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Allergic cough, bronchodilator inhalers, shortness of breath, wheezing

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General & Family Physician
Practicing since : 2003
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Hello, My wife has some kind of allergic cough for the last two years. Earlier she used to get severe cough very uncontrollable once in a fortnight but the frequency started increasing and by July 2009, she was getting the cough every other day. She will cough so much that she will have a hard time even breathing and lot of wheezing sounds like an asthma attack. Initially, we saw a General Physician and after he performed all the blood tests (CBC) and chest x-ray, it was found that she has more eosinophil count. Then she was referred to a ENT doctor and finally they diagnosed it as an allergic cough and was asked to avoid all possible dust and cold items.

This was continuing without much improvement and in November 2009 she conceived, after which this cough aggravated very badly so much so that one afternoon in December we had to rush to a pulmonologist. As she was carrying, we were told that the best possible treatment at that point is using a nebulizer with Levolin and Budecart respules combination. Somehow, through the first 4-5 months of pregnancy she used the nebulizer with a decent relief. During her pregnancy in March 2010, she was first time prescribed a Serflo 250 inhaler by the General Physician who was treating her along with the Gyneacologist. We also thought that this might be like a gestational asthma which will subside after the pregnancy. Was it due to the medicines given pre and post her Cesearean or whatever, she didn't had any cough for couple of months up to September 2010. After this she again started getting the cough and uses the Seroflo 250 inhaler when needed.

Now a days, the cough episodes have increased so much that she has to use the inhaler 2 or 3 times a day some times. The same general physician who saw her during pregnancy says that it is allergic cough and nothing to worry, but i feel very worried because of inspite of using the inhaler she is getting cough many times. She is lactating right now and our baby is 9 months old. She is trying to control her cough with inhaler and sometimes with nebulizer. I know this is a pretty long message to read, but wanted to explain the problem from the beginning...

Please go through this and your response will be a great boon for us..Thank you very much.
Fri, 18 May 2012 in Asthma and Allergy
Answered by Dr. Deepak Anvekar 34 minutes later

Thanks for your query,

In case , your wife does indeed have a allergic cough, bronchodilator inhalers might not be helpful to her. Pollen allergy, rhinitis and hay fever are all examples of different allergies associated with allergic cough. These symptoms can be reduced by taking an antihistamine to lessen the severity of the allergic reaction.

Presence of Wheezing, indicates that the underlying condition might be asthma.
Asthma is due to a hypersensitiveness of the airway tract to variety of stimuli. People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common asthma symptoms include:

1. Coughing, especially at night ;
2. Wheezing ;
3. Shortness of breath ;
4. Chest tightness, pain, or pressure

Still, not every person with asthma has the same symptoms in the same way.

There is a need to rule out asthma by getting a lung function and a bronchial challenge test. Unless a proper diagnosis is made she might not be able to recieve the optimal treatment that might be actually be helpful to control her symptoms.

In case asthma is diagnosed, it can be controlled by taking the regular medications including inhalers. Typically bronchodilators are prescribed for regular use and for acute episodes. When exacerbation occurs, a steroid inhaler can be prescribed by your doctor which will help stabilize the airways and prevent further worsening or future attacks.

In addition medications can be prescribed to prevent the hypersensitiveness of the airway and reduce the reccurance of symptoms. (Eg. Mast cell stabilizers, Leukotriene modifiers )

You might consult a pulmonologist who can examine her and then provide her the proper treatment.

I hope this helps.
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