A persistent cough that won’t go away, even with medication, can be frustrating. – By dr Harold Gunatillake

A persistent cough that won’t go away, even with medication, can be frustrating. – By dr Harold Gunatillake

A reader from Canada reports he has had a persistent cough for the past two months. He went to the hospital, had X-rays done, and was diagnosed with pneumonia. He was prescribed amoxicillin, but unfortunately, nothing has improved. The cough remains constant, causing sleepless nights, and I am now seeking some friendly advice.

For a persistent cough lasting a month (a “chronic cough”), treatment focuses on identifying and managing the underlying trigger. The most common causes are postnasal drip, asthma, acid reflux (GERD),

Additional possible causes include lingering bacterial or viral infections, exposure to environmental irritants (like dust or secondhand smoke), or Chronic Obstructive Pulmonary Disease (COPD).

I think this lingering cough might be due to postnasal drip, which can tickle the back of your throat and trigger a cough. It can also be more noticeable when you’re lying down.

Dealing with a post-nasal drip cough can be uncomfortable, but there are simple ways to feel better. You might find relief by using a saline nasal rinse, drinking plenty of fluids, and trying a spoonful of honey to calm your cough. Sucking on lozenges like Strepsils can also help soothe your throat and make you feel more comfortable.

Rikodeine is an opioid-based oral liquid used primarily to treat stubborn, dry (unproductive) coughs. Its active ingredients are dihydrocodeine tartrate and sorbitol.

(Warning: Severe Interactions: Mixing Rikodeine with alcohol, sleeping tablets, antihistamines, or other sedatives can cause coma or fatal respiratory failure.)

Sometimes warm water saline gargles can do the trick.

Valmee Syrup, also called Athimadura or Welmee syrup, is a cherished Ayurvedic herbal remedy that’s wonderfully comforting for sore throats, calming coughs, and supporting respiratory health. Made mainly from liquorice extract (Glycyrrhiza glabra), it is readily available at Ayurvedic medicine shops across Sri Lanka. Many families find that biting into valmee roots and sucking the saliva can be a natural and effective remedy for chronic irritating coughs.

Bronchodilators are medicines that help relax the smooth muscles around your airways (the bronchial tubes) in your lungs. By opening these air passages, they make it easier to breathe, reduce chest tightness and shortness of breath, and help clear mucus. These medications are mainly used to manage conditions such as asthma and chronic obstructive pulmonary disease (COPD).

Albuterol is widely known and frequently prescribed as a handy bronchodilator. It falls under the category of short-acting beta-2 agonists (SABAs). It serves as a reliable “rescue inhaler” to quickly relax airway smooth muscle and ease breathing during sudden asthma or COPD episodes.

It’s a great idea to talk to your chemist about the bronchodilators available in your area. They can assist you in finding the best options suited to your needs. Ventolin inhaler sprays are quite popular, especially for managing asthma attacks.

If you’re coughing up thick, productive mucus, taking mucolytic tablets like Bisolven can really help clear things up.

For unexplained or refractory chronic cough (coughing lasting longer than 8 weeks despite treatment of common causes), the most significant medical breakthrough has been the development of P2X3 receptor antagonists. These drugs work by desensitising the sensory nerves in the airways that trigger the coughing reflex.

Gefapixant is the most extensively studied drug in this class. Although it has undergone Phase III clinical trials for chronic cough, there have been hurdles in regulatory approval and in managing side effects. Eliapixant and Sivopixant are newer medications designed to be more selective for the P2X3 receptor, thereby reducing unwanted side effects. BLU-5937 is another highly selective P2X3 antagonist being explored as a potential treatment for refractory chronic cough.

Try propping your head up with an extra pillow while sleeping. This simple trick can help prevent mucus from pooling at the back of your throat, making you feel more comfortable and rested.

Because the drip comes from the nasal lining, using corticosteroid sprays like fluticasone or Rhinocort can help dry out the mucosa, which offers quick relief.

My best remedy when I can’t sleep with a chronic dry cough is a good shot of cognac- it works for me.

End