Flowchart for the diagnosis and treatment of chronic cough in adults (duration exceeding 8 weeks)
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Flowchart for the diagnosis and treatment of chronic cough in adults (duration exceeding 8 weeks)
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Yes
Low-dose morphine OR gabapentin/pregabalin
Chest X-ray + Spirometry
Empirical trial: high-dose ICS ± LTRA for 2–4 weeks
Avoid routine anti-acid therapy
Assess other traits
No
Adult with chronic cough 8 weeks
PPI trial
Do NOT routinely perform chest CT
Neuromodulatory therapy
Asthmatic cough / eosinophilic inflammation suspected?
Stop ineffective treatment
Investigate and treat underlying disease
Assess treatable traits based on history
Peptic symptoms / acid reflux?
Response?
Reassess cough severity & QoL
Abnormal findings?
Chronic refractory cough
Cough control therapy
Benefit?
Collect
Collect
Collect
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