Chronic coughs can be a sign for Coughing-variant asthma

Chronic coughs can be a sign for Coughing-variant asthma

An increasing number of people in our society suffer from the chronic disease of asthma or its forms. One of the more unknown forms of asthma is coughing-variant asthma (CVA). Its symptoms are a dry cough for more than six to eight weeks, especially during the night. Almost everybody can suffer from CVA but most of times young children are afflicted with this disease. Compared to classic asthma, the typical symptom of shortness of breath is missing in CVA. But since CVA is a form of asthma, the causes and the treatments are comparable. Most patients suffering from CVA have normal lung function test. To diagnose CVA correctly, certain asthma tests need to be performed.

The treatment of CVA is similar to those of asthma. It consists of inhaled steroid and bronchodilator. These drugs are working differently on the body. While the steroid is reducing the sensibility for the asthmatic trigger, the bronchodilator is decreasing the airway resistance. The bronchodilator is prescribed either as long-acting or as short-acting drug. While the short-acting helps in the acute case of an asthmatic attack, the long-acting helps in the general prevention of symptoms. When CVA is not treated fast and correctly, other symptoms of asthma might occur later.

The causes of the CVA are still under investigation. Like most other asthmatic conditions, CVA can be caused by certain environmental circumstances. Traffic air pollution, cigarette smoke and chemicals are known to cause most kinds of asthma. Extremely dangerous is maternal smoking since it attacks the lungs of the unborn child aggressively. It seems to be proven that genetic factors are influencing a possible asthma condition. Up to now more than 25 genes have been detected which can cause directly or indirectly asthma. Most of them are directly connected to the inflammation reaction or the immune system of the body. In some cases only a combination of genetic and environmental factors are causing asthma or CVA.

Cough Variant Asthma is a Chronic Disease

Cough-variant asthma (CVA) is a form of asthma. It is a chronic disease of the respiratory system. In contrast to classical asthma, the only symptom is a chronic, dry cough without the typical sign of asthma like shortness of breath or wheezing. In some cases CVA turns into classical asthma within some years. The causes of most forms of asthma are not fully understood yet. Practically all studies show that asthma is caused by a combination of environmental and genetic factors. Environmental factors can be a high pollution of the air, tobacco smoke, chemicals or cleaning agents. As an example, CVA can be caused by Beta-blockers that are used for the treatment of high blood pressure or heart failures. Also certain eye-drops contain beta-blockers which can cause CVA. 

Since the chronic dry cough is the only symptom in many cases, CVA is hard to diagnose. In order to confirm the diagnosis, several standard asthma tests are performed. In general, these tests are measuring the function of the lungs and the reaction on methacholine. That drug causes directly an asthmatic attack. An indirect proof of CVA is treatment-based. The patient is treated with a typical asthma medicament. If the treatment is working, the underlying condition can be assigned to CVA. 

The treatment of asthma and CVA contains a double-strategy. On one hand, there are the fast-acting drugs working on the acute symptoms. On the other hand, there are medicaments for the long-term control. The fast-acting drugs contain steroids or bronchodilators to relief the muscles of the wall of the airway system and make them less sensitive to a special asthma trigger. The best working anti-asthma drug is prednisone. But prednisone is a very aggressive drug with numerous side effects. When applied for a maximum time of two weeks, the side effects are reversible but with increased application, the risk for permanent damage of the body increases drastically. Therefore you need to consult your doctor regularly before you consider the usage of prednisone.

Asthma VS Cough Variant Asthma

A very common chronic disease of the respiratory system is asthma. The symptoms of asthma are coughing in combination with wheezing and shortness of breath. Especially young children suffer from a special form of asthma, the so-called cough-variant asthma (CVA). However, the symptoms of CVA are only chronic coughing without wheezing or shortness of breath. In numerous cases, CVA directly leads to asthma.

In both cases, the causes are very complex and not fully understand yet. Recent studies show that a complex combination of environmental and genetic influences are responsible for asthma and CVA. Certain chemicals, tobacco smoke and high air pollution are known to induce asthma. Especially mature tobacco smoke can cause serious lung problems in the unborn baby. If a baby is born earlier than in the 32nd week, the lung is not completely developed. People with any form of asthma are usually very sensitive to certain specific environmental triggers that cause the symptoms. Typical triggers are tobacco smoke, perfumes, chemicals or a sudden change of the air temperature. Usually, the number of individual triggers is increasing with time.

The detection of CVA is very difficult since the chronic coughing is not specific. In certain cases, the CVA determination is performed in an indirect way. In cases when the body is reacting positively on asthma treatment without a complete asthma condition, CVA tends to be the final diagnose. Other diagnoses are slightly changed versions of classic asthma diction methods.

Because of its complexity, a cure for the disease is very difficult. In most cases the treatment is a combination of determining and avoiding the trigger and medicaments that treat the symptoms. The analogy between asthma and CVA can be seen also in the treatment of the symptoms. Both conditions are treated with the same medicaments, usually an inhaler containing fast-acting bronchodilators. 

What is Cough Variant Asthma

Living With Cough-variant asthma

A special kind of asthma is Cough-variant asthma (CVA). CVA is also called chronic cough because it lasts usually longer than six to eight weeks. In general, everyone can suffer from CVA but usually it is very common among young children. In comparison to real asthma, typical symptoms like shortness of breath or wheezing are missing.
The lung function and lung X-Ray function are normal. Therefore CVA is hard to detect, since the cough might be the only detectable symptom. Usually, a classical asthma detection test is used to detect CVA. During this test, the functionality of the lung is tested as well as the reaction of the body on methacholine. This special test is used to provoke the asthmatic attack. A missing reaction on the chemical might lead to the final conclusion of CVA as a medical condition.

The treatment of CVA is similar to the treatment of classic asthma; in light and normal cases patients get inhalers which support the immediate relief of the muscles in the wall of the airways. A working treatment with classical asthma medicaments strongly supports the diagnosis of CVA. Recently, it has been reported that CVA can result in a real asthma condition.

In conjunction with real asthma, the causes of CVA are still unknown. However, both diseases can be caused by the exposure to different allergens, breathing in cold air or an infection of the upper respiratory. As a side effect, CVA can occur when a patient takes Beta-blockers for the treatment of other conditions like high blood pressure, migraine or a heart failure. Since there are genetic circumstances that support the development of asthma, the probability of suffering from CVA depends on the health history of the patient’s family. CVA and asthma are more likely in families where certain members of the patient’s family are suffering from asthma.