Q: I picked up a cough over the winter and, two months later, it still hasn’t gone. It’s not bad, and I am otherwise well, but it is starting to annoy my wife. Will my GP be able to help?
A: typical viral winter cough often takes at least two to three weeks to settle, but two months is too long and you should book in to see your GP. A persistent cough of this duration is never normal.
Possible diagnoses vary from mild whooping cough (yes, it still exists) to underlying heart and lung problems, and investigation and treatment will vary accordingly, but there are a couple of common culprits worth highlighting because they are missed so often.
The first applies to anyone on ACE inhibitors, a family of drugs ending in -pril, such as ramipril and perindopril, used to treat heart problems and high blood pressure. These cause an annoying dry cough in around one in ten of the millions of people in the UK who take them. It can take weeks to come on and just as long to settle after treatment is withdrawn, so the link isn’t always made. And it often presents as a viral cough that never settles. Switching to an alternative drug, and a bit of patience, is all that is required.
A second possible cause is acid reflux, a common problem in the over-50s where the valve at the top of the stomach allows acidic fumes to escape into the throat. This type of cough tends to be worse after meals and often sounds as if the sufferer were continually trying to clear their throat. Medication (typically antacids such as omeprazole) can make a big difference in such cases.
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