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
The purpose of the cough clinic is to improve the quality of life of patients who suffer chronic cough.
The cough service at Northumbria has been running since 2010. This one of a very small number of cough clinics in the UK. The team have contributed to the development of speech therapy treatments for cough, cough research, including trials of novel cough drugs, and national cough guidelines - https://
We will aim to get a better understanding of what might be causing your cough. We will review your history and investigations and may request further tests depending on your circumstances.
We will discuss different options for managing your cough, and make a personalised plan for ongoing treatment.
Ongoing treatment planning often includes collaboration with your GP and the local respiratory team.
This will be done by combining information from a range of investigations, and match these up with the symptoms that each individual patient experiences and describes.
You will see expert healthcare professionals who specialise 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 General Hospital and Wansbeck General Hospital, this will be Dr Simon Fearby.
Most patients attending our cough clinic will also see a specialist speech and language therapist (SLT). Respiratory SLTs specialise in laryngeal hypersensitivity, chronic cough and inducible laryngeal obstruction (ILO).
Depending on how many assessments you have had before coming to this clinic, you may also see a lung physiologist for lung function tests, and/or a respiratory nurse.
It is possible that you would be invited to join a cough research project. If you are invited and would like to hear more, a research nurse would talk to you about the project/s and answer any questions you might have.
People are usually referred to this service from their GP, or from respiratory doctors, nurses and/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, you will receive a telephone call 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 be carried out to give us up to date information about your lung and upper airway function.
Some patients receive a telephone call first to help us to decide which specialist assessments are needed in that first appointment.
The health professionals will explore factors that might be contributing to your cough. This helps them to understand why your symptoms started, why they are still happening, and what could help to reduce symptoms. They will want to know about any patterns you have noticed with your cough, including what makes it better or worse. They 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 get some questionnaires to fill out to give us a better idea of how your cough affects your daily life and wellbeing.
You may get lung function tests including and spirometry FeNO (Fractional Exhaled Nitric Oxide) assessment which looks at the level of inflammation in your airways. Further investigations are not usually needed but may include bronchoscopy and 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 voluntary, and 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 assessment, and will be made in collaboration with 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 trialling new medications
Follow-up can be arranged to monitor progress with treatment. This can be done as a face-to-face, telephone, or video appointment. It is also possible to refer you back to your local team for follow-up.
It is not always possible to completely resolve cough symptoms but evidence suggests that personalised treatment can help people to:
- Reduce the severity of coughing episodes
- Reduce how often people get coughing episodes
- Improve people’s control of cough symptoms
- Improve quality of life and reduce unpleasant symptoms related to the cough
Overall improvement will depend on different factors, such as how easy it is for people 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)
This video was produced by a member of our team in collaboration with Newcastle Upon Tyne Hospitals and provides some practical tips on managing cough: https://
Giving Voice to people with Upper Airway Disorders: https://
Useful patient information sites
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Treatment guidelines
British Thoracic Society statement on cough in adults - https://
European Respiratory Society Guidelines on cough - https://
American cough guidelines - https://