- Refer to smoking cessation programs
Monitoring & Follow-up
- Regular follow-up to assess symptom management and treatment adherence
Risks
- Potential for chronic cough to disrupt sleep and daily activities
- Increased risk of stress urinary incontinence related to coughing
Patient & Prescribing Data
Middle-aged women with chronic cough and normal workup
Focus on non-pharmacological interventions and lifestyle modifications
Clinical Best Practices
- Conduct thorough evaluations including flexible bronchoscopy for persistent cough
- Educate patients on the nature of their condition and coping strategies
- Collaborate with multidisciplinary teams for comprehensive care
References
