Cough

Cough is a typical symptom of asthma—along with wheeze, shortness of breath, and chest tightness. The cough usually sounds dry and is unproductive.1,2 If a cough lasts for eight weeks or more, it is considered to be a chronic cough.3 Chronic cough is a symptom of many different conditions, so your medical history, a physical examination, and tests determine what the cause is.

What other conditions can cause chronic cough?

Other common causes of chronic cough are postnasal drip syndrome, GERD (gastroesophageal reflux disease), taking ACE inhibitors, colds, and exposure to cigarette smoke or other irritants.3 Eighteen percent to 42% of patients have at least two causes of chronic cough, and 42% have three or more causes.3

How common is cough in people with asthma?

Asthma is the second most common cause of chronic cough.4 Asthma is responsible for chronic cough in 24% to 29% of adult non-smokers.4

Cough is the most commonly reported asthma symptom.3 In one study, 88% of people who went to the emergency room for an asthma flare-up reported cough as one of their symptoms.5 Cough may last for up to three weeks after an asthma attack.3

For about 57% of people with asthma, it is the only symptom they have.3 This type of asthma is called “cough-variant asthma.”3

How is cough evaluated?

Your medical history is the first step in figuring out if your cough is related to asthma.3 Questions your health care provider may ask include:

  • Are you a current, former, or never smoker?
  • Are you taking an ACE inhibitor?
  • Are you exposed to irritating chemicals at work or at home?
  • What situations make your cough worse?

Signs that cough is asthma-related are that it is worse in the cold, while exercising, or at night. If your provider suspects that you have asthma, you may be asked to do spirometry. Spirometry is an important lung function test to evaluate how much and how quickly you can exhale air. The test is usually done before and after taking a medication that opens the airways (“bronchodilator”). Asthma is likely if medications are able to open the airways.

If it does not seem like asthma is the cause of your cough, your provider may recommend doing a chest x-ray. The chest x-ray could be used to identify injury or stretching of the airways, abnormal masses or nodules in the lungs, pneumonia, or tuberculosis.3

How is asthma-related cough treated?

If asthma is the cause of your cough, your provider will recommend treatment for asthma. Initial treatment of asthma usually involves inhaled corticosteroids and avoiding asthma triggers.6 It may take up to eight weeks for the cough to go away after starting inhaled corticosteroids.4 Leukotriene receptor antagonists are an alternative to inhaled corticosteroids for adults and children ages 5 and up with mild asthma.6 There is some evidence that these medications are particularly good for treating asthma-related cough.4

Written by: Sarah O'Brien | Last Reviewed: May 2016.
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