Persistent Cough: Causes, Treatment & When to See an Online Doctor (UK)

UK clinicians divide coughs by duration:

• Acute cough: less than 3 weeks — usually viral.
• Subacute cough: 3–8 weeks — often post-viral.
• Chronic cough: more than 8 weeks — needs assessment for asthma, reflux, post-nasal drip or other causes.

Most coughs after a cold or chest infection settle within a month, but a "post-viral" cough can drag on. The job of an online GP is to identify causes that benefit from treatment and rule out anything serious.

• Post-viral cough: the airways stay inflamed for weeks after the infection itself has gone.
• Asthma: often worse at night, with exercise or in cold air; may include wheeze.
• Post-nasal drip: mucus dripping down the back of the throat from sinuses or hay fever.
• Acid reflux (GORD): stomach acid irritating the airway, often worse lying flat.
• Smoking and vaping: direct airway irritation.
• Medication: ACE inhibitors (used for blood pressure) cause a dry cough in ~10% of people.
• Bacterial chest infection: bringing up coloured phlegm with fever and breathlessness.

• Plenty of fluids and warm drinks.
• A teaspoon of honey at bedtime (not for under 1s) — backed by NICE for symptom relief.
• Humidify the air or sit in a steamy bathroom.
• Sleep slightly propped up if reflux or post-nasal drip is a factor.
• Stop smoking and avoid secondhand smoke.
• Over-the-counter cough medicines have limited evidence — pharmacists can advise.

Book an online GP if your cough has lasted more than 3 weeks, you are coughing up coloured phlegm with fever, you are breathless or wheezy, or your sleep and work are affected. Your GP will:

• Take a focused history and listen to you describe the cough.
• Ask you to do simple breathing tests on camera if appropriate.
• Prescribe an inhaler if asthma is suspected, antibiotics if bacterial chest infection is likely, or a PPI if reflux fits.
• Refer for a chest X-ray or in-person review if anything raises concern.

Consultations last 10–15 minutes by video. Be ready to describe when the cough started, what makes it worse, whether you bring anything up, and any other symptoms. If a prescription is appropriate, it is sent electronically to a UK pharmacy of your choice.