What is the chronic cough clinic?
The chronic cough clinic has been established for over 10 years. We are fortunate to be supported by a team of nurses, lung function technicians, chest physiotherapists, radiologists and friendly secretaries.
Our clinic currently treats over 200 new patients each year with hundreds of patients under regular follow up. Whilst the majority of our patients live in the North West, some of our patients travel over 100 miles to attend our specialist clinic. We have a step by step procedure through which our patients are investigated so nearly all of our patients will be asked to undergo a series of tests and procedures to investigate potential causes for their cough and exclude known triggers. Our aim is to provide you with expert clinical care in order to treat your cough where an underlying cause is found.
Tests and procedures you may be asked to undergo include x-rays, blood tests, allergy tests, bronchoscopy, asthma tests and/or provide sputum (phlegm) samples.
If your cough is found to be treatment resistant we may ask you if you are interested in taking part in research in order to try new treatments not currently available in the clinical setting which may or may not improve your cough.
A histamine challenge is a safe and painless way of helping to determine whether a person
has asthma, even if you do not have typical symptoms. Histamine is a medicine which, when
inhaled, can cause the airways to tighten in people with asthma because their airways are
more sensitive.
You will need to stop taking any anti-histamines 2-3 days before the test as this can interfere with the results. During the test you will be asked to take deep breaths from a device called a dosimeter which contains the medicine. After this you will be asked to do a simple breathing test (called spirometry) to see if the medicine has caused any tightness in your airways. If there is no evidence of tightness you will be asked to repeat the test with increasing doses of the medicine. It is unlikely that you will notice any difference in your breathing but we will be able to detect any changes in your lungs.
A bronchoscopy is a procedure where a doctor uses a tiny camera (bronchoscope) to look into the main tubes
that carry air into your lungs. The bronchoscope is passed through your nose, down the back of your throat,
into your food pipe, and down into the bronchi (airways). The test itself usually takes about 20-30 minutes.
We normally sedate patients prior to performing a bronchoscopy.
The doctor may take a small sample (called a biopsy) from the inside lining of your airways. The
samples are then sent to a laboratory for testing. Your nose and throat may be a little sore for a
day or so afterwards. You may feel tired or sleepy for several hours, caused by the sedative. It is
normal to cough up some small specks of blood a few times in the next day or so after a
bronchoscopy
Dr Huda Badri explains a bronchoscopy and histamine challenge
Dr Imran Satia explains a chest X-ray, allergy test and a sputum sample
You may be sent for a chest X-ray to ensure your lungs are healthy, or to see if there is anything in your lungs causing you to cough. An X-ray itself usually lasts for a maximum of 10 minutes and will be carried out by a trained radiologist.
Having an X-ray means that you are exposed to radiation, but the amount of radiation you will be exposed to is only very small and is therefore considered to be safe.
Sometimes allergies may be contributing towards your cough. If the doctor suspects this might be the case, you may be asked to have an allergy test. We usually perform this by taking a small sample of your blood which will be sent to a laboratory for testing. The laboratory staff will measure the number of antibodies in your blood which are produced by your immune system in response to a suspected allergen. Blood tests are quick and simple.
Sputum is a mucus-like substance found in the lungs which you may find you have been coughing up. If the doctor thinks you have a viral lung infection or lung inflammation which might be causing your cough, you may be asked to produce a sample of sputum.
This requires you to breathe from a nebuliser (a machine that turns liquid into a fine mist) containing salty water and then cough into a sterile container.
