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Chronic Cough in Adults with Down Syndrome

August 2018 | Ravi Shah, MD - Family Medicine Resident, Advocate Lutheran General Hospital

Definition:

Chronic cough is defined as any cough that lasts greater than three weeks. It is a common condition in adults with Down syndrome. Reasons that chronic cough have a higher frequency in people with Down syndrome include but are not limited to:

  • Craniofacial features

  • Adeno-tonsillar hypertrophy

  • Airway size

  • Low tone of airway muscles

  • Cardiac disease

  • Obesity

Causes include but are not limited to:

  • Post-nasal drip (mucus from sinuses dripping down to the back of the throat)

  • Asthma

  • GERD (Gastroesophageal Reflux Disease, “heartburn”)

  • Chronic bronchitis

  • Viral or bacterial upper respiratory infection including the “common cold”

  • Flu (influenza)

  • Habitual cough (cough that is behavioral or tic-like in nature; repetitive movements and sounds are common in some adults with Down syndrome)

If a person with Down syndrome has a persistent cough, it is important for he or she to see a healthcare provider to evaluate the cause of the cough.

A healthcare provider can use many tools to help narrow down the cause of the chronic cough such as:

  • A good history of symptoms and a physical exam

  • Rapid flu test

  • Spirometry (test for asthma or COPD)

  • Chest x-ray

  • Blood tests

  • CT scan of the sinuses

  • Visualization of the airway by an ENT using a scope

Treatment of the cough will depend on the cause and include but are not limited to:

  • GERD: Proton pump inhibitors such as pantoprazole or omeprazole to reduce acid reflux

  • Post nasal drip: nasal spray such as fluticasone (Flonase)

  • Cough suppressants

  • Bacterial infection: Antibiotics

  • Flu: Tamiflu if symptoms started less then 72 hours of treatment

References:
Chicoine, B. & McGuire, D. (2010) The Guide to Good Health for Teens & Adults with Down Syndrome. Bethesda, MD: Woodbine House, Inc.

Moore, P.E. (2011) Respiratory concerns in children with Down syndrome [PowerPoint slides]. Retrieved from https://www.ndss.org/wp-content/uploads/2017/11/respiratory_concerns_in_children_with_down_syndrome_slides.pdf

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.

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