Prolonged Cough (Chronic Cough): What to Do - 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.

11. Question by YC

Hi Dr Tan,

I have had cough, itchy/bad sore throat that come and go the past weeks. I have visited GP for 3 times and recovered earlier, completed 1 session of antibiotics after 2nd visits to GP but after a while and now, cough with phlegm recurs at times.

Should I start another course of antibiotic given by my GP to fully recover. Phlegm is white colour. My chest may feel tight when wake up in the morning at times but no breathing issue.

For your advice please.

Answer by Dr Tan Teck Shi

Dear YC,

A cough and sore/itchy throat can linger for a few weeks after a viral illness, and white phlegm is usually less concerning and does not always require antibiotics.

Do you have nasal symptoms? If symptoms keep recurring, it could be due to allergies, post-nasal drip, sensitive airways, or acid reflux rather than infection, so a review would be helpful, and appropriate medications could be prescribed. A chest X-ray may also be indicated if the cough has been ongoing for the past few weeks.

Do seek urgent care if you have difficulty breathing or severe chest tightness, chest pain, bloody phlegm, persistent fever and weight loss.

For now, you can:

• Drink plenty of fluids
• Take warm drinks or honey to soothe your throat
• Rest well
• Avoid smoke, cold drinks, or other irritants
• Monitor your symptoms over the next few days

12. Question by KK Pang

Good morning doctor,

My wife has been suffering from chronic cough with phlegm for more than a year.

Every morning at around 6 am, she starts coughing with phlegm, this will repeat almost every hour till about 12 noon.

At night from 7 pm to midnight again almost every hour stated coughing with phlegm again.

During sleep about 2 or 3 times when waking up to urinate again cough with phlegm. Sometimes the cough is so severe that her urine leaks.

Went to a Lung Clinic to do all the exhaustive tests and change to more stronger medication, but no improvement, also referred to digestive clinic, but the new medication and tests also did not improve, also referred to the clinic to test for thyroid problems but turns out ok, also sent for speech therapy but cannot find anything wrong, finally after about more than 6 months investigation and treatment, the lung clinic doctor said since cannot find anything wrong, so put on open appointment.

My wife has gastric reflex also used asthma medicine, take cholesterol medication. She also has 2 main heart veins 59% blocked, she also has 2 times piles operation.

She has been very careful about her diet, take apple and papaya every day, take vegetables every day, avoid fried food, request for less oil, less salt in her food, do not smoke or drink.

Hope you can enlighten me what to do. Thank you.

Answer by Dr Tan Teck Shi

Dear KK Pang,

It is reassuring that she has already undergone detailed checks by the lung, digestive, thyroid and speech therapy teams, and no serious disease was found.

A chronic cough lasting over a year is often due to multiple factors rather than a single cause. Common contributors include gastric reflux, sensitive airways/asthma, post-nasal drip, throat irritation, or medication side effects.

You may wish to discuss with her doctor whether any medications (especially for heart or blood pressure) could be contributing, and whether her current medications can be optimised. For urine leakage during severe coughing, pelvic floor exercises or continence support may help.

If she is diagnosed with asthma, it is important for her to be regular with her inhalers and ensure that she is inhaling the medications correctly. If her asthma is well controlled, her cough may also improve. A lung function test known as spirometry can be helpful to determine the status of her asthma.

Seek medical attention earlier if she develops shortness of breath, chest pain, coughing blood, weight loss, fever, or worsening symptoms.

As the symptoms are persistent and affecting her quality of life, it may also be reasonable to seek a second opinion from another respiratory specialist for a fresh review and other treatment options.

Take care and wishing your wife improvement soon.

13. Question by KT

Dear Doctor,

I am a generally healthy 76-year-old male with no chronic conditions except that I am on statin drugs for cholesterol reduction.

My problem is that I get phlegm in the throat every time I have a meal. I have to cough it out after finishing every meal and it annoys my wife.

Also, if the food is hot or warm, my nose starts watering to a small extent.

I have no chronic cough or asthma although I have sleep apnoea which I manage by taping my mouth at night.

Could you please advise if there is any treatment that I should follow including over-the-counter medication or any particular Chinese medicine to overcome this problem?

Appreciate your advice.

Answer by Dr Tan Teck Shi

Dear KT,

Despite your symptoms, you are otherwise well without chronic cough, fever, breathing difficulty or weight loss.

The feeling of phlegm in the throat after meals is quite common in older adults and can sometimes be related to, acid reflux, post-nasal drip, or increased mucus production triggered by eating. The nose watering when eating hot or warm food is also a common condition known as “gustatory rhinitis”, where certain food or heat stimulate the nose to produce more mucus. This is usually harmless.

You may try a few simple measures first. Eating more slowly, taking smaller bites, and avoiding very hot foods or drinks may help reduce symptoms. Drinking some warm water after meals may also help clear the throat. It may also help to reduce spicy foods, alcohol, or very oily meals if you notice these make symptoms worse.

For over-the-counter options, a simple saline nasal spray or antihistamine may sometimes help if there is significant nasal mucus or post-nasal drip. However, it is best to discuss with a pharmacist or doctor. Antihistamines and nasal sprays in particular may help. 

Regarding Chinese medicine, some people do find relief with traditional remedies, but it is important to consult a registered TCM practitioner rather than self-medicating, especially to avoid interactions with your current medication.

Sleep apnoea can cause a dry throat, throat irritation and cough. Taping the mouth is unlikely to work. You should see a sleep doctor, have a sleep test done, and consider treatment like dental devices or using a CPAP (continuous positive airway pressure) machine to help you sleep better.

14. Question by Johanen

Dear Dr,

I am a Chinese male 76 years. I have persistent cough for many years.

Itchiness on the throat. If serious, the cough will produce phlegm on my nose and drip down. It will last for one or two weeks. After recovering, it comes back gain. I have visited the polyclinic and GP. Please advise.

Answer by Dr Tan Teck Shi

Dear Johanen,

Your symptoms of throat itchiness, cough with mucus from the nose, and recurring episodes, suggest post-nasal drip, where mucus from the nose/sinuses irritates the throat. This can be triggered by allergies, sinus issues, dust, weather changes, or sensitive airways. Other possible causes include acid reflux, mild asthma, or chronic throat irritation.

You can try simple measures such as staying well hydrated, avoiding cold or irritating foods, reducing exposure to dust or smoke, and getting enough rest. Saline nasal rinses or allergy medications may help if nasal mucus is contributing. Some of these medications may need to be continued on a long-term basis.

Since the symptoms have been ongoing for many years, it may be helpful to ask your doctor whether further assessment by an ENT (ear, nose and throat) specialist or respiratory specialist is needed, especially if this has not already been done.

Please seek medical attention earlier if you develop shortness of breath, chest pain, coughing blood, fever, weight loss, or worsening symptoms.

15. Question by Ben

Dear Dr Tan,

I have had chronic cough for about 20 years with occasional cough syncope/fainting.

I have been followed by Respiratory, ENT and Gastro previously and was told reflux/acid-related cough is likely. I have been taking omeprazole long term.

The cough can flare up suddenly even when swallowing saliva, and chilli/spicy food can trigger it easily.

I would like an assessment for possible LPR (silent reflux), cough hypersensitivity syndrome or neurogenic/vagal cough, and whether there are newer treatment options besides long-term omeprazole?

Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Ben,

Reflux-related or “silent reflux” (LPR) remains a possible cause, especially as coughing is triggered by swallowing saliva and spicy foods. Over time, the cough reflex can become overly sensitive (cough hypersensitivity or neurogenic cough), where triggers like talking, swallowing, cold air, smells or certain foods easily provoke coughing. While omeprazole reduces stomach acid, symptoms may persist if throat nerves remain sensitive.

It also helps to avoid spicy foods, late meals, overeating, alcohol, and lying flat after meals, and to sleep with your head slightly elevated.

As you have experienced cough fainting before, it is important to be careful during severe coughing episodes and seek medical review if the fainting becomes more frequent, prolonged, or associated with chest pain, palpitations or breathlessness.

A review with a respiratory or ENT specialist experienced in chronic cough may be helpful. You may wish to discuss with your doctor about assessment for LPR or cough hypersensitivity. Possible approaches include speech therapy for cough control, stricter reflux measures, medication adjustment, or selected nerve-calming medications or newer treatments available.

16. Question by David

Hi Dr,

The last time I had a cough it lasted awhile. I had to see my GP twice in the interval of 2 weeks. In my last visit my GP told me there is such thing as 100 days cough. My question is - Is there such a thing? After more than 3 weeks it somehow became better.

Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear David,

Yes, the “100-day cough” refers to a cough that can last for weeks after a viral infection, even after recovery. This is usually due to lingering airway irritation and can persist on and off for up to 2–3 months without meaning a serious infection or need for antibiotics. Common causes include post-viral cough, as well as allergies, post-nasal drip, acid reflux, or sensitive airways.

It is reassuring that your symptoms improved after about 3 weeks, which is a common pattern. However, see a doctor if you develop shortness of breath, chest pain, coughing blood, high fever, weight loss, wheezing, or if the cough worsens.

In the meantime, staying well hydrated, avoiding smoke or irritants, and getting enough rest can help recovery.

In the medical literature, 100 days cough usually refers to pertussis, otherwise known as “whooping cough”. It is caused by a bacterium. It is characterised by severe paroxysmal cough usually in the second week of illness, this may be followed by a “whooping sound and then vomiting. It may be the cause of a substantial portion of prolonged cough in adolescents and adults.

17. Question by Yong

Dear Doctor,

I don’t know why when I enter an aircon room with cooler temperature, I get a throat irritation causing me to cough a bit. Similarly, when I turn on the aircon in the car, I also feel throat irritation and cough. The cough is mild and there is no phlegm. Thank you.

Answer by Dr Tan Teck Shi

Dear Yong,

This is quite common and usually due to the throat and airways being sensitive to cold, dry air from air-conditioning.

Cold air can irritate the throat or trigger a mild sensitive airway response, causing discomfort and a light cough. This is more likely in people with allergies, sinus issues, post-nasal drip, acid reflux, or sensitive airways, even without asthma.

As your cough is mild and without phlegm, fever, or breathing difficulty, it does not suggest a serious infection.

You may try a few simple measures such as avoiding very cold air-conditioning settings, keeping yourself well hydrated, and avoiding direct cold air blowing onto your face or throat. Some people also find that sipping warm water helps reduce throat irritation. If you often have nasal congestion, sneezing, throat clearing or reflux symptoms, treating these conditions may also help reduce the cough.

Please see a doctor if the cough becomes persistent, produces phlegm or blood, causes breathlessness, wheezing, chest pain, or starts affecting your daily activities.

18. Question by Alice

Dear Dr Tan,

I frequently have dry and irritating cough and was diagnosed as viral infection. I had it quite often. How can I manage it as I affects my sleep.

Do I need to see an ENT doctor or a specialist on cough?

Hope to hear from you soon. Thank you.

Answer by Dr Tan Teck Shi

Dear Alice,

A recurring dry, irritating cough can be very troublesome, especially when it disrupts sleep. If it is often attributed to viral infections, your airways may simply be taking longer to recover and remain sensitive. However, frequent or recurrent coughs can also be linked to allergies, post-nasal drip, acid reflux, sensitive airways, or mild asthma.

To reduce symptoms, stay well hydrated, avoid smoke and cold air, and limit trigger foods or drinks. Warm drinks or honey may soothe the throat, and sleeping slightly propped up can help, especially if reflux is involved.

Most of these symptoms can be treated by your GP, If symptoms are frequent, affect sleep, or persist despite treatment, consider seeing a specialist — ENT for throat/sinus issues, or respiratory for airway causes.

Please seek medical attention sooner if you develop fever, shortness of breath, wheezing, chest pain, coughing blood, weight loss, or worsening symptoms.

19. Question by Ros

Hi Dr,

How does one take care of oneself for chronic cough? Does any of these help?

a) Foods to avoid?

b) Beneficial foods to eat often?

c) What exercises to do?

d) What vitamins or fruits are necessary?

e) Should I wear mask everywhere?

Many thanks.

Answer by Dr Tan Teck Shi

Dear Ros,

Thanks for your interesting questions.

For chronic cough, there is usually no single “special food” or supplement that can cure it. It is often due to underlying causes like post-nasal drip, acid reflux, asthma/sensitive airways, or throat irritation, so the focus is on reducing triggers and keeping the airways calm.

For food to avoid, it helps to cut down on things that commonly irritate the throat or worsen reflux. These include very spicy foods, oily or fried foods, alcohol, and late-night heavy meals. Some people also find that very cold drinks or strong menthol products can trigger coughing.

For beneficial food, there is no specific “must eat” item, but a balanced diet with fruits, vegetables, and adequate hydration is helpful. Warm fluids such as water or soup can soothe the throat, and honey may help reduce irritation in some people.

There are no specific exercises that directly cure cough, but if the cough is related to reflux or airway sensitivity, breathing exercises, voice therapy techniques, or cough suppression techniques taught by speech therapists can be useful. Regular gentle exercise like walking is also generally beneficial for overall lung and throat health.

Vitamins are not usually necessary unless you have a deficiency. Taking normal fruit and a balanced diet is sufficient. High-dose supplements have not been shown to directly improve chronic cough in most people.

Wearing a mask everywhere is not required. However, it can be helpful in specific situations such as exposure to dust, cold air, smoke, or strong smells that trigger your cough.

If the cough persists for more than a few weeks, keeps recurring, or affects your sleep or daily life, it is important to see a doctor to identify the underlying cause, as treatment depends on the cause rather than general supplements or diet alone.

20. Question by Sally

Dear Dr Tan,

I have been having cough and itchy throat that leads to coughing so badly that I had fall when I was retching.

I even lost my voice in between of conversations with pt. Tried omperazone for a month but not better, has few nasal sprays too

Have seen respiratory and ENT specialists but all tests, CT CHEST, spirometry, challenge test n TB, blood tests all negative. Seen ENT done 2 scopes, my throat are ok too

Both specialists said nothing can help me and wanted just to discharge me which I refused, and kept it open.

I even went to see TCM but not better and now taking Indian borges with hot water for few day , though not better but will try for 2 weeks before giving it up.

Is the itchiness that really kills me as once cough, feel breathless and cough hard for air to pass.

Kindly advise and many thanks.

Answer by Dr Tan Teck Shi

Dear Sally,

Sorry to hear about your experiences trying to cope with your chronic cough.

It is reassuring that your extensive tests - CT chest, lung function, bronchial challenge, TB screening, blood tests, and ENT scopes, are all normal, making serious lung disease or infection unlikely.

When investigations are normal, but the cough is severe and persistent, one possible cause is chronic cough hypersensitivity, where the cough reflex becomes overly sensitive to minor triggers like throat irritation, talking, or cold air. Some people also develop laryngeal or nerve-related cough after repeated irritation, which can feel severe but is not due to ongoing lung damage.

Treatment is different from standard cough remedies and may include cough-control techniques (e.g. speech therapy), medications to calm nerve sensitivity in selected cases, and strict trigger management. Reflux or nasal treatments may help but may not fully resolve symptoms on their own.

As your cough can cause falls and breathlessness, safety is important. Sit down when an episode starts, and seek urgent care if you have prolonged breathlessness, chest pain, or fainting.

As your case has already been thoroughly investigated by specialists, it may still be worthwhile to seek a review with a specialist experienced in chronic refractory cough, as newer treatments are available. While TCM may provide some relief, avoid relying on it alone for severe symptoms.

Although your condition can be very frustrating, you must stay positive, there are still management options that focus on calming the cough reflex rather than treating infection or inflammation alone.

21. Question by Anna

Hi Dr, 

On 16 May 26, I started with cough and runny nose. One week later, was prescribed flu and phlegm medications by a Polyclinic doctor. I have recovered from flu but noticed I cough occasionally. Can you explain what classifies as ‘chronic cough’? Thank you.

Answer by Dr Tan Teck Shi

Dear Anna,

What you are experiencing now is quite common after a viral infection like the flu.

In medical terms, a “chronic cough” means a cough that lasts more than 8 weeks. Based on your timeline (starting on 16 May and now happening only occasionally), this still looks like a normal recovery cough rather than a chronic one.

After a flu, your airways can stay sensitive for a while. This can cause an occasional dry cough, or coughing triggered by things like cold air, talking, or laughing. Some people also notice mild throat irritation or a feeling of mucus at the back of the nose even after they have recovered. The cough can last for weeks as your airways slowly heal.

We are concerned if your cough starts getting worse instead of improving. Warning signs to watch for include shortness of breath, wheezing, coughing up blood, ongoing fever, unexplained weight loss, or night sweats. Also, If your cough persists, it would be a good idea to see a doctor to check for other causes such as sinus drip, sensitive airways, asthma, or acid reflux.

For now, you can try drinking plenty of warm fluids, avoiding irritants like smoke, strong smells, and very cold air, and taking a bit of honey to soothe your throat if it is suitable for you. Overall, what you are experiencing fits well with normal recovery after a viral infection, and it should continue to improve gradually.

22. Question by Tina

Hi Dr,

My cough has no phlegm but it tickles my throat and I begin to cough sporadically thus causing urine leaks so I wear panty liners. How to prevent this ticklish throat sensation? Thank you.

Answer by Dr Tan Teck Shi

Dear Tina,

That “ticklish” feeling that makes you cough is usually due to lingering irritation after a viral infection, some mucus dripping down the back of your nose, or airways that are still a bit reactive.

To help prevent the cough, the main idea is to keep your throat comfortable and avoid things that trigger it. Try to sip water regularly throughout the day instead of waiting until your throat feels dry. Warm drinks can be especially soothing. Taking a bit of honey, especially before bed (if suitable for you), may also help calm the throat.

If you often feel like you need to clear your throat or notice mucus at the back of your nose, rinsing your nose with saline or using a nasal spray can help reduce this “drip,” which is a common cause of that tickly sensation. It is also helpful to avoid triggers like cold air, strong perfumes, smoke, and very dry environments, as these can easily set off coughing when your throat is sensitive.

As for the urine leakage, this is actually quite common when coughing puts pressure on the pelvic area. Wearing liners is a practical short-term option. Over time, doing simple pelvic floor (Kegel) exercises can help improve control. Do come to the clinic for further consultation if the problem persists.

If the cough continues for several more weeks or becomes more frequent, it would be worth seeing a doctor to check for other possible causes like sinus drainage, sensitive airways (similar to asthma), or acid reflux.

23. Question by Charis

Dear Doctor,

I am currently having the worst bout of cough and phlegm ever, having coughed for 12 weeks already.

Now I still have to cough out phlegm every afternoon after having my first meal of the day, though the volume is not as much, but it is still disruptive to my life — I have to stop teaching to run to the toilet to cough out phlegm, wear mask in aircon places to prevent triggering cough… Please advise what to do to fully recover? Thank you.

In the first week, I might have had mild fever for 1 or 2 days, but no more after that. The phlegm has been white and thin, then turned green and thick, now back to white again.

I was getting a bit better in the 3rd week, but the haze irritated my throat.

In the 5th week, I saw polyclinic doctor who gave amoxicillin. The cough only marginally improved. My nose was very blocked so pharmacist recommended using nasal spray daily, which helped somewhat.

In the 9th week, I saw TCM as I was going overseas. I have been slowly improving daily. But till now still coughing now and then, and have to manage my diet strictly too.

I have no wheezing or breathlessness throughout.

Do I need to see lung specialist to check what’s wrong? The polyclinic doctor had mentioned this action if I did not recover after antibiotics.

Thank you for your advice.

Answer by Dr Tan Teck Shi

Dear Charis,

It is understandably frustrating, especially when it affects your teaching and daily routine.

The reassuring part is that you do not have symptoms like breathlessness or wheezing, and overall, it seems to be slowly improving. This pattern usually points away from anything serious and more towards a few common, treatable causes.

From your history, the most likely reasons for your cough are:

• your airways still being sensitive after the initial viral infection
• mucus dripping down from the nose (post-nasal drip), especially since you had nasal blockage and some improvement with nasal spray
• possibly some irritation after meals due to gastro-eosphageal reflux, since your cough tends to be worse after your first meal of the day

The change in your phlegm colour from white to green and back to white, could mean that you had a repeat infection. It is a good sign that your cough has been gradually improving over time, including with nasal treatment.

Do visit a polyclinic for a review. They may consider doing a chest X-ray if you have not had one yet. Specific treatment for allergic rhinitis includes a steroid nasal spray and for acid reflux, acid inhibiting medications. At the polyclinic, we can also carry out a simple office lung function tests to look for asthma, if needed. A referral to a lung specialist can be considered.

Since you are already improving, the focus should be on helping your airways heal and avoiding triggers. Continue using any nasal treatment if prescribed, drink plenty of fluids, and try to avoid things that can trigger your cough, such as cold air, haze, strong smells, and possibly heavy meals. Eating smaller, lighter meals earlier in the day may also help reduce coughing after eating.

24. Question by Jeremy

Dear Doctor,

I am in my 40s and have a history of having very persistent cough since I was a child and an episode typically last 2-3 months if I am lucky, 5-6 months if not.

I'm worried if this will affect me when I'm at an advanced age when my body can no longer handle persistent coughing. Are my worries called for?

The past 1-2 years I noticed something different about my cough, at times the cough leads to a gag reflex especially after a meal. It becomes a vicious cycle as the cough leads to a worsening itchy throat which leads to more cough culminating in the gag reflex setting in. In addition, the phlegm produced is now very thick, so thick that i cannot expel the phlegm by the usual coughing.

As coughing is a symptom, I would like to know if there are any tests that can be done to identify the root cause of the cough?

Based on my recent coughing experience, is it normal for me to have my cough 'evolve' to one with thick phlegm and gag reflex vs the cough I used to have when I was younger?

Many thanks for your time and advice.

Answer by Dr Tan Teck Shi

Dear Jeremy,

The cough has been going on for a long time, so it is completely understandable that you are concerned, especially since it keeps coming back and affects your daily life.

The most common causes for chronic cough include:

• sensitive airways (a mild form of asthma where cough is the main symptom)
• mucus dripping from the nose or sinuses down the throat (often called post-nasal drip)
• acid reflux, where stomach acid irritates the throat

Sometimes, more than one of these can happen together, which is why the cough keeps coming back and is hard to fully get rid of.

Your symptoms have been getting worse recently, to find out the exact cause, there are some simple tests that can help.

These may include:

• a chest X-ray to check the lungs
• breathing tests to see if your airways are sensitive (like asthma)
• sometimes a test to look at airway inflammation
• an ENT (ear, nose, throat) check if sinus or nasal issues are suspected
• in some cases, assessing for reflux
• lung scan

The best next step would be to see a GP or a lung specialist for a more thorough and structured evaluation. The aim would be to identify the main causes of your cough and treat them properly, rather than just managing the symptoms each time it flares up.

Some patients may need more advanced tests like a lung scan. With the right assessment and treatment, there is a good chance of improving your symptoms and quality of life.

Ref: F26