Small Airway Dysfunction In Cough Variant Asthma: Prevalence Clinical And Pathophysiological Features
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Introduction: Small airway dysfunction commonly presents in patients with classic asthma, which is associated with airway inflammation, disease severity, and asthma control. However, the prevalence of SAD, its relationship with cough severity and airway inflammation, and its development after antiasthmatic treatment in patients with cough variant asthma need to be clarified. This study aimed to investigate the prevalence of SAD and its relationship with clinical and pathophysiological characteristics in patients with CVA and the change in small airway function after antiasthmatic treatment.
Small airway dysfunction occurred in over half of patients with CVA and persisted after short-term antiasthmatic treatment, which showed distinctive clinical and pathophysiological features.
Ways To Manage Cough Variant Asthma
In this article:
CVA is a milder form of asthma. Children are more likely than adults to have this type of asthma. This condition is often triggered by exposure to specific allergens and environmental factors or activities such as strong odors, pollen, cold air, exercise, and dust.
In fact, patients with CVA are also likely to suffer from other allergic conditions, such as drug and food allergies, eczema, and hay fever.
It causes long and frequent spells of dry and unproductive coughing which can lead to sleep disruption, exhaustion, cracked or fractured ribs, vomiting, and light-headedness.
Moreover, the continued strain on your air tubes can cause them to become narrow and swollen, which disrupts the flow of air to and from the lungs. However, the risk of severe airway narrowing is lower with this type of asthma than with regular chronic asthma.
Cough Variant Asthma Natural Treatment With Homeopathy
As the name suggests, cough variant asthma is a type of asthma that causes a dry, non-productive and constant cough as its primary symptom. It is commonly seen in children, or during early childhood. It may later develop into a typical Asthma condition with wheezing. Once triggered, an episode of cough variant asthma can last for 6-8 weeks. Homeopathic medicine for cough variant asthma can be used with conventional treatment to help reduce the severity of symptoms and treat the chronic condition.
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What Causes Asthma Cough: Its Symptoms Diagnosis & Treatment
Having a cough can be a big nuisance. Not only are you hacking away the entire day, but it often leaves you feeling tired and out of breath. Constantly coughing in the office can also become a cause of embarrassment when it refuses to let up. In fact, statistics show that a cough is one of the most common reasons or complaints for which people seek medical attention. Asthma cough, also known as cough variant asthma, is a form of asthma that only presents with a cough. Due to the fact that most people associate asthma with breathing trouble, asthma cough tends to go undiagnosed many a times.
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Diagnosing Cough Variant Asthma
You have a persistent cough that does not improve, no matter what you do or the brand cough syrup you take. It seems to linger for weeks after whatever it was that caused it has gone away. Time to go to the doctor to get diagnosed. But how does a doctor determine if you have cough variant asthma as opposed to a stubborn cough?
Unfortunately, many of the tests used for asthma may not work for diagnosing cough variant asthma. Physical exams, chest X-rays, and even spirometry may not reveal cough variant asthma. If thatâs the case, the next step is to take a methacholine challenge test. This test requires the patient to inhale an increasing amount of methacholine aerosol mist before and after a spirometry test. If your lung function drops by 20%, unfortunately, this most likely means asthma or cough variant asthma is present.
After diagnosing the cough variant asthma, you can move onward to treatment.
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Why Do Some People Cough At Night
Well, its normal to cough at night if you are sick. But if you dont have a cold, bronchitis, or pneumonia, you shouldnt be coughing at night. Nocturnal asthma can be caused by a variety of things, such as:3,4
- Changes in the circadian rhythm that can cause hormone changes
- Sinuses draining
- Increased airway resistance due to airways narrowing during sleep
For the last couple of weeks, I have been waking up coughing during the night. This is not like me at all. And Im not sick, so I shouldnt be coughing.
Include Ginger In Your Diet
Ginger is a popular natural treatment for various ailments, including asthma and CVA.
Being an excellent expectorant, it can help reduce the intensity and duration of coughing bouts. It also helps reduce airway inflammation and inhibit airway contraction.
Moreover, it has immune-boosting properties that promote quick recovery.
How to consume:
- Cut fresh ginger into small slices and crush them slightly. Put them in a cup of water and bring it to a boil. Drink this 3 or 4 times a day.
- Another option is to chew fresh raw ginger on and off throughout the day.
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Stay Away From Pollen And Other Irritants
A very common trigger for CVA is exposure to pollen. To reduce your coughing, you must pay attention to the air quality reports and avoid highly polluted areas that can worsen your condition.
- Use an air conditioner to reduce airborne pollen from trees, grasses, and weeds that finds its way indoors. Clean and replace your air conditioner filters on a regular basis.
- Keep your windows closed during the pollen season. Also, venture out less often to minimize the risk of exposure.
- Avoid living in a highly polluted area.
- Do your best to keep your house free from dust and dust mites by vacuuming your home twice a week.
- Wash all bedding and stuffed animals frequently with hot water.
- Avoid intense fragrances, which can cause your airways to act up, triggering a coughing spell.
How Long Does Cough Variant Asthma Last
People with cough-variant asthma often have no other classic asthma symptoms, such as wheezing or shortness of breath. Cough-variant asthma is one of the most common causes of chronic cough, which is a cough that lasts longer than 6-8 weeks. The coughing with asthma can occur during the day or at night.
How do you treat nocturnal asthma naturally?
In addition to taking asthma medications as prescribed, here are seven steps you can take to lower your chances of having a nighttime asthma attack:
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When To Visit Your Doctor
Even a well-managed CVA could escalate into a dangerous incident. It would be best if you visit your doctor immediately when you observe the following signs:
You feel weak, dizzy, or out of breath.
You have trouble performing daily tasks such as cooking and cleaning.
You notice that your cough is not ending.
Your wheezing becomes worse even after taking your medication.
Respond faster when you witness the following signs as it may be an emergency:
Your nails or lips turn blue.
Your nostrils start flaring when you breathe in.
You start taking more than 30 breaths per minute.
Walking and talking becomes difficult.
The skin at the base of your throat stretches when you breathe in.
Treatment For Cough Variant Asthma
The treatment for CVA is similar to that of asthma. You may get the following treatment options:
Inhaled Bronchodilators¹: The airways become blocked when the surrounding muscles tighten. Bronchodilators relax the muscles to keep air tracts open. Beta-2 agonists¹ can be used as either short- or long-term bronchodilators.
Short-term bronchodilators: These are used as needed and can ease muscles in an asthma attack or when you are about to engage in intense exercise. A good example is albuterol¹. Notably, short-term bronchodilators are used to relieve asthma symptoms, not prevent them.
Long-term bronchodilators: These are used to manage asthma and CVA. Your doctor may recommend daily use depending on your diagnosis. Typically, they are used with inhaled steroids.
Inhaled corticosteroids ¹: CVA is commonly treated using inhaled corticosteroids. . It is a common method for treating both CVA and asthma. Corticosteroid inhalers are effective in preventing the occurrence of wheezing. They also reduce inflammation and obstruction of the airways, easing symptoms such as chest tightness and shortness of breath. It would help if you used inhalers as prescribed, whether you have CVA or asthma. Your doctor may prescribe daily usage of an inhaler. Examples of inhalers include fluticasone and budesonide . Follow your doctor’s advice to understand the best inhaler for you.
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Difference Between Asthma And Cough Variant Asthma
The main difference between asthma and cough variant asthma is the absence of symptoms like wheezing, a constricted feeling in the chest, dyspnoea , and shortness of breath in the case of CVA. These are the classic symptoms of asthma, while cough variant asthma is characterized mainly by a dry cough.
S That Can Be Taken To Reduce The Risk Of Developing This Condition
Like chronic asthma, you can avoid CVA by making some lifestyle changes:
Avoid exposure to smoke: Both smoking and inhaling second-hand smoke may irritate the airways, thus increasing the frequency and severity of asthma attacks. Therefore, you should avoid areas where people smoke publicly and ask friends and loved ones not to smoke in common areas such as the house and the car.Maternal smoking² also increases the risk of children developing asthma at some point. Therefore, avoid smoking when pregnant as it exposes you and the child to the risk of developing asthma .
Obesity: Obesity has been linked with more asthma attacks than leaner patients. By effectively managing extra body weight, you may reduce the chances of developing CVA. Follow your doctor’s advice, given that excess weight, could be caused by numerous factors such as medications, lifestyle, and decreased metabolism.
Exposure to allergens: Specific allergies such as allergic rhinitis and dermatitis may increase your risk of developing CVA. Hay fever is commonly caused by exposure to allergens such as pet dander, insects, mold, and pollen. Eczema may be caused by stress, genetic factors, environmental triggers, and immune system over-activation.
Viral respiratory infections: Children who develop wheezing and other viral infections in the breathing tract when younger may develop CVA later. These infections include:
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What Are Symptoms Of Cough Variant Asthma
CVA does not show many typical signs of asthma, such as wheezing. A dry, non-productive cough is the only distinctive symptom. The cough is also chronic, meaning it lasts more than 8 weeks for adults or 4 weeks for children.1
A chronic cough can be a sign of many different conditions. Some features of the cough that indicate the involvement of asthma include:2
- Interruptions in your sleep because of coughing
- Worsening of your cough after exercise
- Worsening of your cough in cold, dry weather
- Triggering of cough episodes after exposure to allergens
What Types Of Asthma Are There
Healthcare providers identify asthma as intermittent or persistent . Persistent asthma can be mild, moderate or severe. Healthcare providers base asthma severity on how often you have attacks. They also consider how well you can do things during an attack.
Asthma can be:
- Allergic: Some peoples allergies can cause an asthma attack. Molds, pollens and other allergens can cause an attack.
- Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.
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Of : Taking Medications
What Is The Difference Between Cough
The main difference, as previously stated, is that cough-variant asthma is characterised by a dry cough that does not bring up mucus, and that is not accompanied by wheezing or other symptoms.
Another difference between the two is that cough-variant asthma may be harder to diagnose than regular asthma. This is because of the absence of other symptoms, and because there are many conditions that can cause a dry cough.
If you are suffering from a persistent dry cough that has lasted for more than 3 weeks, you should seek medical advice.
Causes of a persistent cough other than asthma include:
- Chronic bronchitis
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Cough Variant Asthma Triggers
If you have cough variant asthma, your asthma causes or triggers responsible for your chronic cough are similar to the triggers for other types of asthma. If you have asthma, you will have your own personal list of things that your airways really hate. If you come in contact with or do any of those things on your list, your airways will get really irritated. In the case of cough variant asthma, the result will be your chronic cough.
The following things are a partial list of possible asthma triggers that might be on your list:
- Specific foods could pretty much be anything
- Different types of air pollution
- Aerosol sprays like hair spray or deodorants, etc.
- Pet dander all pets give off dander
- Cockroach droppings
- Weather could be certain types of weather or changes in the weather
- Stress or other strong emotions
- and the list goes on
Anything on the above list could could be one of your cough variant asthma triggers. In fact, you could have any number of those things on your list. You might even have a trigger that is not on that list. Everybody has their own list and the way that you are affected by something on the list will be different from the way that it affects somebody else. Some people with asthma have their airways get irritated all the time while others only see the problem every once in awhile.
Gargle With Warm Salt Water
Salt water is a good home remedy for alleviating irritation in the throat, a common by-product of constant coughing. This beneficial effect rests on the principle of homeostasis and osmosis.
The saline solution will suck in the moisture from the inflamed throat and, thereby, bring down the swelling. Moreover, gargling with warm salt water has been found to be effective in preventing upper respiratory tract infections, which can often trigger a CVA episode.
How to do:
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Data Management And Quality Control
The investigators in the research team were required to attend a training workshop before recruitment. Each one received a copy of the study protocol and they were asked to adhere to the protocol during the study period. The investigators responsible for collecting data received training on how to perform CVAS and quality of life assessments. The lung function and blood tests will be done by medical professionals.
Data will be collected and recorded on case report forms. All data will be entered into a predesigned password-protected database by personnel blinded to group allocation. Data entry will be performed continually throughout the trial using the double-entry method, with any corrections or changes of data written in the case report forms documented and dated. Data quality will be checked regularly by a qualified specially assigned person. The Guangdong International Clinical Research Center of Chinese Medicine , which is independent of the sponsor and does not have any competing interests, will be responsible for monitoring the data. The Department of Science Research of GPHCM, which is independent of the sponsor and investigators, will perform data audits in the middle of the trial.
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What Are The Symptoms Of Cough Variant Asthma
In addition to a dry cough that lacks phlegm or mucus, you are likely to report other symptoms, including suffering from airway inflammation and being more susceptible to allergies. You also may experience narrowing of airways when predisposed to allergic stimuli, medically known as airway hyper-responsiveness ³.
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A Soothing Honey Drink
Honey is another very effective natural cure for CVA. The sweetness of honey stimulates your salivary glands to produce more saliva, which in turn lubricates your airways, easing your cough. It also has antioxidant properties that fight inflammation and boost immunity.
As store-bought honey often comes packed with additional taste-enhancing ingredients such as high fructose corn syrup or sugar, its best to visit a local health store to get premium-quality unadulterated raw honey.
How to consume:
- Add 1 tablespoon of raw honey to 1 glass of warm water or milk and drink it slowly. Repeat a few times a day. This drink will have a soothing effect on the throat.
- Alternatively, mix equal quantities of honey, ginger juice, and pomegranate juice. Consume 1 tablespoon of this mixture 2 or 3 times a day.
- Before going to bed, consume 1 to 2 teaspoons of raw honey with a little cinnamon powder.
- Add 1 tablespoon of raw honey to 1 glass of warm tea with lemon and drink slowly.
Note: Honey is not recommended for children under the age of 12 months as it might contain spores from the bacterium Clostridium botulinum that can cause infant botulism.