Persistent Cough Is Not Better: Should I Worry?

Have you or your child been suffering a persistent cough which seems to be taking forever to recover? Persistent cough can be very annoying and may be associated with sore throat. Coughing constantly can affect your sleep quality. Furthermore, recurrent coughing may lead to pain in your chest from the repeated physical effort made to cough.

Although it is common to suffer a cough after a bad cold, some cases drag on even after antibiotics. As an experienced ENT specialist who sees children and adults, patients with persistent cough always worry about a sinister cough. A thorough ENT specialist checkup will reveal what the common reasons are for a persistent cough or chronic cough. You should have a chest X-ray if a cough has dragged on for more than a few weeks.

IS MY PERSISTENT COUGH DUE TO A POSTNASAL DRIP?

In adults, a postnasal drip from the back of your nose creates a flow of secretions running down from the nose into the throat. When this mucus reaches the voicebox, the natural reflex is to cough to clear these secretions. Otherwise, the waterfall of mucus might enter your lungs and lower airways to spread infection.

Some patients can’t help clearing their throats with recurrent “ahem” sounds. Actually, the best thing to do is sip warm water to wash away the secretions pooling inside your throat. Nasal medications like nasal sprays and anti-allergy medications can help to reduce the backdrip of nasal secretions.

IS MY PERSISTENT COUGH CAUSED BY ACID REFLUX?

Interestingly enough, acid reflux can be a common cause of a persistent cough or chronic cough. In Singapore, ENT patients who suffer from acid reflux or gastritis, may have throat irritation or chronic cough. This results from stomach acid flowing upward towards the voicebox. Sometimes, this may happen if the muscle controlling the opening and closing of the food passage (oesophagus) isn’t working properly. This ring of muscle usually closes at rest to prevent the backflow of acid reflux. So the cough reflex is triggered again and again by the acid’s presence.

IS MY CHILD’S COUGH DUE TO ENLARGED ADENOIDS AND NASAL ALLERGIES?

In Singapore, ENT children with chronic cough or persistent cough may suffer problems with acid reflux, just like the adults do. But there are 2 more common sources of a constant flow of mucus from the nose:

1) Enlarged adenoid tissue at the back of the nose

2) Enlarged “sausages” (turbinates) of the side walls of the nose

If either the adenoids or turbinate tissue are enlarged, they tend to give rise to increased nasal secretions. This may also cause blocked nose and even snoring in children in Singapore. Allergy testing is important in both children and adults when the symptoms of blocked nose and runny nose co-exist with cough. House dust mite allergy is the most common trigger for allergic rhinitis or hayfever. This in turn may eventually lead to a chronic cough or persistent cough in children and adults.

In children with constant cough in Singapore, other causes such as whooping cough, bronchitis, croup or other chest infections should be carefully excluded. In Singapore, children born here have been vaccinated against Pertussis or whooping cough. Croup has a classic “barking” cough which experienced ENT doctors in Singapore as well as paediatricians can easily recognise.

So you shouldn’t just sit at home waiting and hoping for your cough to go away by itself. It is important to get that annoying chronic cough checked out by your friendly experienced ENT specialist in Singapore because we can treat it.

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