Cough is a common symptom of asthma. Wheezing, shortness of breath, and chest tightness are other common symptoms. Coughs caused by asthma are usually dry and unproductive. A cough that lasts for 8 weeks or more is considered chronic.1-3
Chronic cough also can be a symptom of many other conditions. Your doctor will look at your medical history and use tests to determine the cause of your cough. If asthma is the cause, they will suggest treatments to reduce inflammation and control symptoms.4,5
What does cough look like in asthma?
Asthma is a common cause of chronic cough. Other conditions that can cause chronic cough include postnasal drip syndrome, gastroesophageal reflux disease (GERD), and common colds. But in people with asthma, coughing often follows a pattern:1,3,4
- It comes and goes over time or within the same day.
- It starts or gets worse after an infection.
- It is triggered by exercise, allergies, or cold air.
- It gets worse at night or in the morning.
Chronic cough can have a major effect on everyday life. It is often linked to worse health status and more severe disease. For people with asthma, chronic cough is linked to worse symptoms, more frequent asthma attacks, and more doctor’s visits.3,5
Up to half of people with asthma have chronic cough. For some people with asthma, cough is their only symptom. This is called cough-variant asthma (CVA), and it is one of the most common causes of chronic cough. Some people with CVA go on to develop classic asthma.6
Why does asthma cause coughing?
Cough is the body’s way of trying to remove substances that irritate the lungs. Many people with asthma have a more sensitive cough reflex. This means they cough when they are exposed even to small triggers.3,5,7,8
There are many possible triggers of asthma attacks. Once the lungs of a person with asthma come into contact with specific triggers, their immune system overreacts. This means it responds strongly even to substances that are not harmful.2,4
When the immune system is activated, airway muscles tense up. The muscles start to swell and produce thick mucus. This causes the airways to become narrower and narrower. The result is symptoms of an asthma attack, such as cough.2,4,7
How is cough diagnosed and treated in asthma?
Controlling asthma is an important way to treat cough. People with milder and better-controlled asthma have:3,5
- Lower cough frequency
- Better cough-related quality of life
- Lower cough reflex sensitivity
Talk to your doctor if you notice a new or worsening cough. Your doctor will first confirm that the cough is caused by asthma. They will ask you questions about your symptoms and health history. They will also perform tests, such as spirometry and a cough challenge test.5
If asthma is the cause of your cough, over-the-counter cough medicine may not work. Your doctor will suggest prescription treatments for asthma. They also may refer you to an allergist to help you determine your triggers. The treatment they recommend will depend on the frequency and severity of your symptoms. Initial treatment usually involves:3,7,9
- Avoiding triggers
- Daily inhaled corticosteroids to relieve inflammation, which may take up to 8 weeks to begin controlling cough
- Short-acting beta-agonists (SABAs) as needed for quick relief
Leukotriene receptor antagonists (LTRAs) are an alternative for adults and children over 5 years old with mild asthma. These medicines may be better at treating asthma-related cough and cough reflex sensitivity.3,6