The Cough that Won’t Stop

ENT Care

By Dr Rekha Balachandran

A cough is a protective reflex. It’s how your body responds to irritants in your throat and airways. However, any cough that persists for several weeks may indicate an underlying condition that requires medical attention. This long lasting cough is not a disease by itself, but a symptom of some underlying problem.

What are the causes of chronic cough?

  1. Asthma and allergies
  2. Gastro-esophageal reflux disease
  3. Medications
  4. Sinusitis

Asthma presents with cough, chest tightness, shortness of breath, and wheezing which tend to worsen at night or in the early morning. Asthma can be brought on by different factors which differ from person to person. An allergic cough is similar to asthma and occurs as paroxysms of cough after being exposed to a particular allergen like cigarette smoke and other airborne irritants and certain foods.

One of the commonest trigger for a long-term cough is Gastro-Esophageal Reflux Disease or GERD. GERD is caused by the movement of stomach acid back into the food passage and the throat. This acid reflux then causes irritation of the throat giving rise to cough. Other symptoms include sore throat and a blocked-like feeling in the throat. Many will also have associated symptoms of heartburn.

ACE inhibitors are a medication used to treat high blood pressure and heart failure. Although it is an effective drug, almost 25% of those taking it may develop a persistent dry cough. If you suspect your medication is responsible for your cough, don’t stop taking it, please consult your doctor first.

Chronic sinus infections are another cause for cough and one of the commonest conditions I see in my practice. Studies have shown up to 30% of chronic cough is contributed by sinus disease. The mucous from the sinuses is drained to the back of the nose and drops to the throat causing an irritation and cough. To check if sinusitis might be the underlying cause of the cough, an ENT check-up including an endoscope and sometimes a CT scan may be required. Untreated sinus infections can lead to lung infections and can also be a recurring problem if not treated adequately.

How is it treated?

The treatment is based on the cause of the cough. Please keep in mind prolonged cough needs to be investigated by a doctor and should not be ignored. Talk to your doctor about managing your asthma, postnasal drip or GERD.  There are some measures that can help to ease an ongoing cough. These include:

  1. Staying hydrated.
  2. Steam inhalations or humidifiers.
  3. Keep your rooms, bedding and surroundings free of dust especially if the cough is due to asthma or allergies.
  4. Using mentholated cough drops or throat sprays to soothe the throat.
  5. Taking a spoonful of raw honey is a great way to soothe a dry cough.
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