: Cough can be the only symptom of childhood
asthma
DEAR DR.PAUL: My five year old son has been coughing for
the last 3 months. After many visits to different doctors, we
finally saw a doctor who said that this is asthma. How could this
be? He has no difficulty breathing or any other asthma symptoms.
PEDIATRICIAN DR.PAUL Answers: Asthma has three main
symptoms. The first two, a lot of people are aware of: wheezing
a whistling noise while one exhales and difficulty breathing,
The third symptom is a frequent or persistent cough. In fact
the definition of asthma is repetitive episodes or periods of
wheezing and/or shortness of breath and/or cough, in the absence
of any lung disease or problem.
In other words, the child is well otherwise. Using this definition
then, your son may have asthma. Note that asthma is not the
only cause of a persistent cough. However, it is known that
5% of asthmatic children have "Cough Manifest Asthma", where
the only symptom is cough. In this case the chest is usually
clear and there is no history of difficulty breathing.
In children less than 6 years of age, the diagnosis is made
based on history, such as in your child's case. In older children,
there are specific breathing tests that can prove whether or
not a child has asthma or not. These are called histamine or
methacholine challenges.
Another clue in helping confirm the diagnosis of asthma is a
history of eczema or other allergies. Generally, asthma occurs
in children with an atopic history. Atopy means an allergic
tendency. The allergic or atopic tendencies are inherited together
and these include eczema, food and respiratory allergies and
asthma. Additionally, in the family, a positive history of atopy
is also helpful as we know allergic or atopic tendencies are
inherited.
Once the diagnosis is made, the treatment is the same as for
the other forms of asthma ... either a bronchodilator alone
or with an anti-inflammatory medication. However, in my mind,
one of the most important things one can do in terms of treatment
is to make sure that there is nothing in the child's environment
that is triggering these symptoms.
Second hand cigarette smoke is a very common irritant. When
parents stop smoking in the house and in the car, often asthma
symptoms improve dramatically, and in some cases stop all together.
Similarly, dust mites that live in carpets, mattresses, pillows
and stuffed toys can also be making symptoms worse and should
be eliminated. Pets, most often cats, can also make a things
worse. If a child is allergic to a certain pet, then this particular
pet is making the symptoms worse or even causing them in the
first place.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
