144 JULY 2019
Aaron Amat | shutterstock.comCan’t Stop
Here’s where that lingering cough
might have come from, and when
you should see a doctor for it.Coughing
?
Got a persistent cough you just can’t
seem to get rid of? It may be more than
a remnant of that cold you fought off a
few weeks ago. If the cough has lasted
more than eight weeks or longer in
adults, and four weeks in children, it’s
considered “chronic”.What causes chronic
cough?
According to respiratory physician DR
JIM TEO YEOW KWAN, there are a
number of causes, and the treatment
options vary accordingly.Infections
“A cough can linger long after other
symptoms of pneumonia, flu, cold or
other infections of the upper respiratory
tract have gone away,” he says. “A
common but under-recognised cause of
chronic cough in adults is pertussis, also
known as whooping cough.”
If fever persists and purulent phlegm
persists for more than five days, it’s likely
a bacterial infection that’s causing your
chronic cough, and antibiotics may be
prescribed.Chronic bronchitis
Chronic cough can also be a sign of chronic
bronchitis, a long-term respiratory tract
infection that most commonly affects
current or former smokers.
“This long-standing inflammation of
the major airways can cause a cough that
brings up coloured sputum,” says Dr
Jim Teo. “Chronic bronchitis is usuallypart of the spectrum of smoking-related
lung disease called chronic obstructive
pulmonary disease (COPD), which
includes emphysema as well. Chronic
bronchitis and emphysema often coexist
in current or former smokers with COPD.”Postnasal drip
“When your nose or sinuses produce
extra mucus, it can drip down the back of
your throat and trigger your cough reflex.
This condition is also called upper airway
cough syndrome (UACS).”
Luckily, antihistamines and
decongestants are among the different
types of drugs that can be used to treat
allergies and postnasal drip.Asthma
“An asthma-related cough may come and
go with the seasons, appear after an upper
respiratory tract infection or become
worse when you’re exposed to cold or
certain chemicals or fragrances,” says Dr
Jim Teo. “And, in one type of asthma,
coughing is the main symptom.”
The most effective treatments for
asthma-related cough are inhaled asthma
drugs, which reduce inflammation and
open up the airways.Reflux
“Gastroesophageal reflux disease (GERD)
is a common condition where stomach
acid flows back into the oesophagus,
creating constant irritation that can lead
to chronic coughing,” explains Dr Jim
Teo. “This coughing, in turn, worsensThe Respiratory Practice has five
locations: Gleneagles Medical Centre,
Mount Elizabeth Medical Centre,
Parkway East Medical Centre (Joo
Chiat), Farrer Park Medical Centre
and Mount Alvernia Medical Centre D.
respiratorypractice.comGERD, creating a vicious cycle.” He adds
that when lifestyle changes don’t take
care of the acid reflux, a patient may be
treated with acid blockers, medications
that block acid production.Blood pressure drugs
According to Dr Jim Teo, angiotensin-
converting enzyme (ACE) inhibitors,
which are commonly prescribed for high
blood pressure and heart failure, are
known to cause chronic cough in some
people.When to see a doctor
See your doctor if your cough has lasted
for weeks, you’re coughing up blood or
if your cough is associated with fever,
shortness of breath and chest pain. It’s
also important to see a doctor if your
cough is causing you serious problems
such as keeping you from sleeping or
interfering with your work or everyday
activities.
Cough suppressants may be prescribed,
particularly if the reason for your cough
can’t be determined right away. However,
Dr Jim Teo says there’s no evidence that
over-the-counter cough medicines are
effective in treating chronic cough.