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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes chronic cough, wheezing and breathlessness when diagnosed with exercise induced asthma?

Answered by
Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15822 Questions

Posted on Mon, 28 May 2018 in Lung and Chest disorders
Question: For months, since moving from Las Vegas to XXXXXXX I've had a chronic cough and wheezing. It's worse at night. Dogs sleep in the bed. About 3 years ago, I was diagnosed with exercise induced asthma...but my recue inhaler doesn't help for what's happening now.

I should mention...accompanying the chronic cough and wheezing is breathlessness. In recent years I've been an avid racquetball player, and was an endurance athlete (triathlete) till age 40. Until a year ago, I used to go 10 or 12, I get out of breath in 2 or 3 games. I'm 5'9" 195 lbs. ...about 20 lbs. over my ideal for sports weight...but I've been this weight, plus or minus 10 lbs. for the last 15 years.
Answered by Dr. Michelle Gibson James 38 minutes later
Brief Answer:
step up in inhaler therapy, antihistamine/decongestant combination

Detailed Answer:
Hi, thanks for using healthcare magic

There are different possible causes for chronic cough.

The most common causes are--(1) post nasal drip syndrome (now called upper airway syndrome). Medical studies have found that 20% of persons ( 1 out 5 persons) do not realize that the drip is present, they present with the cough.

It is treated with an antihistamine/decongestant combination but this can sometimes take 2 to 3 weeks to take effect. eg zyrtec d, allegra a, claritine d, benadryl d

(2) asthma-- with your history of asthma, this definitely needs to be considered. A step up in your asthma management may need to be considered, this means using a daily inhaled steroid preventer for a few weeks to months. eg flixitide, pulmicort etc

This can be combined with the anti histamine/decongestant combination

(3)GERD- reflux- this is another common cause, if you have any reflux symptoms, these should treated with diet changes and medication

(4)non asthmatic eosinophilic bronchitis- the presence of eosinophils ( a type of white blood cell- responds to infection/inflammation in the body) in the lungs can cause a persistent cough.
This is also treated with a course of inhaled steroid

Treatment--(1)with a history of asthma, the first response to consider would be a step up in your inhaler therapy with the addition of a daily steroid inhaler for a period of time
(2)because it is so common, the use of an antihistamine/decongestant combination even if you have no congestion or post nasal drip

I hope this helps,feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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