Managing Prolonged Cough (Chronic Cough) - Doctor Q&A

Prolonged cough is a common condition that may arise from viral infections, allergies, asthma, smoking or underlying respiratory diseases.

While many coughs resolve on their own, some may persist and develop into chronic cough, affecting sleep, daily activities and overall quality of life.

Understanding the causes, warning signs and triggers of persistent cough is important for early diagnosis and appropriate treatment.

Managing cough effectively involves:

• Identifying and treating the underlying cause,
• Relieving symptoms, and
• Adopting preventive measures to reduce irritation and recurrence.

Early medical attention and proper care can help prevent complications and support better long-term respiratory health.

In this Doctor Q&A, Dr Tan Teck Shi will answer your questions about prolonged cough and chronic cough. Submit your questions now!

Dr Tan Teck Shi is a Consultant at SingHealth Polyclinics. He is also the Clinical Lead of the Respiratory Workgroup at SingHealth Polyclinics, Adjunct Assistant Professor at Duke-NUS Medical School, and Service Chief at the SingHealth Duke-NUS Sleep Centre.

Dr Tan obtained his MBBS in 1985 and Master of Medicine (Family Medicine) in 2009. He has a special interest in respiratory health, sleep medicine and chronic disease management.

He has received several healthcare service awards, including the Singapore Health Quality Service Awards Silver Award and Eastern Health Alliance Caring Awards Gold Award.

Dr Tan has also contributed to research and publications in diabetes care, patient communication and family medicine.

1. Question by Nori

Dear Doctor,

I have been coughing on and off from start of year 2026 and seen quite a number of doctors plus eating medicine like cough syrup, pills, antibiotics etc but my cough is still here.

I have like phlegm stuck at throat but not able to cough out.

Can I know what is wrong with me or is it as time goes by will slowly recover?

Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Nori,

A cough that lasts for months should not be ignored, especially if it keeps coming back even after taking medicine. It is important to find the real cause, not just treat the symptoms.

The feeling of “phlegm stuck in the throat” can be caused by:

• Mucus dripping from the back of the nose (sinus or allergies)
• Sensitive airways after a viral illness
• Asthma symptoms
• Acid reflux (stomach acid irritating the throat)
• Smoking or irritants like dust
• Less commonly, long-term lung problems
• Medication side effects (e.g. blood pressure medications like ACE-inhibitors)

Since your cough has lasted since early 2026 despite treatment, including antibiotics, it would be better to get a more detailed check instead of continuing the same short treatments.

You can talk to your doctor about doing a chest X-ray, checking your breathing with lung function tests, and looking into possible causes like asthma, allergic rhinitis (causing nasal drip behind the nasal passage), or acid reflux. Appropriate treatment can then be given. If needed, your doctor may also suggest seeing a lung specialist.

In the meantime, you can help yourself by drinking more fluids, avoiding smoke, dust, and strong smells, trying warm drinks or honey if suitable for you, and making sure you get enough rest.

You should see a doctor sooner if you develop trouble breathing, chest pain, fever, weight loss, blood when coughing, or if your symptoms get worse or affect your sleep.

2. Question by Stefanie

Dear Dr Tan,

I like to find out how to treat my chronic cough of more than 2 weeks. It started with a mild cough due to a viral infection, sore throat and fever averaging 37.5-38.5 degree celsius. The fever and sore throat went away after a week and I was left with a cough with phlegm.

I self-medicated with panadol for the fever, lozenges for the sore throat and cough mixture for chesty cough. When the cough became chronic and affecting my sleep after more than 10 days, I went to get medication from Kallang Polyclinic and was given Tussidex Forte Linctus cough mixture and Acetylcysteine tablet to clear away the phlegm.

It helps with the resistance to cough and affects my sleep lesser where I only woke up between 3-4am coughing. Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Stefanie,

A cough that continues after a viral infection is quite common and may last for a few weeks even after the fever and sore throat have resolved. This is often due to lingering airway inflammation or mucus in the airways following the infection.

It is a good sign that your symptoms are getting better with the medicine and that your sleep has improved. You should continue taking your medicine as your doctor advised, drink plenty of fluids, and avoid things like smoke or strong smells, as these can make the cough worse.

If the cough is mainly disturbing your sleep, you may also wish to discuss with your doctor adjustments to your medication or further treatment options.

3. Question by Mr Chio

Hi Dr,

I tend to have throat itchy & which resulted in coughing. GP said my lungs are clear using scope to listen to my chest breathing.

He said got be gastric issue causing irritation to the throat, is it so? Thanks.

Answer by Dr Tan Teck Shi

Dear Mr Chio,

Yes, acid reflux or stomach problems can sometimes cause throat irritation and a long-lasting cough, even if the lungs sound normal. This is called “silent reflux,” where stomach acid goes up into the throat without the usual heartburn.

Common signs include an itchy throat, needing to clear your throat often, a dry cough (especially at night or after eating), a feeling like something is stuck in your throat, and sometimes a hoarse voice or sour taste.

Throat irritation and cough can also be caused by allergies, sinus drainage (post-nasal drip), dry air, or irritation after a viral infection.

To help reduce symptoms, try to avoid spicy, oily, or acidic foods and late-night meals, avoid lying down right after eating, drink enough water, cut down on caffeine and alcohol, stop smoking if you are a smoker, and avoid environmental pollutants.

If your symptoms continue, get worse, or affect your sleep or daily life, it is best to see your doctor again, as you may need further tests or treatment.

4. Question by Mrs Leong

Dear doctor,

My husband has been coughing for the past month and it doesn’t seem to be getting better.

He seems to be coughing more in the night.  However, he won’t want to go see a doctor as he has allergy to cough mixture.

What can I do to help reduce his coughing? Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Mrs Leong,

A cough that lasts more than a month should be checked by a doctor, especially if it gets worse at night or is not improving. Night cough can be linked to problems like asthma, sinus drainage (post-nasal drip), acid reflux, or leftover irritation after an infection. Certain medications (e.g. blood pressure medications such as ACE-inhibitors) can also cause coughing as a side effect.

Even if your husband is allergic to some cough medicines, he should still see a doctor. He may need further tests such as chest X-Rays. There are other treatment options available depending on the cause. It is important he tells the doctor which medicine caused the allergy and what reaction he had.

In the meantime, he can try drinking more fluids, having warm drinks or honey if suitable, sleeping with his head slightly raised, and avoiding smoke, dust, strong smells, or cold air. A humidifier may also help if the air is very dry.

He should get medical help sooner if he has trouble breathing, wheezing, chest pain, fever, coughing up blood, or if the cough is affecting his sleep. Most long-lasting coughs can be treated once the cause is found.

5. Question by Wayne

Dear Dr,

My mum is facing chronic cough for almost 10 years and despite multiple visitations to ENT, respiratory specialist and even gastroenterologist, she is unable to find a cure to her cough.

Would like to ask what should I do to help her to find a cure for her. Thank you very much!

Answer by Dr Tan Teck Shi

Dear Wayne,

A long-term cough that continues even after seeing ENT, lung, and stomach specialists can be very frustrating. Often, it is not caused by just one problem. Instead, it may be due to several factors at the same time.

Common causes include:

• Post-nasal drip or sinus issues
• Asthma (including cough-type asthma)
• Acid reflux (including “silent” reflux)
• A sensitive airway (cough reflex becomes easily triggered)
• Irritants like dust, perfume, cold air, or smoke
• Certain medications

If all major causes have been checked, it may be chronic refractory cough, where the cough continues despite treatment.

You can encourage a review of all past tests and treatments with a specialist for your mum. Try to follow up with 1 specialist so that the doctor knows your mum’s condition well. Airway sensitivity or chronic refractory cough could be the cause. So, treatment usually focuses on managing symptoms rather than curing it completely.

You can also explore speech therapy for cough control, which is a proven treatment. Try to identify and avoid triggers such as dust, cold air, or certain foods, and keep a simple cough diary to note when the cough occurs or worsens.

If serious causes have been ruled out, the cough is often not dangerous. While it may not be fully curable, many people manage it well with the right treatment and support.

6. Question by Philip

Dear Dr Tan,

For about 3 years now, I am having phlegm that requires me to clear regularly by coughing.

At night, it drips and accumulates causing me to get up to cough. The phlegm doesn’t always clear and causes congestion that makes breathing very heavy and sometimes wheezing like asthma.

When I see a GP which I saw often, they always prescribe cold and cough medicine. But I don’t really have a cold. Sometimes they will prescribe nasal spray thinking that I have sinus. They even give me nasal wash with a pump. It doesn’t work. One GP gave me treatment for reflux.

Of all, the cold and cough medicine works but only a temporary relief.  The phlegm comes back again.  Sometimes the persistent cough causes pain in my throat.

When I have a bout of cough, I need cough drop or syrup to soothe the cough and give temporary relief so that I can sleep. But I don’t want to be dependent on cough syrup. May I know how I can receive proper treatment to clear the phlegm problem?

Appreciate your advice.

Answer by Dr Tan Teck Shi

Dear Philip,

Your symptoms sound like a long-term chronic cough with mucus or post-nasal drip, rather than a simple cold. Since this has been going on for 3 years despite treatment, it is understandable that it is frustrating.

From your description especially having mucus at night, wheezing, heavy breathing, and frequent coughing, causes including sinus or nose inflammation, asthma (including cough-type asthma), acid reflux, or a sensitive airway. Often, more than one factor may be involved.

It would be helpful to get a more detailed check-up, especially with a lung or ENT specialist if you have not done so. Tests for asthma, airway sensitivity, reflux, or sinus issues may be needed.

In the meantime, staying well hydrated, avoiding smoke and strong smells, sleeping with your head slightly raised, and using any prescribed nasal treatments regularly may help.

The good news is that long-term cough like this is often manageable once the main triggers are identified. It is good not to rely long term on cough syrups for relief, as these have side-effects and some are addictive. Cough syrups may help temporarily, but they do not treat the root cause, which is why the symptoms keep coming back.

7. Question by Jobina

Hi Dr Tan,

I have chronic cough for the past few years.

There are times where I will cough when transiting from one environment to another.

Examples: train platforms to train; from home to private hire vehicles such as Grab.

There are also times where there may be an urge to cough with no apparent trigger, usually in an indoor environment such as in the office.

I had done a nasal scope; chest X-ray and I have been cleared of TB etc. I have been diagnosed with “reflux “.

What else can I do to manage the cough besides cough lozenges? Thank you.

Answer by Dr Tan Teck Shi

Dear Jobina,

You report changes in environmental conditions as triggers such as moving from train platform to train or into air-conditioned rooms, setting off the cough reflex. These changes, such as dry air, changes in temperature, dust, can cause irritation and momentarily cause your airway muscles to contract and cause you to cough.

Try to wear a jacket or a scarf on the MRT train. Sip water regularly during your commute. If your nasal passages are irritated, you can use a saline nasal spray.

If you have frequent nasal symptoms like sneezing, running nose, you may have allergy rhinitis, which may be treated with a steroid nasal spray.

Reflux can also irritate the throat and make the cough more persistent.

You need to manage your reflux well, such as avoiding late meals, trigger foods, and lying down soon after eating, staying well hydrated, and avoiding strong smells, smoke, or sudden cold-air exposure where possible. If you have been prescribed with anti-reflux medication, try to take them consistently.

8. Question by Joyce

Hi Dr,

May I ask if coughing can be psychological? I get cough spells when I am nervous or when I eat food that is too salty or sweet. I can feel the back drip from behind my nose just before I get the coughing spells.

How do I get better? Thanks!

Answer by Dr Tan Teck Shi

Dear Joyce,

Yes, coughing can be influenced by stress or nervousness, but what you are describing sounds more like post-nasal drip with a sensitive cough reflex, rather than purely psychological cough.

The “drip from behind the nose” before coughing strongly suggests mucus from the nose or sinuses irritating your throat. This can be triggered by allergies, weather changes, certain foods, or even reflux.

Stress can also make the throat more sensitive and trigger cough more easily, so both physical and emotional factors can play a role.

To help improve this, you can:

• Use regular saline nasal rinses or prescribed nasal sprays consistently
• Avoid personal food triggers if you notice a pattern
• Stay well hydrated
• Try slow breathing or swallowing when you feel the urge to cough instead of coughing immediately
• Try relaxation techniques when you are stressed

If it persists or worsens, it is worth seeing a doctor again to review for post-nasal drip, reflux, or airway sensitivity, as these are treatable causes.

9. Question by Raphael

Hi Dr,

I suffer from excess mucus and or phlegm discharge for many years and was treated at a specialist clinic but the condition persist.

It seems to come just as I am about to eat a meal or sometimes in cold air-conditioning. Actually I can't say when it comes as sometimes very random.

It's embarrassing for social events and I always have a shoulder bag to carry a large amount of tissues and plastic bags to dispose of used tissues. It's also a post-nasal drip. Am I a hopeless case? Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Raphael,

You are definitely not a hopeless case. Long-term excess mucus and post-nasal drip can be very persistent and frustrating, especially when it affects daily life, but it is usually manageable, even if it does not fully “go away” with one treatment.

What you describe, where mucus occurring randomly, worsening in cold air-conditioning or before meals, and diagnosed as post-nasal drip, often suggests chronic nasal inflammation or an over-sensitive nasal reflex.

Common causes include long-term nasal irritation (allergic or non-allergic), sinus issues, acid reflux (sometimes without obvious symptoms), and triggers like cold air or strong smells. Often, more than one factor is involved.

I suggest you can try to keep warm in an air-conditioned room. You may need to see a specialist to check if you have a food related rhinitis condition. If you know that certain food cause the reaction, you may have to avoid that food. Certain food such as acidic food (e.g. citrus fruits) may also irritate the back of the throat causing cough. Antihistamines can be taken to prevent the symptoms.

Treatment usually focuses on long-term control. This may include regular use of steroid nasal sprays (if prescribed), saline rinses, and managing reflux if present. It is important for you to use your medications regularly.

I do hope you will improve and enjoy your food without embarrassment! 

10. Question by Albert

Hi Dr,

I noticed that my irritating cough is induced by mucus flowing from my nose to my throat. I have used nasal sprays but the effect is limited. My cough now seem to cause heavy chest movements. What can be done? Thank you.

Answer by Dr Tan Teck Shi

Dear Albert,

What you describe sounds like post-nasal drip, where mucus from the nose flows into the throat and causes coughing. This is a common cause of long-term cough.

If nasal sprays help only a little, it may mean the underlying nasal inflammation is not fully controlled yet, or there are other contributing factors such as allergies, sinus inflammation, or reflux.

The “heavy chest movements” during coughing can happen from repeated coughing, but if you also have wheezing, tightness, or breathlessness, it is important to get yourself check to rule out asthma or airway sensitivity.

What you can do:

• Use nasal sprays consistently and regularly (they take time to work)
• Add saline nasal rinses to clear mucus
• Avoid triggers like dust, smoke, strong smells, and cold air-conditioning
• Stay well-hydrated to thin mucus
• Observe if symptoms worsen after meals or lying down (possible reflux)

If symptoms persist or worsen, especially with chest symptoms or sleep disturbance, it is worth re-visiting a doctor to check for sinus issues, cough-variant asthma, reflux, or airway hypersensitivity. Often, a combination of treatments is needed rather than nasal spray alone.

Ref: F26