Consensus Statement on the Diagnosis and Treatment of Refractory Chronic Cough

Why It Matters

The ABA consensus equips clinicians with clear, evidence‑based criteria and treatment pathways for refractory chronic cough, improving patient outcomes and reducing costly, ineffective interventions.

Key Takeaways

• New ABA consensus defines refractory chronic cough (RCC) criteria.
• RCC diagnosis requires ≥8 weeks cough plus thorough workup.
• Highlights central and peripheral neural hypersensitivity as RCC mechanism.
• Recommends neuromodulators, superior laryngeal nerve block, behavioral therapy.
• Provides practical guidance for pulmonologists, primary care, and ENT clinicians.

Summary

The video announces the first American Bronchosophological Association (ABA) expert consensus statement on refractory chronic cough (RCC), published in the Laryngoscope. It aims to give clinicians a clinically oriented framework for diagnosing and managing cough that persists despite standard evaluation.

The consensus establishes an operational definition: cough lasting more than eight weeks after adequate testing and empiric treatment for reflux, sinus disease, and pulmonary pathology. Required assessments include chest imaging, pulmonary function tests, and a trial of inhaled steroids before labeling cough as refractory. The panel also describes the underlying pathophysiology, emphasizing central and peripheral neural hypersensitization that creates a self‑perpetuating cough cycle.

Treatment recommendations focus on three pillars: neuromodulators such as gabapentin or pregabalin, superior laryngeal nerve block, and behavioral cough suppression therapy. The statement outlines efficacy data, potential side‑effects, and the risk of tachyphylaxis, while highlighting emerging evidence supporting nerve block and behavioral interventions.

By standardizing diagnosis and offering evidence‑based therapeutic options, the consensus equips pulmonologists, primary‑care physicians, and ENT specialists to manage RCC more effectively, potentially reducing unnecessary medication use and improving patient quality of life.

Original Description

Laryngologist Lee Akst discusses the consensus statement for the diagnosis and treatment of refractory chronic cough (RCC) that was issued by the American Broncho-Esophagological Association in May 2026, when he began a one-year term as president of the association. RCC is cough that persists for longer than eight weeks despite workup and treatment for common conditions typically associated with cough. #chroniccough #johnshopkins https://www.hopkinsmedicine.org/otolaryngology/specialty-areas/laryngology

The consensus statement offers a number of things that otolaryngologists might consider in their evaluation and treatment of patients who meet the criteria for RCC. Read the full statement at https://onlinelibrary.wiley.com/doi/10.1002/lary.70598.