Chronic Cough

A chronic cough is a cough that lasts for eight weeks or longer. It's more than just a nuisance; it can also be a sign of an underlying health issue. Many people experience occasional coughing, but a chronic cough can disrupt daily life and make it hard to sleep or work.

1. Postnasal Drip: This is one of the most common causes of chronic cough, occurring when mucus from the sinuses drips down the back of the throat, triggering a cough.

2. Asthma: Chronic coughing can be a symptom of asthma, a condition that causes the airways to become inflamed and constricted.

3. Gastroesophageal Reflux Disease (GORD): Stomach acid can flow back into the oesophagus, irritating the throat and causing a cough.

4. Chronic Bronchitis: A type of chronic obstructive pulmonary disease (COPD) characterised by long-term cough and mucus production.

5. Laryngeal Hypersensitivity: This occurs when the larynx (voice box) becomes overly sensitive, leading to a cough reflex in response to minor irritants, such as smoke, cold air, or even talking.

6. Infections: Conditions like pneumonia or tuberculosis can also lead to chronic cough, though they are less common compared to other causes.

7. Smoking: Persistent coughing can result from smoking, which damages the lungs and airways.

8. Medications: Certain medications, particularly ACE inhibitors used for hypertension, can cause coughing as a side effect.

Treatment for a chronic cough depends on the underlying cause. Here are some common options:

1. Addressing Underlying Conditions: The first step often involves treating whatever is causing the cough, such as using asthma inhalers or medications for GORD.

2. Lifestyle Changes: Quitting smoking, avoiding irritants (like pollution or strong scents), and keeping indoor air clean can help.

3. Over-the-Counter Remedies: Cough suppressants and expectorants can provide temporary relief, especially for a cough caused by postnasal drip.

4. Prescriptions: For more severe cases, doctors might prescribe medications like corticosteroids for inflammation or antibiotics for bacterial infections.

5. Cough Desensitization: This therapeutic approach aims to reduce the sensitivity of the cough reflex over time through gradual exposure to the triggers. Working with a speech therapist or specialized healthcare provider, patients can learn techniques to modify their cough reflex and improve symptoms.

6. Superior Laryngeal Nerve Block: This is a specific treatment option where a mixture of anaesthetic and steroid is injected into the area around the superior laryngeal nerve to reduce sensitivity in the throat and alleviate the cough reflex. This is repeated over a few weeks until there is improvement of symptoms. 

7. Laryngeal Botox: In some cases, injecting botulinum toxin (botox) into the laryngeal muscles can help relax these muscles, decreasing sensitivity and improving cough symptoms, particularly for those with laryngeal hypersensitivity.

An ENT doctor can help diagnose and treat chronic coughs by conducting thorough examination and tests, such as laryngoscopy to look at the throat and vocal cords. They can identify underlying issues like postnasal drip, allergies, or GORD. Treatment options including procedures like superior laryngeal nerve blocks and laryngeal botox to reduce throat sensitivity. They can also offer lifestyle advice to avoid irritants and may collaborate with other healthcare providers (SLT) for comprehensive care. If you're struggling with a chronic cough, seeing an ENT doctor can be an important step toward relief.