It’s not normal to cough persistently. Get treated ASAP. By Estelle Low

If you’ve been coughing for more than eight weeks, seek medical attention. Photo: jedimaster /

For weeks, it has caused you sleepless nights, a sore chest… and maybe even to leak pee. But that’s not all. Besides being plain annoying, those endless bouts of hacking could be a sign of an underlying disease.

“Anyone coughing for more than eight weeks should seek medical attention,” says Dr Imran Mohamed Noor, a consultant with the Department of Respiratory Medicine at Changi General Hospital (CGH). Accompanying symptoms like fever and shortness of breath suggest a more serious condition, he adds. Here, experts shed light on common causes of a chronic cough, and what to do about it.

1. Tuberculosis

When an infectious person coughs or sneezes, a germ called Mycobacterium tuberculosis is spread through expelled droplets. This germ, which develops into a disease in about 10 per cent of the infected, can stay dormant in others for years, according to the Health Promotion Board (HPB). Obvious signs of infection are a cough lasting longer than three weeks, coughing up blood, constant fatigue, fever, chest pain and weight loss. People with weakened immune systems are at a higher risk.

Fix it:  See a doctor right away if you experience the above symptoms. You will need to undergo a chest X-ray and further tests to confirm the diagnosis. Treatment involves a course of medication for six to nine months. Stay at home during the first few weeks and cover your mouth when you cough or sneeze. If not treated early, tuberculosis can cause permanent lung damage – or spread to other parts of the body such as the bones, brain and central nervous system – and lead to life-threatening complications.

(Also read: 4 Things to Know About Tuberculosis Infections)

2. Mycoplasma infection

This bacterial infection is transmitted through close contact with infected people, says Dr John Law, a respiratory physician at Gleneagles Medical Centre. Besides a lingering cough, symptoms include a sore throat and runny nose. Mycoplasma infection is more prevalent among smokers, young adults, the elderly, and those who work in crowded places.

Fix it: Antibiotics are often required, on top of getting lots of rest and water, says Dr Law. Wear a face mask and minimise contact with others until treatment is completed. Wash your hands regularly to reduce the chances of spreading.

3. Post-nasal drip

Besides a persistent dry cough, you may feel mucus dripping down the back of your throat. This usually happens after you’ve had a cold and the mucus lining of the nose, throat and voice box is still sensitive and irritable, explains Dr David Chin, an ear, nose and throat consultant at CGH. Other common causes of post-nasal drip include silent reflux and allergies. Post-nasal drip accounts for up to 40 per cent of chronic cough cases, notes Dr Chin.

Fix it: See a doctor if the cough does not cease within a month. Do so earlier if the cough comes with chest pain, blood in the mucus, fever and a hoarse voice. If flu is the cause, you may be prescribed antihistamines, anti-reflux medication, cough suppressants or nasal spray to reduce inflammation. Take regular sips of warm water throughout the day to keep yourself hydrated and the lining of your throat moist, advises Dr Chin.

(Also read: What Your Phlegm Colour Means)


Chronic obstructive pulmonary disease (COPD) damages the lungs and causes the airways to be permanently narrowed. Though it affects mainly smokers, non-smokers with prolonged exposure to cigarette smoke are also at risk. Telltale signs are a nagging, mucus-producing cough and an unusual shortness of breath upon physical exertion, says Dr Augustine Tee, chief and senior consultant of respiratory medicine at CGH.

Fix it: Get medical attention if you’ve been coughing for more than two months, or if you’ve been putting up with recurrent bouts of coughing with mucus throughout the year, advises Dr Tee. Diagnosis involves a spirometry – a quick and non-invasive blowing test for lung function. If you’re a regular puffer, stub out to relieve the symptoms significantly.

5. Asthma

One in 20 adults in Singapore suffer from this chronic inflammatory disease of the lungs, according to HPB. Though it is usually diagnosed in children, asthma can occur at any time in life and regardless of age, says Dr Imran. When exposed to common triggers like animal fur and dander, dust, insects, as well as tobacco smoke, certain medication and food, the airways become inflamed and breathing tubes narrow, causing chest tightness, breathlessness, wheezing and a recurrent cough.

Fix it: While asthma is incurable, it can be well controlled such that you can lead an active life with hardly any symptoms. Work closely with your doctor to manage your asthma. This involves knowing your medication, triggers and symptoms. Get reviewed regularly: at least once a year if your asthma is well-controlled, and more frequently if you have severe asthma. If you find yourself unable to breathe and speak, head to the emergency department immediately.

(Also read: 10 Common Health Problems That Could Mean More)


Gastroesophageal reflux disease (GERD) occurs when stomach acid flows back into your oesophagus (food pipe) and irritates the lining. This causes a burning feeling in the chest that may spread to your throat, leaving a bitter or sour taste in your mouth. Occasionally, you may have a dry cough, hoarse voice and recurrent inner ear infection. This digestive disorder is commonly associated with obesity, high blood pressure and heart disease medications, as well as heavy meals and poorly controlled diabetes, says Dr Poh Choo Hean of CH Poh Digestive & Liver Clinic Pte. Ltd. at Mount Elizabeth Novena Specialist Centre.

Fix it:  Consult a doctor if you’re plagued by the symptoms more than twice a week. You may need to undergo an endoscope and further study for diagnosis. Usually, acid-suppressing medication suffices. Minimise acid reflux by having smaller meals, losing some weight if your body mass index is high (above 23kg/m2), and making sure your head is propped up during sleep, advises Dr Poh.

7. Whopping cough

True to its name, this contagious respiratory infection causes you to produce a “whooping” sound when you inhale after a major coughing episode. Also known as Pertussis, this cough is transmitted by direct contact, usually during the early stage. You may experience cold-like symptoms like runny nose, sneezing and fever, before coughing spells set in. Even if you’ve been vaccinated, you could get this five to 10 years after your last dose as the immunisation wears off, according to HPB.

Fix it: See a doctor to get a proper diagnosis. You may be prescribed antibiotics to speed up recovery and prevent the spread of this cough. Place a humidifier in your bedroom and avoid smoky as well as dusty areas, which may trigger the cough, advises HPB.

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