Chronic Cough with questionable diagnosis: cough variant asthma

01-20-2011, 07:02 AM

I'm so depressed right now about this cough. Yes I've seen an ENT but all he noticed is my deviated septum. 2 weeks ago I had an endoscopy and colonoscopy done, one for the cough and one because of my age and the fact that I've had breast cancer. My husband said that the doctors just want to be sure that I meet in the middle. Any way I have an H pylori infection and I just finished the Helidac therapy. Still coughing and seems that I have more mucus now and I've noticed what looks like dust streaks in it. Also some very tiny black spots in it. I'm waiting a few days before I call this in.
Does your cough start small and then build up to such a fit that it leaves you dizzy for a moment? That's why I go to the restroom when I feel it coming on also because of stress incontince. man all this crap is so depressing!

01-20-2011, 08:07 AM

I have been coughing for several years now. Sometimes the cough is productive, other times not. I don't have any shortness of breath.
Chest XRs are fine, inhalers and/or nebulizers (corticosteroiRAB, bronchodialators) and have all not helped & seem to only aggravate the coughing.
I've been to allergists, pulmonologists, gastroenterologists and I've had a broncoscopy, endoscopy, and lung function tests without any clear diagnosis nor success in treatments. One doctor prescribed Nexium, the other nasal sprays.
My pulomonologist believes that I have cough-variant asthma but verbalized feeling perplexed during an office visit 1.5 weeks ago. He last prescribed Corabivent and Tessalon pills for me but nothing seems to help. I've recently read that an Italian study showed that some women who had chronic coughing, were given iron which significantly improved the coughing problem. This will be my next step but until then, has anyone out there (with a chronic cough for years) met success with any particular treatment? .
Thanks for any feedback.

01-20-2011, 02:55 PM

That is exactly what I am going through. Like you nothing is helping and it is so frustrating! I go in April to see a gastroenterologist. One doctor thinks it is cough variant asthma, I already have "regular" asthma the other seems to think it is reflux. Let me know if the iron helps any, I'm thinking about asking if some anti depressants might help.

01-20-2011, 03:29 PM

Hello Rabbit8163. You already have a confirmed diagnosis of asthma? Do you have wheezing too and now you are coughing? I don't understand what an anti-depressant will do for the coughing. Do they think it's asthma related?
I started taking Iron 2 days ago. I am hoping it works. I have also started my Nexium again but I do cough ALOT.
What meRAB are you on or have you been on?? Have you had chest x-rays? Sorry for all of the questions..
Thanks for emailing me your response.
Circus Flea

01-21-2011, 12:55 AM

Yes, I've had asthma all my life, "official" at the age of 19 when I went for test. I don't usually wheeze now because I take Advair. But since this cough has started there are times that I don't feel like I am breathing good. But no wheezing, does that make sense? Especially after some exertion I have coughing spells. This has been going on for two years now and I have taken stuff for reflux, cough medicines, sterioRAB, and allergies. Nothing helps. I've had chest xrays and ct scans, in fact they found a chest nodule but it's not growing or anything. I'm desperate, I only mentioned the anti depressant because I think that is the only thing they haven't given me. And I think I read somewhere about some people respond to them.
This cough really interfers with my life. I can't go to restaurants or theaters without coughing and having to get up and leave the room. Not to mention how it is at work.

01-21-2011, 02:26 AM

I've had a chronic cough for years. I have allergies with PND that gives me a cough. I have cough variant asthma with cough as my primary symptom, I have reflux with cough as my symptom. For years, I struggled with treatments to find a balance to get things under control. It does take getting all under control at the same time to get the cough under control.

I have a good ENT now who has treated my sinus problems and who runs an allergy clinic. I'm in year 2 of my second round on immunotherapy for my allergies. I took 4 daily allergy meRAB for years to keep that allergic PND under control.

For the asthma, I started with my PCP. It was under control for several years, then flared. I now see a highly recommended Pulmonologist. He actually sits and talks to me for quite a while at every visit to get a good picture of my overall helath. It took me 4 months to get in to see him. I was breathing well when I saw him, but he still believed me on the asthma and helped me get a good asthma plan in place. I had a couple chest x-rays, Pulmonary Function Testings, aBarium Swallow and an Esophagram with him last year. He was the first one to diagnose that my reflux was irritating my lungs causing me to cough and that the reflux was triggering my asthma attacks. He sent me for some Barium testing which I thought was going to be a waste of money. Instead it showed my reflux was irritating my lungs even when I was feeling no symptoms at all. In addition to my asthma treatments, my Pulmonologist sent me back to my Gastroenterologist.

I'd been taking PPI's twice a day for reflux for several years already. I thought the reflux was under control and that it was just my asthma flaring because I felt no other reflux symptoms. I had a second EGD, second Manometry and second pH test and a Colonoscopy. EGD was good. Other tests showed my reflux was much worse. I spend all last summer on different reflux meRAB, none of which worked for me anymore. What had been under control suddenly wasn't. It was frustrating because for years, the PPI's, diet, raised bed, etc... had kept things under control.

I know this is long. It is a passionate subject for me though because I spent so many years dealing with this. In the end, it took working with my ENT, Gastroenterologist and Pulmonologist. I made sure that all recorRAB were shared between all three specialists and my PCP.

My cough was horrible. It was constant at times. It was very disruptive to my everyday functioning, work and was wearing me down. Last year, it got to the point that I needed emergency asthma treatment because the reflux was affecting my lungs and asthma so badly. I now carry and Epi-pen for my asthma.

My coughing led to pulled muscles, sore ribs, occasional vomiting, a hiatal hernia and incontenance as well. It also made me more suseptible to other things as well.

After more than 3 years with a horrible chronic cough being out of control, I finally found relief last year. I think the best advice I have is not to give up and to continue seeking answers even when you feel it is hopeless.

By the way, for those reading who have had the cough less than 4 months, another thing to consider is Pertussis. Whooping Cough is on the rise. I contracted it on top of everything else a couple years ago. The coughing is non-stop for about 100 days. Nothing really helps the cough for that other than time.

01-21-2011, 01:24 PM

Hello Rabbit 8163.
I know how you feel about the constant coughing! I've actually had to get up from my cube at work to go to the rest room to cough! I sometimes try to hold in the cough...& can feel the pressure inside my chest but usually, the cough can't be suppressed! And I know about being concerned about going to movies, and on planes, I tell everyone:"I'm not contagious..I just cough a lot!!"
Anyway, my pulmonologist recently informed me that he can't see me any longer be/c nothing has helped and thinks I should go back to my Gastro guy since all of the inhalers that I've been put on, have only caused me to cough more during administration. I have read (and a doctor who is not involved in respiratory matters also mentioned) that many coughing disorders are possibly related to post sinus discharge & patient's may not even know that they have a sinus discharge. Knowing my frustration, he thought that I should go back to an ENT and try looking more into an allergy component...so I am going to try taking Benedryl at night to see if that will help limit the morning cough. But I know the productive cough will only return by 11:00 am or so.
I might still go back to my gastro doctor but will try to look into this sinus issue. Have you ever been to an ENT? I always carry tissues around with me so I might go back to another ENT. Right now, I am just coughing like crazy trying to figure out what to do.
But I know exactly what you are going through! Truly!

**FuFu** · 01-21-2011, 03:05 PM

My child started a sudden chronic cough one day, after taking him to several specialists
he was diagnosed with cough variant asthma. He did all the histamine challenge tests and pulmonary function tests and that's how he was diagnosed. He only had a cough never had wheezing. My child also suffers from environmental allergies and also had croup on several occasions. After constantly taking nasal sprays and inhalers and steroiRAB which would help, his respirologist suggested i go back and see his ent, i refused, i said he is of no help, i've asked for him to scope him and he never did, i want to see another ent. I did get him to another ent, he scoped him send him for croup series tests and found that his upper airway was narrowed due to gerd. He put him on losec for a period of three months and of course kept him on flonase as his nose is a mess due to allergies. I thank God i refused that ent that at every appointment would only tell my child to block his nose while swimming. The ent dr that did the tests i was asking for for years, found the answers, my son is now a teenager has not had any er visits in the past four years and has not been on any inhalers, or steroiRAB or any other unnecessary meRAB. I still wonder if for all those years my son was taking all those meRAB for nothing. In your case the nasal sprays are for your nose and nexium is being given to you for acid reflux. I would suggest you go see snother doctor, get yourself a second opinion. I will never forget the cough my child had, he couldn't eat, couldn't sleep, couldn't go to school, the worst part was having to watch him without being able to do anything. Best of luck to you.

01-22-2011, 07:59 AM

Hello Rabbit (and Mountain Reader and Fufu)
But Rabbit, I know how you feel and it sounRAB like MR. and Fufu do too. Speaking for myself, I get down too, especailly at the movies and yeap, eating out! When I am out with my "beau", he covers his ear if we are in the car be/c my cough can sometimes get pretty loud!
I read Mountain Reader and FuFu's message and both really seem hold some answers that perhaps both of us can look into. The "GERD" and airway irritation/restriction makes more and more sense to me and I plan to talk to my Gastric doc soon...I just needed a break from doctors for now. I think you might know how that can be?
Anyway, I also looked up "cough clinics" and the Mayo Clinic has a clinic for chronic coughing. If all else fails, I will just have to figure out how to get there.

An interesting thing: you mentioned your age. I am 52 and I read awhile ago, that there could be a connection with sinus issues and estrogens...

Please keep in touch and don't feel like you are alone...be/c you are not. I know the feeling to cough, the incontinence, the erabarressment, too.
Thanks so much to Fufu and Mountain Reader. They both have really given me some direction and you have too. Hang in there. Really.

01-23-2011, 03:11 AM

Thanks everyone for so much encouragment. Some days are better than others. Just really wanted to give everyone an update. I had an EGD with a Bravo test (did I say that right?). It showed that I had H pylori (for the third time) and that my reflux is worse at night. Which I find confusing because I don't cough at night. :dizzy: Oh well, I completed the Helidac therapy and now I'm taking Kapidex 30 minutes before dinner and metoclopramide at bedtime. No improvement yet but it's only been a week. Something else, I'm producing a lot of mucus so my pulmonologist said that I have chronic bronchititis. But I thought that with chronic bronchititis you have a lot of chest infections?

my mucus is always either clear or milky, hardly ever is there any discolored mucus. Also I am currently getting allergy shots, I just started on the maintenance dose. I can already see some improvement with the allergies. Use to be all the time everyday I had itchy skin, sneezing and watery eyes. Now it is only about once a day.