What could be the cause of chronic cough at night and in early morning? How can I stop the cough?

Doctor's Answers 1

Thank you for your question. I’m sorry to hear that your mother is suffering from a prolonged and problematic cough which can be a complex condition.

Coughing is a reflex that protects your upper airway and lungs from irritants such as excessive mucous and foreign bodies. When persistent, it is often a symptom of a condition, ranging from conditions arising from the nose & sinuses (e.g sensitive nose, sinus infections), lungs (e.g asthma and bronchitis), throat and stomach (e.g. acid reflux from the stomach) to side effects from medications or smoking.

If the source of the cough is not found, it is difficult to treat. It would be beyond the scope of this Q&A to address all possible causes of prolonged cough.

The majority of prolonged coughs are due to:

  1. Postnasal drip
  2. Acid reflux
  3. Asthma
  4. Bronchitis
  5. Smoking
  6. Side effects from medications.

Since it seems that your mother has been cleared by a Respiratory Physician, we will discuss cough from irritation of the voicebox.

This is usually due to postnasal drip (back drip of mucous from nose allergy or sinus infection) or acid reflux from the stomach.

As the voicebox is a very sensitve organ, once inflamed, it can take months for the inflammation to resolve. It is important to remove the sources of irritation while waiting for inflammation of of the voicebox to resolve.

Since your mum has seen an ENT Specialist and was given an acid suppressant medication (Nexium) and nasal steroid sprays (to treat sensitive nose or nose allergies), it is important to ensure good compliance with these medications.

The importance of compliance with nasal steroid sprays is often overlooked by many patients. It can take days to weeks for nasal steroid sprays to reduce the mucous in the nose and postnasal drip (which may be a possible source of irritant of your mother’s cough).

Apart from taking Nexium, it is also just as important to ensure that your mother adheres to antireflux measures (e.g no food/drinks 3-4 hours before sleeping, taking small meals and avoiding reflux causing or “heaty” food).

If your mother has done all that I’ve mentioned above, it may also be worthwhile to get her doctor to examine the medications that she is taking (one of the common blood pressure medication can cause cough as a side effect).

Exposure to cigarette smoke can also persistently irritate the voicebox and prevent a full recovery. As your mother’s cough started after a chest infection, she may also have “Postinfectious Cough”, of which the reason is unfortunately unknown.

Some studies attribute this to excessive inflammation of the upper and lower airway after an infection, resulting in a persistent overproduction of mucous. This is difficult to treat and often needs mucous thinners/expectorants and cough medications to keep the symptoms under control or bearable.

If your mother’s cough is accompanied by a whooping inspiratory sound or leads to vomiting, she may need to revisit the Respiratory Physician to rule out infection that is due to B pertusis bacterial infection.

Hope this helps and all the best.

Similar Questions

Could I have throat cancer if I have a persistent sensation in throat?

Thank you for your question. From the clinical history that you provided, I agree with the doctor whom you saw and with Dr Winston Lee that your symptoms are suggestive of acid reflux from the stomach. Specifically, since your symptoms are mostly in the throat, it is called Laryngopharyngeal Reflux (LPR). The most likely reason that you have a feeling of something stuck in the throat or a feeling of a “lump” in the throat (aka as globus sensation) is due to swelling of the voicebox (larynx).

Photo of Dr Eng Cern Gan

Answered By

Dr Eng Cern Gan

ENT Doctor

What could be cause of episodic, violent coughing?

Thank you for your question. Coughing during or after a cold is often due to postnasal drip (nose mucous dripping down the back of the throat, causing irritation and inflammation of the voice box). The voice box (medical term is larynx) is a very sensitive organ. Once inflamed, minor irritations of the voicebox (e. g from mucous, phelgm, saliva and in some people even a breath of dirty/cold air) will easily trigger a cough reflex. It takes time for the inflammation of the voice box to settle and often, treating conditions of the nose and acid reflux from the stomach may help.

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Answered By

Dr Eng Cern Gan

ENT Doctor

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