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Most patients have a resolution of their cough within 4 weeks of smoking cessation.
If the chest radiograph findings are abnormal, further workup depends on the specific finding.
Although oftentimes a causative etiology for the rhinitis might be suggested from the patient’s history and symptomatology, the hallmark of UACS is that this syndrome has no pathognomonic findings, and the diagnosis is made based on response to specific therapy, which includes antihistamines and decongestants.
The hallmarks of asthma are variable airflow obstruction and airway hyperresponsiveness, which manifest as shortness of breath, wheezing, dyspnea, and cough.
Chest CT scan, bronchoscopy, needle biopsy, and sputum studies are all potentially warranted studies if a pulmonary lesion is found.
Recent research that shows a high proportion of patients with asthma and coexisting allergic rhinitis has paved the way for the “one airway” theory, in which a continuum of inflammation that involves the entire airway can be thought of as the underlying mechanism for disorders that start from the nose and mouth and extend to the most distal aspects of the lungs.
The second entity refers to laryngopharyngeal reflux (LPR) or extraesophageal GERD, and it differs from traditional GERD in that it does not manifest as heartburn and tends to occur when the patient is upright as opposed to lying flat.
This silent GERD can be present in as many as 75% of patients with chronic cough.
Cough occurs in all asthmatics, and in a subset of patients with cough-variant asthma (CVA), it is the only presenting symptom.
The treatment of asthma, regardless of whether it is of the cough variant or not, includes beta-2 agonists and corticosteroids.