August 2018

Chronic in Adults with Down Syndrome Ravi Shah, MD Family Medicine Resident at 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) • • GERD (Gastroesophageal Reflux Disease, “heartburn”) • Chronic • Viral or bacterial upper respiratory including the “common cold” • Flu () • 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

1610 Luther Lane, Park Ridge, IL 60068 847-318-2368 www.advocatehealth.com/health-services/adult-down-syndrome-center // www.facebook.com/adultdownsyndromecenter

August 2018

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 http://www.ndss.org/wp- content/uploads/2017/11/respiratory_concerns_in_children_with_down_syndrome_slides.pdf

1610 Luther Lane, Park Ridge, IL 60068 847-318-2368 www.advocatehealth.com/health-services/adult-down-syndrome-center // www.facebook.com/adultdownsyndromecenter