Advice after your nerve block for surgery
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What is chronic cough?
Chronic cough describes a cough which has persisted for some time, and/or has been resistant to treatment. Some people have a chronic cough for weeks or months, other people for years.
A common factor in chronic cough is cough hypersensitivity, sometimes referred to as cough reflex hypersensitivity, laryngeal hypersensitivity or cough hypersensitivity syndrome.
What causes cough hypersensitivity?
There may be underlying medical causes for a chronic cough, such as respiratory condition, post-nasal drip or acid reflux, but cough hypersensitivity can occur on its own. There is usually an initial trigger for the cough, such as a cold or chest infection, but sometimes a cough persists even after the initial trigger has resolved.
Coughing is a reflex controlled by a nerve response. When you cough repeatedly it can result in ‘overstimulation’ of the nerve, causing the nerve to become hypersensitive, which means it triggers more frequently than normal. A number of factors, including viruses and certain medications, can also have a direct impact on the cough reflex nerve, making it more sensitive.
Repeated coughing causes the vocal cords to ‘bash together’, which irritates them. It also causes tension in the muscles of your throat. This irritation and tension can make you want to cough or clear your throat more, and can cause a sensation of throat tightness, something stuck in your throat, or a hoarse voice.
How is cough hypersensitivity diagnosed?
Cough hypersensitivity will be diagnosed after detailed assessment of your symptoms and their history. Initially, your lungs will be investigated in case there is an underlying respiratory cause. You may also be investigated for acid reflux. You are then likely to be referred to a specialist speech and language therapist for cough therapy.
You may not have heard the term cough hypersensitivity syndrome before. This is because it is a relatively new diagnosis, which is still being researched and understood.
What treatment is there for cough hypersensitivity?
Cough hypersensitivity is often not responsive to medications. If you have been prescribed medicines that haven’t helped, speak to your doctor about stopping them. If reflux is suspected, it is important to follow dietary and lifestyle advice, as well as taking prescribed medication.
Often the most effective treatment for cough hypersensitivity is behavioural strategies designed to help ‘break the cycle’ of repeated coughing. If you can stop yourself from coughing, this reduces the overstimulation and hypersensitivity of the nerve, which reduces the amount of coughing.
Understanding the nature of chronic cough will help you considerably. You may that you have no control over your cough, but this information can help give you back a sense of control, which will greatly help the success of your treatment.
Cough control strategies
Follow these strategies consistently, every time you want to cough.
- When you feel the urge to cough, try to stop yourself and swallow instead
- If you have a drink (preferably water) to hand, take a sip of fluid instead of coughing. You should aim to sip water continually throughout the day
- Blow out through tightly pursed lips. If there is an irritation or tickle in the throat, this can help dissipate it
- Sniff inwards gently through your nose, then swallow or blow out as above. You can cycle this over – sniff, blow, sniff, blow…
- Press your tongue against the roof of your mouth, count to five and then swallow
- Sucking a sugar-free sweet or chewing sugar-free gum will encourage swallowing, soothe your throat, and give your brain a different sensation to focus on
- Relax and breathe slowly and calmly through your nose
- If you do have to cough, use a ‘huff’ or quiet ‘pop’ of air – then swallow or sip fluid, to minimise irritation to the throat
With time and persistence, these strategies should help you to reduce the amount you are coughing.
Contact us
If you have any queries relating to this information, please contact the Speech and language therapy service.
About this information
Service:
Speech and language therapy
Reference:
VV/029
Approval date:
27 September 2024
Review date:
1 September 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.