Tonsil removal 'could cure cough'

Chronic cough can be a disabling illness

A small number of patients with chronic, unexplained coughs might benefit from having their tonsils taken out, say experts.

Thousands of people are plagued by an overactive cough reflex - with no apparent cause.

Doctors at Glenfield Hospital in Leicester noticed that after some of them had had their tonsils removed, the cough cleared up.

However, other explanations are likely for the bulk of cases.

Some patients who consult doctors with a chronic cough have enlarged tonsils - it is possible that this may be a manifestation of the inflammation in the airway that causes the problem.

Theory tested

Dr Surinder Birring decided to test the theory that removing these tonsils might ease the problem.

Eight patients were treated this way - and the sensitivity of their cough reflex tested once they had recovered from the operation.

They found significant improvement in their coughs three months after the operation.

The average concentration of pepper needed to trigger five coughs increased 50-fold in these patients.

Ordinary tonsillectomy patients whose cough reflex was tested before and after showed no change.

'Treatable'

Dr Birring wrote in the European Respiratory Journal: "For the first time, it has been shown that chronic tonsillar enlargement is present in some patients with unexplained chronic cough, and the cough symptoms and cough reflex sensitivity improve three months after tonsillectomy."

He said that it might prove a "common and treatable causes".

Professor Neil Thomson, an expert in respiratory disorders at the University of Glasgow, told BBC News Online that he had never heard of enlarged tonsils as a possible factor in chronic cough.

He said: "Between 80% and 90% of cases do have a cause that can be identified, such as inflammation of the airway or reflux.

"The condition can be quite disabling for patients."