Understanding Chronic Cough and Cough Hypersensitivity Syndrome with Professors James Hull and Surinder Birring

A Clear Voice

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In this episode of BLA Connections: A Clear Voice, host Natalie Watson speaks with Professors James Hull and Surinder Birring, leading experts in respiratory medicine, to discuss the challenges of diagnosing and treating chronic cough.

Chronic cough, affecting 5-10% of the population (primarily women), is a debilitating condition often misdiagnosed and misunderstood. It can significantly impact quality of life with symptoms such as urinary incontinence, throat irritation, and headaches.

Professors Hull and Birring explain how chronic cough is now recognised as a neurological condition linked to nerve hypersensitivity, moving away from being seen as just a symptom of asthma, reflux, or nasal disease. Questions explored and answered in this episode cover why chronic cough is frequently misdiagnosed. How is cough hypersensitivity syndrome changing the approach to treatment? and what are the latest advancements in therapies, including new treatments like Gefapixant, that offer hope for managing nerve sensitivity and improving patient outcomes?

Top three takeaways:

• Chronic cough is common and frequently misdiagnosed, leading to a cycle of treatments for conditions like asthma, reflux, or nasal disease, which may not be the root cause.
• Cough hypersensitivity syndrome reframes chronic cough as a neurological condition, prompting a shift in treatment focus.
• Promising treatments, such as Gefapixant, aim to address nerve sensitivity, offering new hope for chronic cough sufferers.

We hope you enjoy this episode.
Resource Links
ISSC Hull Airway Reflux Questionnaire: https://www.issc.info/HullCoughHypersensitivityQuestionnaire.html
Article: Development of a symptom-specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ)
https://pmc.ncbi.nlm.nih.gov/articles/PMC1746649/pdf/v058p00339.pdf
Article: Development and validation of the Newcastle laryngeal hypersensitivity questionnaire

https://pmc.ncbi.nlm.nih.gov/articles/PMC3931290/

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Chapters

1. Understanding Chronic Cough and Cough Hypersensitivity Syndrome with Professors James Hull and Surinder Birring (00:00:00)

2. What is chronic cough? (00:02:20)

3. What are the common causes of chronic cough? (00:04:55)

4. What sensitivity tests are available, and what are their limitations? (00:07:40)

5. What tools do you use to help with diagnosis of chronic cough? (00:10:06)

6. What's your approach for the work up of cough in your scenario? (00:11:21)

7. How are genetics tests being used in diagnosis? (00:14:48)

8. What initial treatments should GPs consider for persistent throat symptoms before referring to a tertiary centre? (00:17:25)

9. How can we recognise and treat EILO in cough patients? (00:20:08)

10. What is your treatment algorithm? (00:21:19)

11. How do medications targeting neural hypersensitivity differ from traditional treatments, and what options are currently available? (00:23:05)