From the Guidelines
Three significant lower respiratory tract problems that cause a subacute or chronic cough are chronic bronchitis, chronic obstructive pulmonary disease (COPD), and bronchiectasis. These conditions are associated with a significant impact on morbidity, mortality, and quality of life.
- Chronic bronchitis, as defined by the presence of cough with sputum production for at least 3 months per year during 2 consecutive years, is a major contributor to chronic cough, particularly in patients with a history of smoking or exposure to irritating inhalants 1.
- COPD, which includes chronic bronchitis and emphysema, causes a chronic productive cough with shortness of breath, and management includes bronchodilators and smoking cessation.
- Bronchiectasis involves permanent airway dilation causing a chronic productive cough with purulent sputum, and treatment includes airway clearance techniques, bronchodilators, and targeted antibiotics during exacerbations. These conditions cause cough through different mechanisms, and accurate diagnosis and management are crucial to improve outcomes and quality of life. The most recent and highest quality study, published in 2020, highlights the importance of addressing chronic bronchitis as a cause of chronic cough, and the need for a comprehensive approach to management, including smoking cessation and avoidance of irritating inhalants 1. In contrast, other studies, such as those published in 2018 and 2006, provide additional insights into the management of chronic cough in the context of interstitial lung disease and nonbronchiectatic suppurative airway disease, but are not as directly relevant to the question of lower respiratory tract problems causing subacute or chronic cough 1.
From the Research
Lower Respiratory Tract Problems Causing Subacute or Chronic Cough
- Chronic Obstructive Pulmonary Disease (COPD) 2, 3, 4, 5, 6: COPD is a respiratory disorder characterized by largely irreversible changes in air flow due to irritants such as tobacco smoke, leading to symptoms like chronic cough.
- Bronchiectasis: Although not directly mentioned in the provided studies, bronchiectasis is a condition where the airways are permanently enlarged, leading to chronic cough and sputum production.
- Asthma-COPD overlap syndrome: Some patients may have features of both asthma and COPD, leading to chronic cough and other respiratory symptoms 5.
Note: The provided studies primarily focus on COPD, and there is limited information on other lower respiratory tract problems. However, based on the available evidence, COPD is a significant cause of subacute or chronic cough.