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Respiratory Disorders (Expert Forum)
5-year old uncontrollable dry cough-pt2
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
5-year old uncontrollable dry cough-pt2
by def, Sep 17, 2003 12:00AM
We have gone to an allergist to no avail.
We just went back to his pediatrician who says he is too young for a lung test and seems to think his throat clearing is psychogenic although lately it seems to be he is trying to pass air through his throat rather than clear it of something. We do give him nasal spray when he has the sniffles and his eyes get dark and it definitely helps. He has been put on full dose asthma meds and his cough has mostly subsided as has the throat clearing for the most part. but not completely. After he gets upset he goes back to the cough and throat clearing for a bit. What do you think of Laryngopharyngeal reflux? The ped GI says that his airway area looked good when they scoped his esophagus, but would not rule out reflux because he did not do the ph test. I think he must have something irritating us upper airway or something. Should I go back to his ENT?
We just went back to his pediatrician who says he is too young for a lung test and seems to think his throat clearing is psychogenic although lately it seems to be he is trying to pass air through his throat rather than clear it of something. We do give him nasal spray when he has the sniffles and his eyes get dark and it definitely helps. He has been put on full dose asthma meds and his cough has mostly subsided as has the throat clearing for the most part. but not completely. After he gets upset he goes back to the cough and throat clearing for a bit. What do you think of Laryngopharyngeal reflux? The ped GI says that his airway area looked good when they scoped his esophagus, but would not rule out reflux because he did not do the ph test. I think he must have something irritating us upper airway or something. Should I go back to his ENT?
Doctor's Answer
by National Jewish, Sep 18, 2003 12:00AM
, Sep 18, 2003 12:00AM
This is obviously a very frustrating situation for you and your family. It is not clear from your note how the diagnosis of asthma has been made. Has he wheezed or had breathing problems that responded to medicine? Some 5-year-old children are very good about performing lung function tests. Others simply cannot do them.
One of the most important aspects of defining children who have psychogenic causes to symptoms such as these is what happens after they fall asleep. Those children who have psychogenic reasons for clearing their throats and/or coughing often cough up to the point of falling asleep. Once they are asleep these symptoms stop unless they wake up during the night. You might observe your son late at night, at least 2 hours after he has fallen asleep. Look at his breathing and listen to how he breathes. You can learn a lot from that. If there is persistent drainage, he will have some problems even after being asleep.
We, at National Jewish Medical and Research Center, often see children with exactly the same problems you have described. It sometimes takes a few different types of specialists (ENT, allergy and/or pulmonary) to make the diagnosis and create a treatment plan that works. That is one of the advantages of having a center that only focuses on these types of problems. If you are continuing to be frustrated, you may consider a short visit to Denver to sort out these problems and create a way to understand and deal with them at home.
One of the most important aspects of defining children who have psychogenic causes to symptoms such as these is what happens after they fall asleep. Those children who have psychogenic reasons for clearing their throats and/or coughing often cough up to the point of falling asleep. Once they are asleep these symptoms stop unless they wake up during the night. You might observe your son late at night, at least 2 hours after he has fallen asleep. Look at his breathing and listen to how he breathes. You can learn a lot from that. If there is persistent drainage, he will have some problems even after being asleep.
We, at National Jewish Medical and Research Center, often see children with exactly the same problems you have described. It sometimes takes a few different types of specialists (ENT, allergy and/or pulmonary) to make the diagnosis and create a treatment plan that works. That is one of the advantages of having a center that only focuses on these types of problems. If you are continuing to be frustrated, you may consider a short visit to Denver to sort out these problems and create a way to understand and deal with them at home.
