To ask about ‘cough variant asthma’

[timeisnotaline]

My 5yo had a chronic cough last year which started to interfere with activity and daily life. Gp suggested cough variant asthma, there was no other noticeable difficulty breathing except the coughing so asthma hadn’t occurred to me. He went on ventolin and montelukast, with no noticeable difference even having ventolin 4 x a day. We went back at Christmas and added qvar inhaler (steroid) at night, which basically stopped the cough and he’s stopped all meds now. Specialist appt is tomorrow and I’d really like to understand more about this asthma,it’s Telehealth so they can’t do a lung function test. Is it likely to be ongoing, can it be dangerous like wheezing asthma, how should I tell if it’s a cough or another asthma episode starting again? Has anyone experience of this type of asthma? His 2yo brother has also just been suggested ventolin for a, you guessed it, cough, adding to my concern that I don’t understand this asthma and how it manifests, or even how do they confirm that’s what my boys have- seems pretty strange they both get it similar timing at such different ages.
In Australia if relevant!

My daughter has it. She wasn’t diagnosed till she was about eight or nine. Till then she had a pretty near constant dry cough. We put it down to a nervous tick.
It was discovered when a GP referred dd for a chest X-ray.

She’s currently on only the brown and blue inhaler. Two puffs of the brown inhaler in the morning and evening and the blue inhaler if she is having difficulties breathing.

She’s not had to increase the use at all. Although she says she does get coughing fits in winter more. So I ensure she’s properly wrapped up and has her mouth covered as it helps her not to breathe in cold air.
She has regular checks with the asthma nurse as well.

My middle son had it.

Nothing really worked for us, steroids helped when it got really bad.

Hi Timeisnotaline,

I had cough variant asthma as a child (I still have a salbutamol inhaler (ventolin) but I only use it when I have viruses or experience another trigger, which is not very often!). I had a chronic asthma cough from age of 1 until I was 7/8ish but got away with just the salbutamol (preventer steroid inhalers were less commonly prescribed in those days though) so my situation sounds a bit different to your son's.

Cough variant asthma can turn into classic asthma (with wheeze, shortness of breath etc.) in about 30% of cases or can stay as cough-variant asthma, in which case people sometimes outgrow it.

People with cough variant asthma can still have asthma attacks (which may start with a period of prolonged coughing- it will feel to the sufferer like they cannot breathe out at all without coughing) so it's definitely worth making a plan in case that should happen and making sure that anyone who looks after your son knows how to respond in the event of an attack.

Very similar to PP

DS2 had this when younger. Brown inhaler morning and night, blue when needed (usually winter). He completely grew out of it by age 12.

DS1 had/ has traditional wheeze asthma which got quite serious as a child, many hosp admissions, so I suppose we were quite clued up with all things asthma and knew to look for the cough.

If it's any consolation his cough asthma wasn't nearly as bad as his brother's wheeze asthma.

Thanks very much all. I’ve been starting to wonder if I have it too- many chronic coughs very much with that feeling that I can’t breathe without coughing, so describing it that way very much hits home. Qvar is the brown inhaler, and it sounds like others have taken it over a long period of time which is another relief.

The ‘a cough can turn into an asthma attack’ does worry me as I never felt like the blue inhaler helped, and it’s hard to tell until he can explain it better. I know he’s 5 but we haven’t had much luck getting a clear picture from him of if it the blue inhaler eased the cough. So if it got more severe I’m not sure options, I’ll ask the doctor tomorrow.
@frazzledasarock what did the X-ray show re asthma? Does it show narrower airways? My son is supposed to have a lung function test but with lockdown we are Telehealth only.

I don’t remember now what the X-ray showed. Although the GP did show me and explain. It was a long time ago now she’s late teens and managing well. Thankfully.

I’m in my 40s and have it. Can be dangerous (like all asthma) as I ignore the cough thinking it’s a virus or hay fever. Progressively gets worse and takes a while to increase my qvar to improve the situation. My ventolin barely helps.

I often get it after a cold and it can last weeks (so not like an ‘attack’). Had it this time last year and my peak flow was around 270.

Take it seriously, take the steroids as directed (it’s taken me around 30 years to get there!) and keep an eye on peak flow to know when to up the steroids and control it.

It is horrid because sleeping is difficult and your chest and back hurt so much!

My DS (8yrs) has had this from birth. Bizarrely, his occurs almost on a monthly cycle and the doctors have never been able to get to the bottom of why. Anyway, he has a beige snd a blue inhaler which I think help to a degree.

My son was told he had this by our GP. Beclometasone inhaler massively impacted my son's MH so we were given montelukast.

None of them made any difference. What did was an air purifier in his room and sleeping on a top bunk. Having seen a specialist, they were happy that it was controlled with these steps and said their would have recommended these first....

My daughter had this and was on inhalers through childhood. She is in her twenties now and is mostly free from it (odd use of inhaler during winter but that is all).

My dd got that diagnosis at 5. It was eventually changed to asthma and vocal cord dysfunction.

It’s definitely a serious condition. It limits her ability to engage in physical activity because exercise is her biggest trigger. Speech therapy has helped with that.

Little colds can mean a week off school because she just can’t stop coughing.

We’ve also had some scary moments where her oxygen levels dropped pretty quickly, but we’ve always been under a doctor’s care by the time an attack got that bad.

Basically, it’s a big scary disease. Some kids grow out of it. Some kids don’t. There are also some kids at DD’s school that have asthma as in they have inhalers, but have had to use them once and the only reason we know they have asthma is because they told dd. Everyone knows she has asthma because everyone in the school has seen and heard her have an attack because with the coughing it’s quite an attention draw. With any luck, your kid will be the former and you won’t develop a personal relationship with the school nurse.

If your child does have attacks regularly, You and your child will pretty quickly learn the personal triggers and come up with your own tricks for getting through an attack. The biggest thing is no cold drinks even though their throat hurts. Warm or room temperature is fine. Keep a list of all medications and emergency contact numbers with the inhaler so you have it handy. You can keep a copy in your phone too, but if you are handing the inhaler to grandma, you want her to have the list.

I’m sure my child suffers from this type of asthma. They do not have any typical asthma symptoms like wheezing and are usually fit and well. However, as soon as they pick up a cough or cold it ends up in a course of steroids. Hospitalised at 3 on one occasion, they take a purple inhaler now but never require a blue one. It actually seems to make it worse when they have a cough and steroids are the only thing that bring any relief. Other child was similar until older and then grew out of it.

Thanks again all, it’s so helpful to hear from others.

Sorry,I would love to know if you also used any supplements to help your child. My child is on montelukast which works really well until she catches a cold. Then it just DOESN'T work! Nebulizing for now but I do want her to outgrow it in the long run. She does have a sensitive tummy.

My DD has it (although thankfully seems to be outgrowing it at 11). It's horrendous and I feel your pain. I've had periods of no sleep for days on end due to constant coughing and its driven me to the brink of mental illness.

My DD is on beclomethasone and was until recently on montelukast which I think helped a bit but once the cough really gets underway the only thing that's really worked is steroids. My DD's variety isn't triggered by allergens which is unusual so thankfully it was only ever really after colds or respiratory infections. But that was bad enough because a cold could turn into a three week long illness with multiple trips to A&E.

The one thing to keep in mind is that the vast majority of children do grow out of asthma.