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Eur Respir J 2005; 25:211
Copyright ©ERS Journals Ltd 2005

From the author

A. H. Morice

Division of Academic Medicine, University of Hull, Castle Hill Hospital, Cottingham, UK.

Teramoto and colleagues have completely misunderstood the purpose of the ERS Task Force on diagnosis and management of chronic cough 1. The document deals with patients who have had a cough for >8 weeks. It is not about patients who can't cough. To suggest in their opening paragraph that we neglect cough in the elderly is simply disingenuous. We deliberately separated chronic cough in children from that in adults since the aetiology is different. However, in adults the causes and treatment of chronic cough are not age related and the elderly were frequent attendees in the 13 studies quoted in table 1 which presents the accumulated experience of specialist cough clinics 1.

Decreased cough and aspiration are important clinical problems but they were not the subject of our discussions. Clearly neurological illness 2, 3 and anatomical abnormality 4 can increase the likelihood of aspiration but this is neither age specific nor relevant to clinicians dealing with patients who present with isolated chronic cough.

Finally, an important function of documents such as the Task Force report is to provide a balanced overview of the literature. Teramoto and colleagues seem to have concentrated largely on their own work, which perhaps goes some way to explain the current debate.

REFERENCES

  1. Morice AH and committee members. The diagnosis and management of chronic cough. Eur Respir J 2004;24:481–492.[Free Full Text]
  2. Fontana GA, Pantaleo T, Lavorini F, Benvenuti F, Gangemi S. Defective motor control of coughing in Parkinson's disease. Am J Respir Crit Care Med 1998;158:458–464.[Abstract/Free Full Text]
  3. Dicpinigaitis PV, Grimm DR, Lesser M. Cough reflex sensitivity in subjects with cervical spinal cord injury. Am J Respir Crit Care Med 1999;159:1660–1662.[Abstract/Free Full Text]
  4. Fontana GA, Pantaleo T, Lavorini F, Mutolo D, Polli G, Pistolesi M. Coughing in laryngectomized patients. Am J Respir Crit Care Med 1999;160:1578–1584.[Abstract/Free Full Text]




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