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Cough in IPF: a difficult symptom

Coughing: for most people it’s the easiest way to clear their throat or just an annoying symptom of the common cold. But for people with a lung disease a cough can be very different. For IPF patients for instance, cough can have a huge negative impact on their quality of life. It can also be a sign of a more severe disease. Despite this impact, few studies have investigated the cause of cough in IPF and effective treatments are lacking.

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Some patients cough about 2 times per hour, but in others this number reaches a staggering 39 coughs per hour! 

Because cough is a common symptom of many pulmonary disorders, IPF patients often suffer for years before a definitive diagnosis is made. In many IPF patients cough is the first symptom, unresponsive to cough suppressants. They describe a dry cough that gets worse when exercising or talking. Some patients cough about 2 times per hour, but in others this number reaches a staggering 39 coughs per hour! You can imagine this has a huge negative impact on a patient’s quality of life. They often greatly modify their lives to avoid social situations in which their cough can be embarrassing.

But apart from this huge impact on the quality of life, cough in IPF has also been shown to be a predictor of disease severity and disease progression. So, if you have IPF and you cough, you probably have a more severe disease. Unfortunately, the exact mechanism of cough in IPF is not exactly known. It is a complex reflex and the changes in lung tissue in IPF may ultimately lead to an increased cough sensitivity. This means that in IPF, patients cough sooner upon stimulation of their lungs by an irritating agent compared to healthy people. Also, progress in treating cough in IPF still has to be made. Most patients will have tried standard cough suppressants, but these have limited efficacy.

IPF, patients cough sooner upon stimulation of their lungs by an irritating agent compared to healthy people

So, it can be concluded that cough in IPF has a huge impact on IPF patients’ lives, and a lot of research is still needed, not only on the mechanisms of cough, but also, and maybe more importantly, on effective treatments.

Source:
Vigeland CL, Hughes AH, Horton MR. Etiology and treatment of cough in idiopathic pulmonary fibrosis. Respir Med 2017;123:98-104.

 

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