Check Up: My coughs are causing chest pains

Dear Readers,
Alecia B has noticed a recurring cough since August, which is quite distressing and leaves her feeling tired and with chest pain. Her doctor says she’s not wheezing and there’s no sign of asthma. However, it is only after using her brother's asthma pumps that she feels any better and stops coughing.

Alecia asks Check Up if she could be asthmatic even though she isn’t wheezing. 

Chronic coughs can be difficult to treat, and even when a doctor suspects that asthma could be involved, sometimes the tests done, like spirometry, which records air being breathed in and out.

Nevertheless, if your cough goes away after using asthma treatment, you probably are having a variant of asthma. Why some people respond with a cough instead of wheezing is not fully understood. Wheezing and feeling short of breath are the usual asthma symptoms, but some people with asthma cough instead. This type of asthma is called cough-variant asthma and occurs in one out of four asthmatics, so it isn’t rare at all.

If asthma pumps don’t help, a chronic cough acid reflux can be considered as a possible cause, and these coughs will respond to antacids, Histamine 2 receptor agonists (like Zantac) and proton pump inhibitors (like Nexium, Pantecta, Lanzap, etc).

Many people also cough when they experience a sinus post nasal drip, and this is usually treated with nasal decongestants, nasal steroids and oral antihistamines.

A chronic post viral cough, which is dry and hacking, can remain after a respiratory viral infection and persist for many weeks or even months. They also can respond to inhaled steroidal medications which are used to treat asthma.

When these trial treatments of the mentioned disorders don’t clear the chronic cough, the cough will need to be further investigated to rule out other chronic lung diseases.