Before the world came to know the existence of COVID-19, the sound of a cough would barely turn a head. Unfortunately these days a persistent cough in public often draws attention and can make the person coughing feel quite uncomfortable. So why do some people have a lingering cough that they just can’t shake?
Coughing is your body’s way of protecting your lungs. A cough is usually effective at clearing mucous produced during a respiratory tract infection, it protects your lungs when food or drink may enter the airway due to swallowing incoordination and it responds to irritants entering the airway to clear it.
Persistent coughing may be a sign of a serious health condition and should be thoroughly investigated by your GP or respiratory specialist. For some people, these investigations may be completely normal but that still doesn’t answer the question as to why the cough persists. This is where laryngeal hypersensitivity may be playing a part in triggering the cough reflex.
Laryngeal hypersensitivity refers to a larynx, otherwise known as the voice box, which overreacts to stimuli or irritants. It can often begin with a viral illness which causes coughing but the coughing doesn’t resolve after you have recovered from the illness. Unfortunately we are frequently seeing this as a lingering symptom after COVID-19 infection also. After the virus the coughing continues with the smallest of triggers:
- drinking a cold drink
- walking in cold air
- after symptoms of reflux
- certain odours or exposure to chemicals
- Or no clear trigger at all!
Persistent coughing is like a mosquito bite. The more you scratch it, the more swollen and red it becomes and the more you need to scratch. With ongoing coughing, your threshold for coughing becomes lower and lower until the smallest irritation like a small amount of sticky mucous causes forceful coughing, at times even to the point of vomiting.
The good news is that chronic cough due to laryngeal hypersensitivity is responsive to speech pathology treatment. The aim of treatment is to identify triggers for the cough and learn breathing techniques to reduce the severity, shorten the duration, delay the cough trigger or suppress the cough altogether.
It’s important that you have a complete respiratory work up prior to commencing cough treatment with a speech pathologist to rule out any other medical conditions that may be causing the cough. This may be done through your GP or they may refer you to a respiratory specialist. It may also be recommended that you see an Ear Nose and Throat specialist who can visualise your larynx and treat any reflux or post-nasal drip that may be contributing to the cough. At times the ENT may also suggest medication that can assist with your response to cough therapy. The medication is aimed at reducing the overactivity of the nerve which supplies sensation to your larynx.
Adelaide Voice Therapy have extensive experience treating patients with chronic cough and would be delighted to work with you to find a solution to stop the cough so you can get on with the things that you enjoy.