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Respiratory Disorders (Expert Forum)
chronic cough
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chronic cough
by pla, Apr 19, 2004 12:00AM
My 8 year old daughter is having chronic cough, started in August 03. Since then she has been to several doctor's including Children's in Boston, but the diagnosis is not clear. She is now on singulair, Flonase, Advair 250/50, Foradil, Patanol (eye drops) and albuterol as needed. But she still is not cough free. She has shown allergies to dust mites and cats in the allergy test. She complains of itchy eyes, and is almost always having a runny nose and sometimes stuffy nose. Her cough is usually productive and she is always clearing her throat. Her symptoms seem to get worse when she gets excited or is physical. The doctor's are treating her for cough variant asthma, but are not sure why it is not coming under control. When she is coughing badly, we give her albuterol generously and that seems to reduce the intensity of the spell after a while. Before she started having this problem, she was a healthy child with no real problems. Asthma runs in the family (father). Is there anything we can do to get her cough under control? I would be grateful for any help or guidance in helping my child. Thanks.
Doctor's Answer
by National Jewish, Apr 20, 2004 12:00AM
, Apr 20, 2004 12:00AM
In a child who has a normal chest x-ray the most common causes of cough are postnasal drip, chronic sinus problem, heartburn, and asthma. You will need to continue to work with your daughter’s doctor. She may need to have testing done to figure out what this could be and the best treatment. You may want to have your daughter seen by a specialist, such as an allergist or pulmonologist. There could be something else triggering the asthma so that the asthma medicines are not able to control the cough. It is common for allergies, physical activity, and postnasal drip to trigger 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 reason is an allergy. 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 a productive cough as a result of irritation of the throat and lungs. You may notice your daughter is always clearing her throat because of mucus in the back of her throat.
The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as your daughter is not on a fluid restriction she should be drinking 6 to 8 8-ounce glasses of non-caffeine fluid daily. Clearing the throat can irritate her throat and make it sore. When she feels the need to clear her throat, have her sip some water to clear the mucus.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier. A combination antihistamine-decongestant will do both. Check with her doctor to see which would help her more. Often an antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis.
A nasal wash helps remove mucus and germs from the nose and sinuses. This can temporarily decrease the postnasal drip and lessen your daughter’s productive cough. A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses. This may prevent the postnasal drip and productive cough. To get the most help from 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. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering her. 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 daughter’s doctor to see if she would benefit from this daily treatment.
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 reason is an allergy. 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 a productive cough as a result of irritation of the throat and lungs. You may notice your daughter is always clearing her throat because of mucus in the back of her throat.
The fat content in dairy products can thicken mucus. Generally eating dairy products with less fat content is helpful. Drinking plenty of water will help to thin the mucus so that it moves more easily. As long as your daughter is not on a fluid restriction she should be drinking 6 to 8 8-ounce glasses of non-caffeine fluid daily. Clearing the throat can irritate her throat and make it sore. When she feels the need to clear her throat, have her sip some water to clear the mucus.
An antihistamine can dry up the postnasal drip. However, it may make the mucus thicker and more difficult to move. A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier. A combination antihistamine-decongestant will do both. Check with her doctor to see which would help her more. Often an antihistamine and decongestant are taken only when the postnasal drip gets bad. It may be more helpful to take the antihistamine and decongestant on a regular basis.
A nasal wash helps remove mucus and germs from the nose and sinuses. This can temporarily decrease the postnasal drip and lessen your daughter’s productive cough. A prescription nasal steroid spray decreases mucus production by decreasing the inflammation of the nose and sinuses. This may prevent the postnasal drip and productive cough. To get the most help from 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. Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering her. 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 daughter’s doctor to see if she would benefit from this daily treatment.
Member Comments (3)
by ozark, Apr 19, 2004 12:00AM
has she been worked up for reflux...even though it may sound odd given she's 8 and it just started you never know...also have her sinuses been checked out...maybe she needs a steroidal nasal spray.good luck
by ozark, Apr 19, 2004 12:00AM
sorry i just realized she's on flonase..but maybe get a ct of her sinuses....my daughter's dr didnt think she had a sinus infection until he did sinus films and they saw it...
by woofer5508, Mar 05, 2009 04:38AM
A related discussion, copd exerbation was started.
