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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for cough variant asthma

Hi 11 year old son diagnosed with cough variant asthma only symptom is dry barking cough he is very active he is in a running club and plays football but cough is getting in the way of his sports brown and blue inhaler does not stop cough has had cough for 2 years consultant says his lungs are outstanding due to running don t understand why he still has cough any suggestions ?
Tue, 22 Sep 2015
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Allergist and Immunologist 's  Response

Thank you for asking at HCM.

I went through your son's history and would like to know more about him as follows:

1. There can be many causes for dry cough in children. How was he diagnosed as cough variant asthma?

2. Has he ever had wheezing (whistling sound from chest), or shortness of breath?

3. What are his nose symptoms - running nose, nose congestion, sneezing, etc?

4. Does he get cough only while physical activity or at other times also? If at other times also, more during night or more during day?

5. Are there any seasonal variations? Which is the worst and the best season for him?

6. Does he have any digestion related symptoms like vomiting, nausea, regurgitation of fluids after eating, constipation, etc?

7. Does he have headache?

8. Does he have any one in family with allergies?

9. Is he routinely exposed to smoke, dusts or pollution outside or inside home?

Above details would help me to understand his complaints better.

At present, from your provided history, I would like to make suggestions for him as follows:

1. Only after knowing more details and investigations like spirometry, I would like to diagnose as "cough variant asthma". Till then, there are many alternative possibilities.

2. Inhalers (I guess brown one is the preventer and blue one is the rescue inhaler) are usually good in asthma. However, if he is not responding to them, I would think of two possibilities:

a. Technique of using inhalers could be wrong - please verify the inhaler technique in front of your doctor. Please shake the inhaler vigorously before use. Please use spacer with inhaler, if not using. Make sure your son gargles after each use of inhaler.

b. He may respond to other anti-asthma drugs like montelukast. In that case, I would prescribe him montelukast. However, before that, I would like to confirm his diagnosis.

c. He might not have cough variant asthma.

3. For children with exercise induced bronchospasm, I also prescribe vitamin C for at least 1 month which helps.

4. As he has long standing cough, I would suggest him regularly warm saline gargles twice a day.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask at HCM.

Wish your son the best of the health ahead.

Thank you very much & regards.
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