Chronic persistent cough is one of the most common

complaints of our patients. Many of these patients have suffered

with this symptom for years, especially if they have been

diagnosed with COPD. Chronic cough is a symptom which defines

chronic bronchitis which, in turn, is a common associated illness

with COPD. However, many issues may confuse our adequate

understanding of chronic cough in COPD. These limitations are

evident when it is falsely assumed that chronic cough can only be

related to COPD and does not warrant any further investigation.

The cost of these false assumptions is a lost opportunity to

provide better treatment, and the possibility of a missed


Even if a patient has COPD, it is incorrect to assume that a

chronic cough which is affecting his or her quality of life can only

be explained by their lung disease. The diagnosis of chronic

bronchitis is made from a history of mucous- producing cough

occurring for 3 months a year for two consecutive years. Many

times the cough presented by COPD patients does not meet this

definition and other causes need to be explored.

The work-up for chronic cough does consist of a number of

investigations which could include additional x-rays or CT scans,

specialized breathing tests and, in some cases, empiric therapy

based on the symptom complex. Most of our COPD patients have

been smokers and an occult malignancy must be considered.

Investigating the cause for a chronic cough is worth the effort.