Throat Irritation and Dry Cough: Is It Asthma?

Q: Throat Irritation and Dry Cough: Is It Asthma?

Hello： You may have allergic rhinitis, so be careful not to consume overly cold foods. <br>If you are not experiencing difficulty breathing, you might consider not using bronchodilators for the time being!

Itchy throat and dry cough?

I have a habit of running 10 kilometers or hiking regularly, and I participate in full marathon events.
I do not smoke or drink alcohol.
I have been experiencing nasal allergies, often sneezing, and I frequently have a scratchy throat and dry cough, although the dry cough tends to improve when the weather warms up.
A few years ago, I started having nasal allergies and sneezing, but the symptoms of a scratchy throat and dry cough were less frequent.
In mid-November last year (2022), I experienced symptoms of a scratchy throat and cough, and I was diagnosed with COVID-19; however, my condition improved after taking medication for two days.
A few days later, I started coughing again, particularly in the evening and at night, but it improved after going to bed, with no nighttime coughing.
After completing my quarantine, I sought medical attention, reporting that my parents do not have asthma, but my younger brother does.
I sometimes experience chest tightness, and both my child and I have nasal allergies.
Based on this information, the doctor suspected asthma, but chest X-rays and pulmonary function tests were normal, and allergy testing did not reveal any allergens.
The doctor prescribed a bronchodilator inhaler, advising me to use it twice daily, but after a month, I did not see any improvement.
During follow-up visits, I continued to receive prescriptions for the bronchodilator, but I only used it intermittently in the mornings, sometimes forgetting to use it for several consecutive days due to my busy schedule.
However, as the weather gradually warmed up, my scratchy throat and cough actually improved.
I would like to ask the doctor: 1.
Besides the medical history, are there other tests that assist in diagnosing asthma? 2.
Does my situation qualify as a confirmed asthma diagnosis? 3.
Is there a risk if I do not use the bronchodilator inhaler now? 4.
Are there any other precautions I should be aware of? Thank you, doctor.

kochien, 60~69 year old female. Ask Date: 2023/04/26

Dr. Yang Wenda reply Pulmonology

Hello: You may have allergic rhinitis, so be careful not to consume overly cold foods.
If you are not experiencing difficulty breathing, you might consider not using bronchodilators for the time being!

Reply Date: 2023/04/26

More Info

Understanding throat irritation and dry cough can be complex, especially when considering the possibility of asthma. Based on your description, it seems you have a history of allergic rhinitis, which is characterized by symptoms such as sneezing and nasal congestion. This condition often coexists with asthma, as both are manifestations of airway hyperreactivity and inflammation.

1. Asthma Diagnosis: The diagnosis of asthma typically involves a combination of clinical history, physical examination, and specific tests. While a thorough history and physical examination are crucial, additional diagnostic tools can include spirometry (a lung function test), peak flow monitoring, and sometimes methacholine challenge tests. These tests help assess the degree of airway obstruction and responsiveness to bronchodilators. In your case, normal X-rays and lung function tests suggest that significant airway obstruction may not be present at this time, which complicates the asthma diagnosis.

2. Asthma Confirmation: Given that your symptoms of throat irritation and dry cough improve with warmer weather and are associated with allergic rhinitis, it is possible that you are experiencing a form of cough-variant asthma or exercise-induced bronchoconstriction. However, without clear evidence of airway obstruction during testing, it may be premature to definitively label your condition as asthma. The presence of family history (your brother has asthma) and your symptoms do raise the suspicion, but a formal diagnosis should ideally be based on objective findings.

3. Risks of Discontinuing Medication: If you stop using the bronchodilator (the inhaler), there is a potential risk of experiencing increased symptoms, especially if your airways are reactive to allergens or irritants. However, if your symptoms are currently well-controlled and you are not experiencing significant wheezing or shortness of breath, it may be reasonable to reduce usage. It is essential to communicate with your healthcare provider about any changes in your symptoms or medication regimen.

4. Additional Considerations: Given your history of allergies and respiratory symptoms, it is crucial to manage your allergic rhinitis effectively. This may include avoiding known allergens, using antihistamines, or considering intranasal corticosteroids. Additionally, maintaining good hydration, practicing good respiratory hygiene, and engaging in regular physical activity can help improve overall respiratory health. Monitoring your symptoms and keeping a diary of triggers can also provide valuable information for your healthcare provider.

In summary, while your symptoms may suggest asthma, the absence of significant findings on lung function tests complicates the diagnosis. It is essential to work closely with your healthcare provider to monitor your symptoms, adjust your treatment plan as necessary, and ensure that you are managing both your asthma and allergic rhinitis effectively. If symptoms persist or worsen, further evaluation may be warranted to explore other potential causes of your throat irritation and cough.

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