Habit cough can be a problem for many children and adolescents. Cough is a common symptom for which children and adolescents seek medical care. When cough is present for 4 or more weeks, the cough is considered to be chronic. Habit cough is a cough without any organic basis. habit cough is repetitive coughing , which is defined as up to several times per minute for extended periods from several hours at a time to all day, but with complete absence when asleep. A retrospective study was done in patients diagnosed with habit cough and the authors came to some general conclusions. (Journal of Allergy and Clinical Immunology, March 2016). Most had a cough characterized by a loud barking sound; a repetitive softer throat-clearing sound was present in 10% of patients. Duration of cough averaged 4 months (before seeking care at the authors clinic), but it ranged from less than 1 month to greater than 1 year. Frequent use of albuterol, oral steroids, singulair, inhaled steroids, antibiotics, gastric acid suppressants and cough suppressants were described in most patients.
It must be emphasized that habit cough should only be diagnosed when all other diagnosis can be excluded. The authors felt that diagnostic tests were not necessary to support the diagnosis of habit cough, which they based on history and observation, but many patients did have spirometry or pulmonary function tests done. Clinical criteria, consisting of repetitive cough up to several times per minute for extended periods of time that is totally absent once asleep is sufficient to make the diagnosis of habit cough. Once identified, the authors propose a simple behavioral methodology that can provide cessation of the cough.
- Approach the patient with confidence that the coughing will be stopped
- Explain the cough as a vicious cycle that started with an irritant that is now gone and now the cough itself is causing irritation and more cough.
- Instruct the patient to concentrate on holding back the urge to cough for initially brief periods of time.
- Tell the patient that each second the cough is delayed makes it easier to suppress further coughing.
- Repeat expressions of confidence to the patient that they can suppress the cough.
- Give strong affirmations of the cough can be suppressed for prolonged periods
- Express confidence to the patient that they can do it on their own at home.
It must be emphasized that habit cough should only be diagnosed by a physician and after all other diagnosis have been ruled out. If the conclusion is habit cough, the above suggestions may be helpful in suppressing the cough.