5-year old uncontrollable dry cough

[def]

My five year old son was born with severe reflux and was 6 weeks early.  He has been chronically ill ever since.  He catches "everything".  When ever he gets a virus he will get croup. He has been hospitalized with RSV and croup.  And has been to the hospital with croup many times.  The last time he needed 4 adrenalin masks to get him going.  He has had throat clearing and cough many times an hour for the past few months.  I cannot seem to get a handle on this with his asthma meds (ventilin and flovent 125).  He is also on Zantac which he says doesn't make him feel better although he says Maalox does.  He has been checked for aspiration into his lungs which was negative.  He has been checked by a pediatricd GI with a barium swallow and endoscope with biopsies, both of which showed nothing.  We could not get him to do the ph probe.  He gets the hiccups quite frequently and has on occasion told me that he feels like there is something in his throat. He has also told me that he has thrown up and swallowed it.  The pediatric GI says he doesn't know what to do with him, maybe send him to a pulmologist.  Maybe he has lung problems.  (he has had a bit of pneumonia).  We have air cleaners in our house, no pets and no smoking. He cannot do much of any kind of real active activity without coughing.  He has had swollen sinus area (says his ENT) and blackish eyes. Sometimes he feels sick to his stomach.  What should I do?

[National Jewish]

This is certainly a frustrating situation.  Asthma is more likely to occur in a child who is born early and following a RSV infection.  Activity, aspiration, infections like croup, postnasal drip, and reflux can make it hard to get a handle on asthma.

Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One is an allergic reaction to inhaling something.  A second reason is a non-allergic, non-infectious inflammation in the sinuses that can linger after a cold.  A third reason is chronic sinusitis.  Postnasal drip can cause coughing as a result of irritation of the throat and lungs.  Your son may experience the postnasal drip as a feeling of something being in his throat.  This could explain his throat clearing many times an hour for the past few months.  It is also possible that this mucus is making him sick to his stomach.  He may be throwing up this mucus and swallowing it.  As long as he is not on a fluid restriction he should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.  This will thin the mucus so that it moves more easily.  A nasal wash helps remove mucus from the nose and sinuses.  This can temporarily reduce the postnasal drip and lessen the coughing.  A prescription nasal steroid spray decreases nasal swelling and mucus production.  This may prevent the postnasal drip and coughing.  To get the most out of a nasal steroid spray use it after doing a nasal wash.  A nasal steroid spray does not provide immediate relief of symptoms.  It may require several weeks of routine use to become effective.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.

Your son should be able to do any kind of real active activity without coughing.   A pulmonologist would be the type of specialist to identify if there is a lung problem in addition to the asthma.

[ozark]

I would have him checked by a pediatric allergist....he sounds like he has allergies maybe stemming from the nose causing blockage and post nasal drip and cough ....especially at night....the "racoon" eyes are telling also...does he rub his nose up with the palm of his hand?  this is an allergy sign....i know your treating his asthma with inhalers....what about a steroid nasal spray? and or oral prednisone?

[Concerned lady]

I agree with Ozark! A pediatric allergist might be able to help you find out whether your son has some food sensitivities that may be adding to his reflux problems.

Cow's milk, milk products (cheese), and other foods like wheat (& other glutenous foods) can cause some people to have episodes of a high up type of gastric reflux.

The high up type of reflux, can cause breathing problems. This type of reflux is called LPR (Laryngeal Pharyngeal Reflux).

I also think a Pediatric Pulmonologist, and a pediatric ENT (Ear, Nose & Throat) specialist may be helpful to see.

You can telephone a LUNG LINE nurse, at 1-800-222-LUNG(5864), to ask for advice, and to check on either having your son seen at Nat'l Jewish, or, to get referrals to Allergists in your area, who have worked at Nat'l Jewish. Nat'l Jewish is a great medical center. We know, from our own experiences of being helped by them.

I wish you the best.

Concerned lady
<a href=http://cantbreathesuspectvcd.com>http://cantbreathesuspectvcd.com</a>

[momlisa]

My daughter is 12 now and at age 6 we went through months of problems with a chronic dry cough.  To keep a long story short, I researched on the internet and requested my pediatrician to eliminate the 7 or 8 possible causes I had found.  Start ELIMINATING.  We had the pulmonologist, gastrointologist, Allergist, and more on the list.  We start the eliminating.  Tests at the Pediatricians (blood, xrays) showed NO allergies or asthma.  Gastrointologist said lets see the ALLERGIST/ASTHMA Doctor before doing the hospital testing for Reflux etc.  Could have reflux but the ALLERGIES/ASTHMA is more of the COUGH and feeling that swallowing something also type problems.  SAW the ALLERGY ASTHMA specialist and did further tests (of which the Pediatric blood and xrays showed nothing.)  SURE enough allergies and asthma were diagnosed.  IT TOOK 4 full months to get it under a decent control.  Tool lots of meds and did the nebulizer 3 times a day for about 3 months.  It took about one year to feel like it was controlled.  This has now been 6 years and we are still taking meds but MUCH less!!  It sounds as if your son has been diagonosed with some allergy/asthma problems.  Wondering if the MEDICATION process has been really focused.  We now take Singulair (for the lungs), ADVAIR (for the airways), and Zyrtec.  No more nebulizer and very few times a year the albuterol inhaler.  I believe the Singulair made quite a difference.  Also - we did not see the normal ALLERGY symptoms that most people have.  We saw really nothing - yet swelling was going on in the nasal areas and breathing areas.  It has been a long haul to understand and trust that so many meds were needed for a long period.  Don't know if this helps or if you've been down all this...

Blessings and good luck

[Sebastians Mom]

Wow...I cannot believe how closely your story relates to my son. He's only 3 but we've been going thru the same since 18 mos. Unfortunately, we have yet to see any major improvement with the allergy and asthma drugs (other than albuterol). He too, is on singulair and nebulizer treatments. Also he's on Prevacid for the reflux. Unfortunately, his reflux went on too long before a Dr. noticed.

In any case, we are diligently working on ruling out Cystic Fibrosis right now. He has many of the symptoms although his sweat tests have been negative.

Thank goodness for the internet, huh? It has been my place of refuge for all these symptoms. We probably know more than most pediatricians do now.

Take care and glad to hear your little one is under control! Cross your fingers for mine!