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Chronic Cough

A chronic cough is a cough that lasts longer than eight weeks. It can affect sleep, work and daily activities. A persistent cough can come from problems in the upper airway, the lungs, the stomach, or a combination of these. An ENT specialist can help identify causes related to the nose, sinuses, throat and voice box, and guide appropriate treatment.

Symptoms, Causes & Triggers

You or your doctor may notice one or more of the following common symptoms:

  • Cough lasting more than eight weeks
  • Throat clearing or constant need to clear the throat
  • Sensation of mucus or dripping at the back of the nose or throat
  • Hoarseness or voice change after coughing
  • Cough that is worse at night or when lying down
  • Shortness of breath, wheeze or chest tightness when the cause is lower airway related
Chronic Cough

Typical Causes and Triggers

Chronic cough often has more than one contributing factor. Common causes that ENT doctors assess include:

  • Upper airway cough syndrome, sometimes called post nasal drip, from allergic rhinitis or chronic rhinosinusitis
  • Laryngopharyngeal reflux, where stomach acid reflux irritates the throat and voice box
  • Chronic bronchitis or asthma, which may need joint assessment by a respiratory physician
  • Cough hypersensitivity, where the cough reflex is overactive after a viral illness
  • Side effects of medications such as angiotensin converting enzyme inhibitors
  • Smoking, environmental irritants, or occupational exposures
  • Less commonly, structural problems of the larynx or throat or persistent infections

How We Diagnose Chronic Cough

ENT specialist examines the nasal passages, sinuses, and throat using a monitor

A targeted and stepwise approach helps find the cause and guide treatment. Typical steps include:

  • 1

    Detailed clinical history and symptom review to identify likely triggers and medication effects.

  • 2

    Physical examination including ear nose and throat assessment.

  • 3

    Flexible naso endoscopy to visualise the nose, throat and larynx.

  • 4

    If indicated, tests such as chest X ray, spirometry or allergy tests may be recommended.

  • 5

    Referral to other specialists such as a respiratory physician or gastroenterologist if the cough has lung or reflux features.

  • 6

    Trial treatments are often both diagnostic and therapeutic, for example a short course of nasal steroid for post nasal drip or inhaled therapy for suspected asthma.

Treatment Options

Treatment is directed at the underlying cause or causes. Common approaches include:

  • Treating nasal and sinus disease with saline rinses, intranasal steroid sprays and allergy control for upper airway cough syndrome.
  • Managing reflux with lifestyle measures and medication when laryngopharyngeal reflux is suspected.
  • Inhaled bronchodilator or anti inflammatory therapy when asthma or airway hyperreactivity is present.
  • Stopping or changing medications that can provoke cough, under medical supervision.
  • Smoking cessation and avoidance of airborne irritants.
  • Speech and cough suppression therapy for cough hypersensitivity or habit cough.
  • Antibiotics only when a persistent bacterial infection is suspected.
  • Combined care with pulmonology or gastroenterology when the cause spans specialties.

Your ENT specialist will explain recommended options, expected benefits and any risks so you can make an informed decision.

What to Expect During Treatment

  • Some causes respond quickly, while others require weeks of treatment to assess benefit.
  • Treatments such as nasal sprays or inhalers may need regular use for several weeks.
  • Follow up appointments allow reassessment and change of therapy if needed.
  • If symptoms do not improve with initial measures, further tests or specialist referrals may be arranged.

Dos and Don’ts (Practical Advice)

Do:

  • Keep a symptom diary noting timing, triggers and any medicines taken.

  • Try saline nasal rinses if you have nasal drip or congestion.

  • Avoid smoking and second-hand smoke.

  • Follow prescribed treatment regularly and attend follow‑up visits.

Don'ts:

  • Stop prescribed medication unless advised by a doctor.

  • Rely solely on over-the-counter cough remedies for persistent cough.

  • Ignore warning signs such as coughing up blood, significant weight loss or progressive breathlessness.

Frequently Asked Questions

See an ENT when cough has lasted more than eight weeks, or earlier if you have throat symptoms such as persistent throat clearing, voice change or a sensation of something stuck at the back of the throat.

Yes. Allergic rhinitis and chronic sinusitis can cause post nasal drip that triggers chronic cough. Treating the nasal inflammation often improves the cough.

Laryngopharyngeal reflux is reflux of stomach contents that reaches the throat and voice box. It can irritate these tissues and cause chronic cough, throat clearing and hoarseness.

Improvement depends on the cause. Some patients notice benefit within days, while others may need several weeks of treatment and follow up.

Not always. Many cases begin with clinical assessment and flexible naso endoscopy. Additional tests such as spirometry, imaging or specialist referrals are used when indicated.

Next Steps and Booking

If you have a persistent cough, book a consultation so we can review your symptoms and arrange appropriate investigations.

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