Do you have a chronic cough? Feel as if you need to clear your throat all the time? These are two common complaints many people ignore or try to hide. Throat clearing can be a symptom of some serious health issues. That’s why it’s a good idea to seek help early rather than let the condition linger.
If you have a cough that just won’t go away and isn’t responding to other treatments from your doctor, then here’s a guide to help you understand more about a chronic cough and suggest what you can do next.
What is a Chronic Cough?
A chronic cough is one that lasts more than 8 weeks. The cause of a chronic cough can be an infection or virus, but the cough itself often lingers after the original cause has passed. It can occur seemingly at random or be triggered by:
- Cold air
- Talking too much
A chronic cough affects around 10-20 percent of the population and is one of the most common reasons why people go to their doctor (Knickerbocker, 2019). This symptom can be associated with:
- Sleep disruptions
- Financial difficulties because of the ongoing doctor’s appointments
- Attention problems
- Social life disruptions because of the worry about disturbing others
- Social isolated because other people can become concerned about catching something from you
These issues can increase the risk of mental health difficulties including anxiety and depression, which is why early intervention is a great idea.
Testing a Chronic Cough
If you have a cough or you’re constantly clearing your throat because you feel as if you need to cough, then make sure you see your doctor. An ongoing cough can be complicated, so you’ll need to:
- Give a complete medical history
- Have a chest X-ray taken
- Receive a thorough physical examination
- Let your doctor know if you’re on any medications that cause coughing, like ACE inhibitors
Your doctor will consider other common causes of a chronic cough and either treat them or eliminate them as causes of your symptoms.
Common Causes of Chronic Coughing
Constant throat clearing or a cough can indicate several health conditions such as:
Asthma can cause a dry cough that doesn’t produce mucus as well as wheezing. The inhaled medications taken for asthma can also irritate the throat and cause coughing.
If you have mucus from your nose or sinuses dripping down the back of your throat, it’s known as postnasal drip. This very annoying feeling can result in ongoing throat clearing and voice quality changes. This is usually a symptom of something else rather than a health condition on its own.
Acid rising up because of Gastroesophageal Reflux Disease (GERD) and Laryngopharyngeal Reflux (LPR) can irritate the delicate tissue in the throat and cause coughing. A specific stomach enzyme known as Pepsin can also stay in the larynx when you have reflux and cause harm.
A chronic cough can be a sign of chronic bronchitis, a long-term inflammation of the bronchi of the lungs. Being a smoker increases your risk of this issue.
Neurogenic Laryngeal Hypersensitivity
This was once the label given to coughs that have no apparent cause. It often occurs in conjunction with other issues like hoarseness, larynx spasms, swallowing problems, and the feeling that something’s stuck in the throat, causing constant throat clearing.
Paradoxical Vocal Fold Movement (PVFM)
PVFM occurs in around 50% of people with a chronic cough and is strongly associated with reflux, asthma, and rhinitis as well. When you have this condition, your vocal cords involuntarily move together sometimes when you breathe. This leads to coughing, throat tightness, and difficulty breathing and is often associated with asthma, but doesn’t respond to asthma treatments.
Chronic Cough Treatment Options
The most effective chronic cough treatment options will depend on the cause of your cough. That’s why it’s so important that you see your doctor to have any underlying conditions diagnosed and treated.
However, if your doctor can’t find a cause or if you still find yourself with a chronic cough after treatment, then getting some speech therapy may help. A speech therapist will assess your medical history and your cough characteristics and then create a personalised program that can include:
- 2-4 sessions
- Education on the potential causes of coughing
- A vocal hygiene assessment
- Breathing techniques
- Cough suppression techniques
- Hydration education
- Use of a respiratory muscle training device
The aim of treatment is to:
- decrease the frequency and intensity of your cough
- increase your ability to delay or completely suppress the cough
- increase your threshold of sensitivity to cough triggers
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How to Gain Control of a Chronic Cough
There are also several techniques you can use that will help you to gain more control over your chronic cough. You can practice these techniques regularly, even when you don’t feel the urge to clear your throat, so you get used to the right way to perform the techniques.
Here are some strategies that may help you avoid coughing in combination with medical treatments:
Well lubricated and hydrated vocal cords are essential for avoiding that ‘dry tickly’ feeling that can trigger a cough.
Try to avoid or delay your coughing by swallowing hard a sip of water or a dry swallow of saliva.
Sucking lollies/ Chewing gum
Chewing gum encourages the production of saliva and regular swallowing. This can help to reduce the trigger of a cough.
Other strategies your Speech Pathologist may introduce to encourage your vocal cords to move apart instead of slamming together while coughing include:
- Pursed Lips Breathing
- Sniff and Swallow
- Making a ‘SS’ Sound
A chronic cough can be more disruptive than you might think. It can affect every aspect of your life, from your financial life to your social life and physical health. And unfortunately, around 20 percent of coughs don’t respond to traditional treatments (Vertigan, 2014), which is why specialised options such as speech therapy can help.
Talk to your Speech Pathologist today to see if some speech therapy may assist in improving your chronic cough and the overall health and functioning of your throat and voice.
Knickerbocker, K. (2019). Chronic Cough Handouts [Online]. A Tempo Voice Center. https://atempovoicecenter.com/all-products/chronic-cough-handouts/
Vertigen, Dr A. (2014, August 13). Clinical management of chronic cough and paradoxical vocal fold movement: a multidisciplinary approach. [Webinar]. Australian Voice Association Webinar Series.