Does chronic idiopathic cough exist?

Chronic cough is a common problem in adults. In most cases, a cause is identified and specific treatment leads to cough improvement. However, in some patients (7 % up to 46 % of cases), no recognisable cause is identified in spite of thorough diagnostic investigation, or specific treatment of co-existing aggravant conditions has failed. Such patients are mainly women around the menopause suffering from a dry cough, following an upper-respiratory tract viral infection. Persistent heightened cough reflex hypersensitivity is the main feature. All therapeutic trials are often ineffective. Thus, understanding the exact physiopathological mechanism of cough reflex sensitization is needed to optimize treatment for patients with unexplained chronic cough. (C) 2011 Published by Elsevier Masson SAS.