Dr Prina Ruparelia on ‘treatable traits’ in chronic cough, and the under-recognised phenomenon of cough hypersensitivity

In this episode, Dr Prina Ruparelia, joint clinical director for respiratory medicine at St Bartholomew’s and Royal London Hospitals, talks to Dawn Liz Powell about identifying and managing chronic cough in primary care.

Dr Ruparelia explains that after ‘worrying conditions’, such as lung cancer, have been excluded in patients with chronic cough, a thorough history should be taken to identify any potentially ‘treatable traits’. Treatable traits, she says, are factors (for example, smoking) that might cause a cough. Once identified, these traits can be addressed to help manage the cough.

One trait, in particular, discussed in this episode is cough hypersensitivity. Dr Ruparelia explains that this is ‘under-recognised’ and probably relates to a dysregulation of the neuronal pathways that control cough — resulting in a cough response to relatively minor irritants,such as perfume or laughing. 

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