DS cough every winter for years

[BreezyClouds]

The short version: son gets a cough every winter for years, sounds like an asthma cough but it's not asthma. Goes on for 6 months. Makes him sick and disrupts his life. What to push for with GP?

Ds17 gets a cough every October l, it's always triggered by a slight cold then lasts until April or may. It's worse at night and kind of like an asthma cough, one or two coughs at a time but a few times a minute. It often makes him vomit and he starts restricting his food intake because he doesn't want to.

Obviously we go to the GP. Went twice the first year, checked over and told no issues, chest is clear no wheezing, coughs last while, etc. same the following year. Year 3 see a locum who says it's asthma and also refers for a Spiro-something. Asthma nurse examines and finds (I think) nitrogen exhalation in asthma range, get inhalers, maybe help a bit .

This summer went for asthma check, nurse says no asthma at all, asks whether he's ever been wheezy etc - no. Takes off inhalers and re-refers for Spiro because, despite me calling surgery several times to say we haven't had an appointment through and being told to be patient, we should have had it by now. That was 8 weeks back, still no appointment. She says to go back to GP when cough comes back.

Cough is back, going to gp tomorrow. What can I ask for?

I get that he's healthy and they're not concerned but he's already very slim, is autistic and has OCD so it upsets and distracts him, it causes him distress in college AND he'd got a casual job in our local cafe over Christmas last year but they had concerns from (elderly and probably vulnerable) customers and stopped giving him shifts - I am not willing to fuss about this one it's just for context on impact.

The house is clean, no mould, well ventilated, we have trialled dehumidifiers. We do have pets, they stay out of bedrooms and he has no issues in the summer. He's out of the house at college every week day and does lots of sport evenings and weekends. Slim, fit, eats healthy food, stays hydrated.

What do we need to do? He is so distressed and made worse by GP saying it's nothing.

My teen son had almost the exact same issue, right down to the asthma clinic visit. Turned out to be a form of acid reflux - GP advised OTC antacid liquid after every meal and that seems to have sorted it for now. Does your son ever complain of heartburn?

ETA - worse at night also points to reflux as lying flat can exacerbate stomach acid travelling up the oesophagus and irritating the throat.

This sounds interesting. He doesn't have indigestion but had terrible reflux as a baby so sounds very possible .

Easy enough to try this, thank you. Is it gaviscon type of thing?

Yes, just regular liquid gaviscon. He takes it after every meal and it eliminated the cough almost immediately. Good luck - my son is also autistic and I know how distressing this type of thing can be for ND kids.

Cough variant asthma.
GPS are useless at this.
Request a referral to respitory dr

OP, if he met the criteria of the FeNo test ( Fractional Exhaled Nitric Oxide) NB, NOT Nitrous Oxide, laughing gas...v v different! Then you should be taking this seriously. When diagnosed and prescribed inhalers, did he take them diligently and religiously, for minimum 6 weeks? You mentioned a slight improvement?
However, I agree with
@QueenKong101 my son had awful reflux as an infant, and it could well be that, as he still gets reflux as an adult. BUT, he's also asthmatic, and is on regular inhalers and can lead a very normal life on these.
Both can exist at the same time. Do try some regular Gaviscon, or even two weeks of over the counter Omeprazole ( check potential interactions with any other meds, but this, and standard prescribed inhalers eg, Fostair...are fine, but check for yourself first.

If you have exhausted ant-acids/6 weeks of prescribed inhalers, i would agree with @Badvocthebad a respiratory referral, or at least ask the GP to ask for 'Advice and Guidance" from secondary care.

DS also had similar, would always cough after meals, think it was a mixture of anxiety as people would notice the cough so they stopped eating around people and a slight allergy irritation with the food they were eating, starting taking Clarityn each day and gaviscon and it has disappeared.

It's cough variant asthma. The postive FeNO test confirms it. Speaking as a lifelong asthmatic who only wheezes when she can barely breathe.

Every asthma exacerbation I have to point out I never wheeze.

If the inhalers only helped 'a bit' could be multiple reasons most likely poor technique, poor compliance or needing escalation to stronger inhalers/ a different inhaler regime.