Why my cough isn't resolving after so long?

Everyone must have experience at least a few episodes of cough in their lifetime. The majority of the cough are self-limiting (it will resolve itself).

As you might know, cough is a body protective mechanism to prevent the entry of microorganisms, phlegm or foreign materials into the airways and lungs.

It helps to clear irritants and secretions from our lung.

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Cough can be categorised into different types depending on its nature:

• Dry cough: A cough that is irritating to the lungs and throat but does not produce any mucus.
• Productive/wet cough: A cough that produce whitish mucus/sputum. Take note that green or yellowed-coloured sputum may indicate a bacterial infection.
• Barking or whooping cough: Barking cough may indicate croup or viral illness in children whereas whopping sound of coughing may indicate pertussis which need immediate medical attention. Pertussis is a highly contagious disease tha could be deadly to infants (babies less than 1 years old).

Even though an acute cough is usually self-limiting, chronic cough is often bothersome to most of us.

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Chronic cough an interrupt our sleep and leave us feeling exhausted the next day. Chronic cough may also cause you to vomit and feeling lightheadedness at times.

People has been categorising cough based on different definitions. However, American College of Chest Physicians defined different types of cough based on the duration as below:

• Acute cough: lasting < 3 weeks
• Subacute cough: 3-8 weeks
• Chronic cough: > 8 weeks

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The priorities of treating cough is to identify the precipitant (or etiology), then find ways to avoid the precipitant as well as to treat the underlying cause.

Some of the common underlying cause of chronic cough are cigarette smoking, asthma and acid reflux.

• Smoking: Cigarette smoking is one of the most common causes of chronic cough. In short, staying away from tobacco smoke is a good way to stay healthy.

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• Gastroesophageal reflux disease (GERD): GERD is also known as backward flow of stomach acid and content into the oesophagus. Acid reflux may irritate the airway, causing bronchospasm (tightening of airways), leading to shortness of breath and coughing.

• Asthma: Inflammation of airways, which leads to recurrent episodes of breathing difficulties as well as breathlessness may precipitate chronic cough too. Asthma symptoms may be further aggravated by cold air, exposure to allergen, air pollution or infections.

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• Chronic bronchitis or chronic obstructive pulmonary disease (COPD): Inflammation of your bronchioles often leads to cough of coloured sputum. For your information, being a smoker or ex-smoker is a major risk factor of bronchitis or chronic obstructive pulmonary disease. Infections: Cough can be one of the symptoms of respiratory tract infections and linger longer after infections liked pneumonia, flu or cold has gone away.

• Medications: Hypertension medicine like Angiotensin-Converting Enzyme inhibitors (eg. Captopril, perindopril, enalapril, lisinopril) are known to cause coughing as one of its common side effects. Therefore, if you are just started on new medicine and experienced subacute or chronic cough, you may want to inform your doctor or pharmacists.

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Besides from avoiding the precipitating factors and treating the underlying cause, some of the tips which may help to symptomatically relief cough are:

• Take some over-the-counter cough medicines including cough lozenges
• Drinking lots of water (it will really helps)
• Inhaling steam

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-JiaFui-