Thousands of individuals dealing with chronic coughs are reportedly being neglected by the NHS, enduring this debilitating issue for many years, according to experts consulted by The Mail on Sunday.

The experts highlight a scarcity of specialized care, leading some patients to travel extensive distances for treatment, while others remain undiagnosed for long periods or are mistakenly diagnosed with mental health issues.

Many approach their GP and may even be referred to a specialist, only to be informed there is nothing wrong, leaving both the patient and the doctors without a solution or exploration of the true diagnosis.

Chronic cough, defined as a cough persisting for more than eight weeks, is estimated to affect one in ten people in Britain. This condition causes prolonged sleepless nights, fatigue, continence challenges, and social discomfort for many.

‘With only eight specialist centres and the absence of specific NHS guidelines for chronic cough, numerous patients continue to endure this distressing condition for extended periods,’ says Professor Nicholas Hopkinson, a respiratory medicine expert at Imperial College London.

The magnitude of the issue became apparent earlier this month when Mail on Sunday GP columnist Dr. Ellie Cannon discussed recent research exploring genetic factors contributing to chronic cough.

Her comments prompted a torrent of responses from readers desperate for answers.

Among them was Angela Pilkington, 75, from Norfolk, who has endured a cough for more than 25 years after contracting a chest infection on holiday.

She described fits striking every 20 minutes, triggered by smells or crowded places, which left her unable to go to the theatre, embarrassed in shops and even struggling to control her class when she worked as a teacher.

‘Doctors kept giving me medicine and telling me it was likely asthma but nothing was working,’ she said. ‘It became very embarrassing and I coughed so hard I often wet myself or felt I was going to blackout.’

After years of failed treatments she now takes codeine, which she says has restored some ‘quality of life’, though the cough has never gone away.

Other readers detailed similar stories of frustration.

Carolyn Dunn, 76, from Hertfordshire, said she has had a cough since 1987. Despite undergoing multiple tests, doctors concluded it was psychological.

And Catherine Thom, 78, from Winchester says that she has been suffering from a painful cough for three years.

‘The cough is particularly difficult when eating and even drinking water as I regularly choke with violent spasms,’ she said.

‘I have noted this to doctors on three separate occasions but as I have numerous other serious health issues, my cough has never been addressed.’

Frustratingly, research suggests that 90 per cent of cases can be managed if the underlying condition is diagnosed and treated.

Specialists have now identified three common conditions, which are often missed by GPs, and they say patients suffering long-term cough must be aware of.

‘There are a number of lung conditions which unsurprisingly cause chronic coughing,’ says Professor Jaclyn Smith, an expert in the condition at the University of Manchester.

These include chronic obstructive pulmonary disease (COPD) – a progressive lung condition, usually caused by smoking, that makes it hard to breathe – as well as lung fibrosis, where scar tissue builds up in the lungs, often after long-term damage from smoking or infection.

NHS guidelines state that anyone with a cough lasting more than three weeks should be referred for a chest X-ray, which means these conditions are usually identified early and patients passed on to a lung specialist.

‘So when patients are complaining of a cough that has gone on for years, this is usually not what they are talking about,’ adds Professor Smith.

So what else might be to blame? High up on the list is asthma, which affects around 7.2 million people in the UK. While classic symptoms include wheezing, breathlessness and a tight chest, in harder-to-diagnose cases the only sign may be a persistent cough.

‘With no single test to diagnose asthma, many patients who come into our clinic having suffered with the condition for years,’ says Professor Smith, who runs the specialist cough clinic at Manchester University Hospitals. ‘Once asthma has been diagnosed it can be easily managed with inhalers.’

Another common cause is acid reflux. This occurs when stomach acid escapes upwards, sometimes splashing high enough to inflame the throat and voice box.

In other cases, the acid doesn’t travel that far, but still irritates nerves in the oesophagus, making the airways extra sensitive and prone to coughing.

The most recognisable symptom is the burning sensation known as heartburn, when acid rises into the oesophagus and throat.

Simple steps to reduce reflux include avoiding late-night meals, cutting back on caffeine and alcohol, and raising the head of the bed. In some cases, doctors prescribe stomach acid-suppressing drugs such as proton pump inhibitors (PPIs).

Experts say another treatable cause of chronic cough is post-nasal drip. This occurs when excess mucus from the nose or sinuses trickles down the back of the throat, irritating the airways and sparking a cough.

Symptoms tend to be worse at night, when mucus can collect in the back of the throat.

One patient who has been blighted with a debilitating cough is Lisa Young, 75, from Eastbourne. Her symptoms began suddenly in 2019 and left her wiped out for months. ‘I could not stop coughing, could not lie flat at night and friends had to do my food shopping as there was no way I could drive,’ she says. ‘I would be struck with coughing fits that would last minutes.’ After years of suffering, Lisa was finally diagnosed with post-nasal drip caused by a dust allergy.

‘I was in complete shock when the doctor told me it was because of dust,’ she recalls. ‘The measures they suggested were quite drastic – such as ripping up my carpets and removing the curtains.’ In the end, an over-the-counter antihistamine nasal spray provided enough relief for her to get on with daily life.

Another key explanation for chronic cough – thought to affect up to one in ten patients – is a little-known condition that does not respond to standard treatments. Known as refractory chronic cough (RCC), it is believed to be driven by an over-sensitive cough reflex, where the nerves in the throat and airways trigger far more easily than normal. Patients often report attacks brought on by changes in temperature, strong smells such as air fresheners, or even everyday activities like eating, drinking or laughing.

The condition is seen most often in women, and is particularly common in middle age.

Professor Smith estimates that approximately 70 per cent of the patients referred to her cough clinic have refractory chronic cough. ‘This is a condition that many doctors are still unaware of,’ says Professor Smith. ‘There is currently no test and it can only be diagnosed once common causes like asthma and acid reflux are ruled out. That and there being no licensed medication mean that many doctors are reluctant to give a diagnosis.’

Although there are no licensed treatments the professor explains that there are ways that the condition can be managed. ‘We are essentially looking to retrain the brain,’ says Professor Smith.

‘Patients are given exercises from speech and language therapists that can help to reduce the tension in the throat or spot when a coughing fit may be coming on and using a trick like sipping water to keep it at bay.’

In severe cases, sufferers can also be given morphine – an opioid – to manage their symptoms, providing they are carefully monitored. ‘This can really be remarkable for patients,’ says Professor Ashley Woodcock, an expert in chronic coughs at the Alexandria Hospital. ‘We see patients that have had symptoms for 20 years and a small dose sees their cough disappear.’

Given that RCC is not included in NHS guidelines – a move she is calling for – the professor says many people may be undiagnosed with the condition. ‘I do wonder whether the patients we see in our clinic with RCC are the tip of the iceberg. There are probably many patients out there who have given up seeking solutions and are simply putting up with it,’ says Professor Smith.

If a patient has tried a number of treatments that have failed and they feel they may have RCC, it is recommended that they ask their GP for a referral to one of the countries eight specialist clinics.

‘We are really at an evolution in the treatment of chronic coughs,’ says Professor Woodcock. At the moment we have a limited number of specialist clinics, but with understanding changing, that this is a separate condition, and new promising treatments on the horizon, I suspect that very soon all hospitals will have a cough clinic.’

Experts say that patients putting off getting their cough checked is a serious concern.

‘To often we see patients who have a long term cough but have not seen a doctor,’ says Professor Hopkinson. ‘If you are coughing for eight weeks you should not ignore it.

‘If you are coughing up blood, there is pain associated with the cough or you generally feel unwell, losing weight or suffering from night sweats or a hoarse voice then you should see a GP and not wait to see if it lasts weeks.’

Asthma and Lung UK said: ‘A long-term cough, lasting three weeks or more, could be a sign of an undiagnosed lung condition – always see your doctor if you’re worried. If you need advice or support about any breathing symptoms or your lung condition you can give the Asthma and Lung UK helpline team a call on 0300 222 5800, Monday to Friday between nine and five.’

DID YOU CURE A COUGH THAT WOULDN’T GO AWAY? Write to us at health@mailonsunday.co.uk