Can You Have Asthma Without Coughing? Allergies and Symptoms

Can asthma be diagnosed without a cough?

Hello Doctor: I have a history of allergies, and both of my parents are allergic as well, but neither of them has asthma.
I have had dermatitis and rhinitis since childhood, and I gradually developed urticaria.
Recently, we got a dog at home, and all my allergies flared up at once.
My throat also feels a bit tight and itchy; I used to experience this occasionally, but since getting the dog, my throat feels tight and itchy all day long, sometimes more severely.
After showering and in the morning, my nasal allergies are at their worst, and my throat also becomes very itchy.
Could this be asthma? Just now, a family member vacuumed the dog hair, and even though I was 1.5 meters away, as soon as the vacuum turned on, I felt my throat suddenly tighten, making it hard to breathe.
I quickly left the area, and I felt a bit better afterward.
This was the first time it was this severe; usually, I only feel a bit of breathlessness.
I looked online and found that asthma is associated with coughing and phlegm, but I don't cough at all, and I have very little phlegm.
However, I do hear a wheezing sound when I exhale, and occasionally I feel a constriction in my throat or trachea (between my neck and collarbone) when I inhale.
Does this count as asthma? I am currently working in Japan and won’t return home for another two months, so I can't see a doctor before then.
If it is asthma, will continued exposure to this environment lead to severe asthma? I am still a minor; if it is asthma, would early treatment help with better control? I had a pulmonary function test two years ago before going abroad, and the results were normal.
Could it be that the test didn't show anything because I wasn't experiencing allergies at that time?

You, 10~19 year old female. Ask Date: 2020/05/11

Dr. Zhang Ziyan reply Pulmonology

Hello, based on your questions, I have categorized them into the following points:
1.
Regarding symptoms such as dermatitis, rhinitis, and urticaria, along with increased allergies triggered by pets, you may also experience a tight and itchy throat.
If your throat suddenly feels very tight and you have difficulty breathing, leaving that environment seems to improve your condition.
This indicates that your symptoms may have reached the level of asthma, or at least a severe allergic reaction.
2.
If it is indeed asthma, continued exposure to such an environment could lead to persistent asthma attacks and further deterioration of lung function.
It is advisable to seek examination and treatment as soon as possible.
3.
Early treatment for asthma is certainly beneficial.
Lung function in asthma patients can often appear completely normal when not experiencing an attack.
Please follow the advice of your treating physician for detailed information.

Best regards from the Department of Pulmonary Medicine at Changhua Hospital.

Reply Date: 2020/05/11

More Info

It sounds like you're experiencing a complex set of symptoms that may be related to your allergies and potential asthma. Let's break down your situation and address your concerns regarding asthma, allergies, and the symptoms you're experiencing.

Firstly, it is indeed possible to have asthma without the classic symptom of coughing. Asthma is characterized by inflammation and narrowing of the airways, which can lead to various symptoms, including wheezing, shortness of breath, chest tightness, and coughing. However, not all individuals with asthma will exhibit coughing as a primary symptom. In your case, the tightness and itchiness in your throat, especially after exposure to allergens like dog hair, could indicate an asthmatic response, even if you are not experiencing significant coughing or phlegm production.

Your history of allergic reactions, including skin conditions like eczema and urticaria (hives), suggests that you have a predisposition to allergic responses. The recent introduction of a dog into your home may have exacerbated your symptoms due to the presence of pet dander, which is a common allergen. The tightness in your throat and difficulty breathing when exposed to allergens, such as when your family used a vacuum cleaner, further supports the possibility of an allergic reaction that could be linked to asthma.

The wheezing sound you described when exhaling, along with the sensation of your throat or airways tightening, are significant indicators of bronchial hyperreactivity, which is often associated with asthma. Even if your lung function tests were normal two years ago, asthma can develop or change over time, especially in response to new allergens or environmental factors.

Given your situation, it is crucial to manage your exposure to known allergens as much as possible. Here are some recommendations:
1. Avoidance of Allergens: Try to minimize your exposure to dog hair and dander. This may involve keeping the dog out of your bedroom, using air purifiers, and ensuring that your living space is regularly cleaned to reduce allergens.

2. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This can help you identify patterns and provide valuable information to a healthcare provider when you are able to see one.

3. Consider Over-the-Counter Medications: Antihistamines may help alleviate some of your allergy symptoms, such as throat itchiness and nasal congestion. However, consult with a healthcare professional before starting any new medication, especially given your history of allergies.

4. Seek Medical Attention: If your symptoms worsen or you experience significant difficulty breathing, it is essential to seek medical attention as soon as possible. Asthma can progress, and early intervention is crucial for managing the condition effectively.

5. Future Evaluation: Once you return home, consider getting a comprehensive evaluation from a healthcare provider, including a detailed history, physical examination, and possibly repeat lung function tests. This will help determine if you have developed asthma and what management strategies would be appropriate.

In summary, while you may not currently exhibit the classic symptoms of asthma, your experiences suggest that you could be at risk for developing asthma or experiencing allergic asthma. It is important to manage your environment and symptoms proactively and seek medical advice when possible. Early diagnosis and treatment can significantly improve your quality of life and prevent the progression of asthma.

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