Our cough clinic aims to improve the quality of life of patients with chronic cough.

This is a specialist clinic for people who have had a cough for 8 weeks or more which:

  • Has an unclear cause
  • Has not responded to medication

Our service has been running since 2010. It is one of a very small number of cough clinics in the UK. The team has contributed to the development of speech therapy treatments for cough, cough research, including trials of novel cough drugs, and national cough guidelines.

We will aim to get a better understanding of what might be causing your cough. We will review your history and investigations. We may request further tests if needed.

We will talk to you about different options for managing your cough. We will make a  treatment plan tailored to you.

Your ongoing treatment plan will likely involve your GP and local respiratory team.

You will see experts in cough assessment and management.

The clinic will be led by a consultant respiratory doctor. In North Tyneside General Hospital, this will be Dr Sean Parker. In Hexham and Wansbeck general hospitals, this will be Dr Simon Fearby.

Most patients will also see a respiratory speech and language therapist (SLT).

Depending on previous assessments, you may also see a lung physiologist for​​​​​​ lung function tests, and/or a respiratory nurse.

You may be invited to join a cough research project. If you are interested, a research nurse would talk to you about the project/s and answer any questions you might have.

People are usually referred by their GP, or from respiratory doctors, nurses or physiotherapists.

We accept referrals from out of area, including for second opinion.

You will receive an appointment letter in the post. Sometimes if there is a last-minute cancellation, we will phone you to see if you could come in at late notice.

Most patients are seen in a face-to-face clinic first. This allows a number of assessments to take place. They will give us up-to-date information about your lung and upper airway function.

Some patients receive a phone call first to help us decide which assessments you need in that first appointment.   

We will explore factors that might be contributing to your cough. This helps us to understand why your symptoms started, why they are still happening, and what could help to reduce them. We will want to know about any patterns you have noticed with your cough, including what makes it better or worse.

We may also ask about any:

  • History of colds, viruses, or chest/throat infections
  • Allergies, including hay-fever
  • History of smoking
  • Whether you are taking any ACE inhibitors e.g. Lisinopril
  • Daily water intake
  • Exposure to dusty environments e.g. at work
  • Whether you have reflux or sinus problems, and how these are managed
  • Whether you use a spacer with your inhalers. 
  • What usually triggers your symptoms

You may need to answer some questions to give us a better idea of how your cough affects your daily life and wellbeing.

You may get lung function tests. You may need a spirometry FeNO (Fractional Exhaled Nitric Oxide) assessment which looks at the level of inflammation in your airways. Further tests are not usually needed, but you may need a bronchoscopy (to look at the inside of the breathing tubes (airways) in your lung) or a CT scan of the chest.

For some people, it is helpful to look at the health and function (movement) of the throat muscles. To do this, we would carry out a nasendoscopy assessment. This is a small camera that slides into your nose and allows us to see your throat. If we do think you would benefit from a nasendoscopy, we will discuss this with you in the clinic. You can decide if you would like to have it during that appointment, or return at a later date.

The department is very active in cough research, and you may be asked to participate in a study. Participation is entirely up to you. Your treatment will not be affected if you decide not to participate.

We are currently running a number of observational studies including a European cough database (Neurocough) and the STARR study looking at cough sensations. We are also running a number of trials of novel cough drugs that we can discuss this with you.

This will depend on the outcome of your assessments. We will arrange this together with you, and your local team (or the person that referred you).

Treatment usually includes:

  • Medication for the cough. Sometimes cough suppressant drugs such as low-dose morphine or gabapentin/pregabalin are used to improve quality of life if the cough is severe.
  • Throat care advice
  • Breathing exercises to support ‘cough control’
  • Potentially trying new medications

Follow-up may take place to check on your progress. This can be face-to-face or or by phone. It is also possible to refer you back to your local team for follow-up.

It is not always possible to completely resolve acough symptoms.

However, evidence suggests that treatment tailored for you can help to:

  • Reduce how severe your symptoms are
  • Reduce how often you get symptoms
  • Improve control of symptoms 

Overall improvement will depend on different factors. This includes how easy it is for you to:

  • Make recommended lifestyle changes
  • Take recommended medications, at recommended times
  • Practice breathing exercises regularly
  • Manage ‘other’ factors that may be contributing to symptoms e.g acid reflux, sinus problems, medication use (e.g. ACE inhibitors)