Common Causes Of Persistent Coughing
- Asthma. Chronic cough as the only sign of asthma is often referred to as cough variant asthma. Its usually a dry, hacking cough that may worsen following exercise, talking, laughing or crying. Pulmonary function tests may be normal or reveal a mild obstructive pattern. When pulmonary function tests are normal, a positive methacholine challenge helps support the diagnosis of asthma. Such patients often have a dramatic response to asthma medications included beta agonists , cromolyn sodium and or inhaled corticosteroids.
- Non-asthmatic eosinophilic bronchitis. These patients have evidence of eosionophils in their sputum and often respond to corticosteroids. Their methacholine challenge is negative and distinguishes these patients as non-asthmatics.
- Gastroesophageal reflux disease . It is thought that the gastric acid irritation of the respiratory mucosa stimulates the Vagus nerve, leading to a chronic cough. Treatment includes a proton pump inhibitor , inhibiting acid production and reflux by elevating the head of the bed, discontinuing smoking, losing weight and following a diet that doesnt stimulate acid production. All of these treatments can decrease this cough.
- Upper airway allergy . This may lead to chronic post-nasal drip.
- Post infectious cough. This may follow a viral infection of the respiratory tract and coughing can last up to 6 months.
- Chronic sinusitis.
- Bronchiectasis. This is caused by damaged bronchial tubes
- Psychological causes. Cough diminishes during sleep.
Identifying An Asthma Cough
Coughing has a purpose. Your body has you cough to remove foreign particles and bacteria to prevent possible infections.
Coughing in people with asthma can be helpful because its one of the bodys natural defense mechanisms.
There are two main types of coughs: productive and nonproductive.
When a cough is productive, it means that a noticeable amount of phlegm is expelled. This enables the lungs to get rid of harmful substances. A productive asthmatic cough will expel phlegm and mucus from the lungs.
But in most cases with asthma, the cough is considered a nonproductive dry cough. Its a response to an irritant that forces the bronchial tubes to spasm or constrict.
Swelling and constriction of the airways which prompts this type of nonproductive cough characterizes asthma.
An asthma cough is also often accompanied by wheezing. This is a high-pitched whistling sound caused by a constricted airway.
What Are The Manifestations Of Coughing
Asthma cough reflex and throat clearing are common phenomenons. Usually, they go away on their own. Most people self treat and dont seek medical attention. However, sometimes these symptoms become chronic, which is defined as coughing or throat clearing that persists for 8 or more weeks. This is usually when people seek help. The best path to finding the best treatment options begins by seeing a doctor and getting a proper diagnosis.
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Start With Some Home Remedies For Cold And Allergy Symptoms
When you start feeling icky, some simple home remedies can provide temporary relief. For starters, try to get more rest. Both allergies and colds can cause tiredness, so listen to your body and take it easy.
Also, take advantage of saltwater to soothe irritated nasal passages and scratchy or sore throats.
For your nose, use a neti pot. A neti pot can be picked up at any local drugstore or online, and typically comes with packets to mix with warm, distilled water to create a saltwater solution to pour through your nasal passages.
For your throat, simply mix a quarter or half teaspoon of table salt into an 8-ounce glass of warm water. Take a sip and gargle for a few seconds like you would with mouthwash. Then spit and repeat until the solution is gone. You can do this a couple times a day.
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Diganosis And Management Of Specific Cough Syndromes
4.4.1 Cough variant asthma and eosinophilic bronchitis
Definition
An isolated cough in a patient without objective evidence of asthmathat is, variable airflow obstruction and evidence of eosinophilic inflammation. In cough variant asthma bronchial hyperresponsiveness is present, whereas in eosinophilic bronchitis it is absent.
These syndromes are a common cause of isolated cough, accounting for around 30% of cough referrals to cough clinics., Clinical indicators of cough variant asthma include cough occurring nocturnally, after exercise, or after allergen exposure, although how reliable these features are is unclear. Some studies have highlighted overdiagnosis of cough variant asthma in children.
Diagnosis of cough variant asthma
Recommendations
Current methodology for measurement of airway hyperresponsiveness is well standardised and widely accepted. A negative test excludes asthma but does not rule out a steroid responsive cough.
This requires the demonstration of variable airflow obstruction and/or airway hyperresponsiveness. In patients with normal or near normal spirometric values , tests of airway responsiveness are more sensitive and specific than bronchodilator reversibility studies and PEF records.,
Asthma syndromes and cough
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Chronic Cough And Asthma
A cough can put extra stress on your bladder.
Many people have urinary leakage when they cough, laugh or sneeze. This is called stress urinary incontinence . In some cases, asthma or a chronic cough that lasts for many years can stretch the muscles of the pelvic floor and may make tiny tears in the muscles. These tears may cause stress urinary incontinence.
During surgery, childbirth, or with other physical stress, the muscles of the pelvic floor can become weak, and dont support the bladder and urethra . This muscle weakness allows urine to leak when you are sneezing, coughing, picking up something heavy, or other similar activities.
In some cases, a chronic cough or asthma cant be prevented. However, in many cases smoking triggers the chronic cough or asthma. Some people stop leaking when they give up cigarettes.
Pelvic floor exercises can help make the pelvic floor muscles stronger. You may wish to learn to do Kegel exercises with a physical therapist to learn how to strengthen your pelvic floor muscles. Tightening the pelvic floor before a cough may help prevent leakage.
Many people who live with incontinence do not tell their doctors. In most cases, your stress urinary incontinence can be treated or improved. Please to talk with your health care provider about many of the available options.
Medical Reviewer: Diana Hankey-Underwood, MS, WHNP-BC
What Causes Asthma Cough Reflex And Throat Clearing
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About 57% of asthmatics cough.1 Sometimes its the first sign of an impending asthma attack. Sometimes its chronic, or seemingly always there. Sometimes its the only symptom experienced. So, what causes an asthma cough? Heres what to know.
Throat clearing is another common symptom, often going hand-in-hand with coughing. Some asthmatics clear their throats often. This may also cause throat irritation and hoarseness. The cause of all these symptoms is probably the same: the asthma cough reflex.
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Asthma And Copd: The Similarities And Differences
They are both lung diseases and affect the airways, and they have similar symptoms, including cough, shortness of breath, wheezing, and chest tightening, said David A. Beuther, MD, chief medical information officer at National Jewish Health in Denver and an assistant professor in the division of pulmonary, critical care, and sleep medicine at the University of Colorado Denver School of Medicine.
One differentiating characteristic of COPD is that a morning cough is often productive, meaning you produce mucus or phlegm.
Asthma and COPD are both diagnosed with a simple lung function test known as spirometry, and the treatments are also similar. But the severity of your breathing problems and how responsive they are to treatment remain the best ways to determine whether it is asthma or COPD that is causing your symptoms.
The main difference is that the lung function decline with asthma is more reversible, Dr. Beuther said. There are much more severe lung function abnormalities in the COPD crowd than the asthma crowd. People with COPD have more chronic symptoms. They cough up mucus and phlegm even on a good day, where an asthmatic may have periods of time where they feel fine and then experience a flare.
The reasons for flares may also differ. Asthma attacks may occur in response to known triggers, such as allergens or exercise. COPD exacerbations usually follow respiratory ills, such as the flu or the common cold.
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Mucus Postnasal Drainage & Cough
The membranes that line your nose, throat and bronchial tubes are very sensitive. Normally, they secrete up to two liters of mucus a day to moisten and protect themselves. When these membranes become irritated, congested, and swollen, they secrete an extra amount of mucus. This mucus helps to protect the lungs and nose from irritating particles and infection.
If you have asthma, your membranes are more sensitive to irritants, such as smoke, cold air, strong odors and dust, causing them to secrete more mucus than normal. Infections may cause even more congestion, mucus, and discomfort. However, increased mucus or yellow mucus does not always mean that an infection is present. Check with your physician if you have more mucus than usual or if it is green or yellow-colored.
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How To Treat Asthma Cough
Treating an asthma cough involves taking controller medications. Corticosteroids for inhaling will help reduce the inflammation in the lungs, which is said to be the biggest cause of an asthma cough. Inhaled corticosteroids are usually a long-term solution for cough variant asthma. For getting relief in the short term, oral corticosteroids are usually prescribed. Quick-relief inhalers are recommended to keep handy to take care of coughing and wheezing incidences. These quick-relief inhalers, though, are only meant for using once or twice in a week. You may also use them before exercising or if you are suffering from a disease and are generally feeling unwell, triggering a bout of coughing.
Oral medications for relieving asthma cough include leukotriene modifiers such as montelukast, brand name Singulair. These drugs work by treating the symptoms of asthma which are associated with allergic rhinitis.
There are also some alternative treatments that you can opt for treating an asthma cough. However, you should not stop taking your prescribed medications for other complementary treatments such as homeopathy. Your doctor will be the best person to advise you on whether the following options can provide relief in cough variant asthma:
- Herbal therapy with gingko and dried ivy
Can Allergies Cause A Sore Throat
So, the short answer here is yes, Evan Li, MD, an allergist and assistant professor of medicine specializing in immunology, allergy and rheumatology at Baylor College of Medicine, tells Health. A sore throat can be from a direct inflammatory effect of allergens on the back of your throat, from mucus draining down into your throat, or from the irritating effect of coughing.
Sneezing, congestion, itchy eyes and nose, and runny nose are the most common symptoms associated with seasonal allergies, Kelly Simpson, MD, an allergist at Austin Regional Clinic in Austin, Texas, tells Health. But sore throat can also be added to that list, often caused by whats referred to as postnasal drip. This is when increased mucus in the nasal passages drips down the back of the throat. As it drips down, it irritates the throat.
Postnasal drip, other than causing sore throat, can also cause the sensation of something getting stuck in your throat, tickling or itching in the back of your throat and also irritation that leads to cough, Dr. Li says.
No one allergen is more prone to causing sore throat than others, but the more potent the allergen, the more likely it is to cause symptoms of allergies overall, Dr. Li says. Some of the most potent allergens are grasses, ragweed, dust mites and cat dander.
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Medications For Chronic Asthma
The two categories of asthma medicines are long-term control and short-term medicines. Long-term control medicines are often taken every day to help prevent symptoms. Quick-relief medicines calm asthma symptoms fast, but they only last for a short time. Depending on the setting, one or both of these types of medications may be appropriate.
Long-term control medicines
At first, it may take a few weeks for long-term control medicines to work. You must take these medicines every day. These medicines include:
- Inhaled anti-inflammatory medicines. These medicines reduce or prevent airway swelling.
- Inhaled bronchodilators. These relax muscles around the airways.
- Leukotriene modifiers. These block the action of chemicals called leukotrienes, which are chemicals that cause airways to be inflamed and narrowed.
- Biologic therapy. These medicines target the inflammatory cells in the body that start the asthma reaction. They are often given by injection or infusion.
Quick-relief medicines
Quick-relief medicines quickly relax the muscles around the airways, but the relief only lasts about 2 to 3 hours. These medicines may include:
- Inhaled short-acting beta2-agonists. These help relax muscles around the airways.
- Inhaled anticholinergics. These block a chemical in the body called acetylcholine. This chemical makes airway muscles contract. It also causes more mucus in the airways.
Inhalation devices for asthma
Can Allergies Cause A Cough
Yes, and you can blame it on your immune system. When your body mistakes a substance like pollen or mold as a harmful invader, it sets off an intense response to try and flush it out, according to the American Academy of Allergy, Asthma & Immunology . During this process, your cells release histamine and other chemicals, which triggers an allergic reaction. Cue the cold-like symptoms, including a sore throat, runny or stuffy nose, sneezing, and coughing.
Allergy coughs are typically caused by swelling or irritation of the airways, the AAAI says. And, if you develop post-nasal dripwhen the mucus hanging out in your sinuses trickles down the back of your throatthat can also cause a cough, Dr. Bassett says.
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Asthma Development: Allergy Features
In a cross-sectional comparison of the characteristics of 115 classic asthma and 74 CVA patients, the two groups of asthmatics were sensitized to one or more allergens at a similar prevalence. However, patients with classic asthma had greater age, disease duration, smoking prevalence and airflow obstruction, and higher blood eosinophils, total IgE, numbers of sensitized allergens, and rates of sensitization to dog dander , HDM , and moulds than did patients with CVA. No specific antigen of CVA with higher sensitization rate than classic asthma was found .
Table 4
Forty CVA patients from this original cohort were prospectively observed for 2 years to determine whether CVA would progress to classic asthma despite ICS treatment. Asthma developed in six patients with CVA , who had lower FEV1, larger number of sensitized allergens and higher rates of sensitization to HDM and dog dander than the remainders without wheezing development .
Table 5
Another cross-sectional study of a more recent larger cohort from the same laboratory showed very consistent results , confirming the importance of sensitization to HDM and animal dander, for the presentation as classic asthma rather than CVA.
Table 6
As summarized in Table 7, factors that may predict the development of classical asthma include AHR , exaggerated maximal airway response to methacholine, sputum eosinophilia, allergen sensitization and failure to use ICS .
Table 7
When You Have A Dry Asthma Cough How Do You Know If It Changes Into A Dry Covid
Heres what Dr John Blakey says:
Cough can be a normal symptom in asthma and other allergic disease like allergic rhinitis . For a person to distinguish their cough from a COVID-19-type cough, they should consider a number of things:
If you experience any of these symptoms, make a telehealth appointment and/or seek medical assistance and avoid any outings to public places.
If youre having trouble convincing others your cough is from your asthma or your sneeze is from your allergies, you can direct people to this blog.
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Diagnosis Of Chronic Variant Asthma
Diagnosis of CVA can be quite challenging as it is usually characterized by a chronic cough. Chronic cough lasts more than four weeks in children and more than eight weeks in adults.
Therefore, one should always consult a doctor if they are experiencing an unexplained persistent cough, though it is wise to keep track of your cough and share the details with your doctor to avoid misdiagnosis.
A spirometry test is used by a healthcare professional to diagnose asthma. This test assesses how well your lungs work. If symptoms and test results are negative for asthma, the next step is a methacholine challenge test.
Ideally, when a person with asthma inhales methacholine, it triggers coughing and bronchial spasms. Therefore, a person with asthma will be more sensitive to methacholine than a healthy person causing lung function to drop during the test.
If a doctor strongly suspects CVA, they may skip the methacholine test and prescribe asthma treatments. Since CVA responds well to asthma treatment, a healthcare provider will be likely to diagnose CVA.You can also get some insights on how to know if you have asthma on our blog.
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What Other Symptoms Might You Have If You Have A Chronic Cough
Some symptoms can be more common and less likely to be serious, such as:
- A runny or stuffy nose.
- Post-nasal drip .
- Wheezing or shortness of breath.
- Sore throat or frequent throat clearing.
Other symptoms might be more serious, such as:
- Weight loss without any effort.
- Coughing up phlegm or blood.
- A hoarse voice that does not go away.
- A drenching overnight sweat.
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