IPF remains to be one of the most unrecognized and undiagnosed respiratory illness. IPF leads to stiffening of lung making it hard due to progressive replacement of lung tissue with scarred tissue (fibrosis). The symptoms are dry cough and progressive symptom of breathlessness.
Dry cough constitutes to be the most common symptom in IPF. Many patients of IPF complains of chronic refractory cough. Chronic cough in IPF is important symptom leading to significant deterioration of quality of life. Chronic cough in IPF is not just a disabling symptom but also and an important predictor of disease progression.
Important triggers for cough in IPF patients are
- smoke perfumes
- throat irritation
- noxious fumes
- speech
- exercise
- cold dry air
- eating and
- humidity
The co- morbidities influencing cough in IPF are
-gastroesophageal Reflux disease (GERD)
- emphysema
- Ace inhibitor use
- chronic Sinusitis
- lung cancer and
- infection
Usual cough syrups aur antitussives Do not benefit much. Steroids and antifibrotic may benefit In cough but further studies are required. Treatment of comorbidities, neuromodulator like gabapentin or pregabalin have been shown to improve cough. There are various trials undergoing evaluating novel medications, Azithromycin, laparoscopic anti Reflux surgery, supplemental oxygen, Omeprazole and cognitive behavioral therapy for management of cough
