Asthma Symptoms and Chronic Cough: A Patient's Guide

Q: Asthma Symptoms and Chronic Cough: A Patient's Guide

Hello Monica： Patients with asthma often have allergic rhinitis, a history of atopic dermatitis in childhood, or a family history of allergic rhinitis or asthma. <br>When asthma patients are not experiencing an attack (such as nighttime cough or wheezing with associated wheezing

Asthma with chronic cough?

Hello Dr.
Yang,
(1) I am planning to go bungee jumping next month, but during high school, I was randomly selected for a screening that indicated possible asthma symptoms (though I did not follow up with further testing).
Additionally, I have a long-term cough issue.
I recently visited a pulmonologist near my home, and both the chest X-ray and pulmonary function tests came back normal.
Does this mean I do not have asthma, and can I safely participate in bungee jumping?
(2) Regarding my chronic cough, I have seen several doctors in the past, but my condition did not improve, so I stopped seeking treatment.
I often experience hoarseness, a persistent feeling of phlegm in my throat that requires clearing, and the phlegm is clear to white in color.
Typically, my symptoms improve in the afternoon (I rarely cough at night or while sleeping).
However, when I catch a cold, my cough worsens (I do cough at night but not to the point of being unable to sleep), and the phlegm is mostly thick yellow with occasional white.
I can hear the phlegm rolling in my lungs when I breathe.
Once the cold resolves (after about 8 days), these symptoms also improve and return to my usual condition.
Additionally, my father has a similar cough with a lot of phlegm.
Could this be hereditary? Which specialty should I consult? (I have previously visited internal medicine, ENT, and pulmonology.)
Thank you for your assistance!

Monica, 20~29 year old female. Ask Date: 2009/04/17

Dr. Yang Wenda reply Pulmonology

Hello Monica: Patients with asthma often have allergic rhinitis, a history of atopic dermatitis in childhood, or a family history of allergic rhinitis or asthma.
When asthma patients are not experiencing an attack (such as nighttime cough or wheezing with associated wheezing sounds), their lung function may be normal.
Therefore, if your last pulmonary function test was conducted during a period of significant clinical cough symptoms and the results were normal, the likelihood of asthma is low.
Conversely, if the pulmonary function test was normal when you had no obvious cough symptoms, asthma cannot be ruled out.
In this case, a bronchial provocation test should be arranged (where you inhale substances that are more irritating to the bronchial mucosa; normal individuals will not experience a significant decline in lung function (20%) beyond a certain cumulative dose, whereas patients with latent asthma may show a significant decline in lung function before reaching the normal tolerance threshold).
This aspect should primarily be evaluated by a pulmonologist.
Additionally, your symptoms may resemble chronic cough and a sensation of a foreign body in the throat caused by post-nasal drip, so it would be advisable to consult an otolaryngologist for further diagnosis.
Best wishes!

Reply Date: 2009/04/17

More Info

Hello! Thank you for your detailed questions regarding asthma symptoms and chronic cough. Let's address your concerns one by one.

1. Asthma and High-Altitude Activities: You mentioned that you had a previous screening for asthma symptoms during high school, but you did not follow up with additional testing. It's great to hear that you recently had a chest X-ray and pulmonary function tests that came back normal. Generally, normal results from these tests suggest that you do not have asthma or significant lung dysfunction. However, asthma can sometimes be exercise-induced or may not show up in standard tests if it is mild or intermittent. If you have a history of wheezing, shortness of breath, or coughing during physical activities, it would be wise to consult with a healthcare provider before engaging in high-altitude activities like bungee jumping. They can assess your risk more thoroughly and may recommend a bronchodilator to use as a precaution.

2. Chronic Cough and Throat Symptoms: Your description of a chronic cough, especially with phlegm that varies in color and consistency, suggests that you may be dealing with a chronic respiratory condition. The fact that your symptoms worsen during colds and improve afterward indicates that you might have a reactive airway condition or chronic bronchitis, especially if you have a family history of similar symptoms. The transparent white phlegm you experience could be related to allergies or post-nasal drip, while the yellow phlegm during colds suggests a possible infection.

Given your symptoms and family history, it would be beneficial to see a pulmonologist or an allergist. They can perform more specific tests, such as allergy testing or a methacholine challenge test, to determine if you have asthma or another underlying condition. Additionally, they can help you develop a management plan to address your chronic cough and throat irritation.

Genetic Factors: It’s not uncommon for respiratory conditions to run in families. If your father has similar symptoms, it could indicate a genetic predisposition to respiratory issues, such as asthma or chronic bronchitis. This familial link can be significant, as environmental factors combined with genetic susceptibility often play a role in the development of chronic respiratory conditions.

Management Strategies: In the meantime, consider the following strategies to help manage your symptoms:
- Stay Hydrated: Drinking plenty of fluids can help thin mucus and make it easier to expel.

- Avoid Irritants: Stay away from smoke, strong odors, and allergens that may trigger your symptoms.

- Use Humidifiers: Keeping the air moist can help soothe your throat and reduce coughing.

- Monitor Your Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider.

In summary, while your recent tests are reassuring, it’s essential to remain vigilant about your symptoms, especially if they worsen or change. Consulting with a specialist will provide you with the best guidance for your situation. Enjoy your upcoming activities, and take care of your health!

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