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Dr. Andrew Rynne

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

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15822 Questions

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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 games...now, 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.
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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
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