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Chronic cough is a symptom not a diagnosis and the great Paediatric Laryngologist Jackson said that “cough is the watchdog of the airway and we shouldn’t drug the watchdog”, in other words we shouldn’t suppress the cough if it is helping the child clear secretions until we find a cause. From birth to 18 months the most common causes are a variation of asthma with cough, reflux or an abnormal artery in the chest pressing on the trachea.

Between ages 1 ½ – 6 years the most common causes are sinusitis, asthma and abnormalities around the vocal cord region. Following this age group between ages 6 – 16 cough variant asthma is the most common but occasionally the cough can be due to psychogenic causes. Investigations include a full history and determining whether there is a history of passive smoking from the parents, the type of cough and whether it is associated with throat clearing, whether mucopus is coughed up and following a full history and examination, radiology and blood tests may be performed as well as some skin tests for allergies and some rarer conditions.  If the cough lasts for more than 6 – 8 weeks and if there is a history of foreign body or obstructive lesion the most effective examination is endoscopy of the lungs.

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