When Is A Cough Asthma?

Is My Coughing Asthma?

Coughing is the main symptom of asthma in some people. Known as cough-variant asthma, this is not always diagnosed correctly, especially in children. For children with recurrent coughing (2 or more episodes a year of coughing without a cold) it may be a long time before the doctor considers asthma. But other doctors may diagnose a coughing child as 'asthmatic' all too readily, without doing enough tests. The important point is that asthma involves episodes of
bronchospasm - narrowing of the airway muscles. Without this it is not asthma. Bronchospasm can be detected by medical tests such as peak-flow readings. Wheezing is one possible symptom of bronchospasm, but coughing is another.

When Coughing Is NOT Asthma

If there is only coughing as a symptom, and never any wheezing, this is probably not asthma (usually the coughing will develop into wheezing at some stage if it's not treated). Allergies are unlikely to be involved. The cause of such coughing may be:

• The effects of smoking (or in children the effects of parental smoking)

• Perennial allergic rhinitis can cause mucus from the nose to run into the lungs. This is called post-nasal drip and produces a persistent cough.

• In your 30s or 40s a persistent cough could be eosinophilic bronchitis. This is an inflammation of the airway tubes and results in persistent coughing. Allergies do not seem to play a part (it is no more common in atopics than anyone else) and the airway muscles do not contract abnormally. Treatment is with inhaled steroids.

• In atopics (those prone to allergies), a condition sometimes called atopic cough. It involves eosinophils (white blood cells) congregating in the trachea (windpipe) and bronchi, but not in the lower airways. There is inflammation but no airway narrowing. Very little is known about this disease at present; it may or may not involve allergies. Again, inhaled steroids are effective. Read more about atopics here: what causes asthma?

• In a few people persistent coughing can be the result of an underlying emotional problem and responds to psychological treatments. The cough often has a honking or barking sound.

Any of these can be misdiagnosed as asthma. For patients with eosinophilic bronchitis or atopic cough, this is no tragedy as they will probably get the right treatment (inhaled steroids) anyway. But if more exact diagnostic criteria are being used (such as a reversibility test) such patients will not be classed as asthmatic - this is more of a problem because they may not get appropriate treatment.

See also when is asthma not asthma?

Asthma Questions

What is asthma? Simple explanation and definition.
What triggers an asthma attack? Top 10 most common triggers.
How is asthma diagnosed? Testing for the condition.
What is the treatment for asthma? Brief guide to drugs and treatments.
What is an asthma diet? Foods to eat, foods to avoid.
What is the best exercise for asthma? Walking, when to stop and more.
What are the symptoms of asthma? Coughing, wheezing and more ...

• Got another question? See: Allergy Questions

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