A chronic cough can mean a miserable life

Having a chronic cough apparently gives rise to a long list of common problems ranging from incontinence, anxiety to partners re-locating to another bedroom; and this is just the start of it!

According to a new report by Mayo Clinic pulmonology specialists, patients with a chronic cough ie.one lasting over three weeks, suffer due to a variety of factors.

The most significant are, anxiety due to the possibility of underlying serious illness, uncomfortable public attention, anger and frustration with constant cough, and actual physical discomfort.

The survey of chronic coughers was an attempt to understand how chronic cough adversely affects the patient, socially, psychologically and physically, says Kaiser Lim, M.D., Mayo Clinic pulmonologist and allergist, and lead study investigator.

Lim says it is important for people with a chronic cough to receive empathy and realize physicians are working to help understand this problem.

It appears that for such patients the psychological and physical sufferings appear to be paramount reasons for seeking medical help.

In a 12-week prospective study, Dr. Lim and colleagues examined 146 consecutive chronic cough patients about how the condition affected them.

The patients completed a questionnaire about cough-related difficulties and sufferings prior to medical evaluation and again six months later.

Of those in the initial survey, 56 completed the repeat questionnaire.

The top problems for chronic coughers when they were first evaluated at Mayo Clinic were:

• interference with lifestyle and leisure,
• frequent physician visits and testing for cough,
• sleep disturbances,
• interference with social gatherings,
• other people's reactions to the coughing,
• and frustration, irritability and anger.

For patients under age 65 with chronic cough, one-third of their spouses or roommates had moved out of the bedroom.

Patients also indicated that sleep disturbance due to cough led to daytime exhaustion and fatigue.

Dr Lim says this suggests the possibility of a more serious than anticipated disruption of family life.

One of the findings suggests that the long and tedious process of diagnosing and treating the underlying problem causing chronic cough may frustrate patients.

Dr. Lim says this is because there is no single test that will determine what causes chronic cough and even after a meticulous evaluation, the diagnosis may still be unclear.

According to Dr. Lim, an estimated 23 million Americans see their physicians each year because of a cough.

How many of those have chronic cough is unconfirmed.

Dr. Lim recently received Mayo Clinic grant funding for further research into the science behind chronic cough and plans to continue his work in the laboratory and with chronic cough patients.

The survey results will be presented at the American College of Chest Physicians CHEST 2005 meeting in Montreal.