My Cough Is Not Better, it’s Persistent: Should I worry?

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

Although it is common to suffer a cough after just having had a bad cold or the flu, some cases drag on even after antibiotics. As an experienced ENT specialist who sees both children and adults at our busy ENT clinic in Singapore, many patients with chronic or persistent cough turn up as they are worried that their cough may be related to a more sinister condition. A thorough ENT specialist checkup is performed: Guess what the common reasons are for a persistent cough or chronic cough? A chest X ray is advised if a cough has dragged on for more than a few weeks.

In adults, a postnasal drip or runny nose from the back of your nose creates a flow of secretions running down from the nose into the throat and voicebox. When this waterfall of mucus reaches the voicebox, the natural reflex is to cough to clear the voicebox and airway of these secretions so that they don’t continue to enter your lungs and lower air passages. Some patients notice a strong urge to keep clearing their throats with “ahem” sounds and actually, the best thing to do at this point is to take a sip of warm water to wash away the secretions pooling inside your throat. Nasal medications in the form of nasal sprays and anti-allergy medications can also help to reduce the backdrip or postnasal drip of nasal secretions and mucus.

Interestingly enough, at the other end, acid reflux may also 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 from the 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 to prevent the backflow of acid reflux. This then leads to the cough reflex being triggered again and again by the acid’s presence.

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

1) Enlarged adenoid tissue at the back of the nose

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

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