Kaszel – trudny problem kliniczny

*Halina Batura-Gabryel

Summary
In this paper there is presented cough as an important clinical problem, which is often connected with difficulties during differential diagnosis and treatment. Cough is one of the commonest new presentations to primary care and to the respiratory physicians. Cough is the cause of 10% visits in primary care. It has been traditional to divide this group of patients who have acute, subacute and chronic cough (according the duration of cough) and with productive and non-productive cough (according the amount of expectorated sputum). 12% of normal population complain of chronic cough, and 7% of thought in interfered with activities of daily living. To the most common causes of acute cough in the general population belong viral infections (80%), especially in upper or lower respiratory tract, asthma, exacerbation of COPD. The most common causes of chronic cough in the general population are: post-nasal drip syndrome (25-30%), asthma (20-25%), GERD, bronchial hyperreactivity, (especially post infection), chronic bronchitis. The reasons of chronic cough depends on individually clinical situation of patient. In smoking persons with or without changes in chest X-ray very often cause of cough are nicotin-dependent respiratory system diseases (COPD, chronic bronchitis, lung cancer) and treatment with ACE inhibitors. Chronic cough of unknow etiology is diagnosed in 20% patients with chronic cough. Treatment of cough depends on the reason of this symptom, and sometimes is very difficult.

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