Management of Cough Variant Asthma

[Ollie1976]

Hello all,

My youngest (almost 8 yo) has Cough Variant Asthma (CVA) and is on Seretide 50 (2 puffs morning + night) and Montelukaust (1 tab) at night. His coughing goes CRAZY when he gets a cold or other upper respiratory infection but he's totally fine outside that (i.e. no wheezing, cough and laboured breathing).

Can I ask if others have experiences of CVA and if you or your kids every 'out-grew' it? I know you never cure asthma - but I'm hopeful that as his lungs mature that he'll be better able to fight these challenging CVA episodes. During a CVA episode, we're advised to dose his with Ventolin as needed as we could be talking 4-8 puffs every 4-6 hours for around a 1-2 day period, with it tailing-off after that. If we don't do that then its a short-course of steroids (typically 3-days) but we hate those given the impacts on growth velocity.

Grateful for any community experiences and insights on this - thanks!

[Oldandgray]

Sorry to hear of your lads CVA. I’m at the other end of the age spectrum but also have CVA.

Have the doctors said if allergies make it worse or it’s worse at certain times of the year. I have a prescribed antihistamine which helps and it may be worth discussing this with his GP.

[Gareth57]

hi Ollie1976, as a child I had asthma which was ok for long periods and then wasn't and I'd be laid up for weeks but it subsided as I went through early teens and by late teens I had no issues. Unfortunately after 25 years (possibly triggered by work?) it came back more in the form of CVA, luckily it's not exercise induced as exercise seems to improve my lung health.

[Lysistrata Administrator Community Ambassador]

Hi Ollie1976, sorry to hear your son's struggling with this! It does seem to be more common for children to have coughing as a main feature of asthma, especially at night (this is what the asthma nurse told my mum when I was 7).

Mine did get better as I got older (it's back worse now but that was after swine flu when I was 23). It seems to be more common for asthma in boys to improve as they get older, especially when they start puberty - off the top of my head, there's research suggesting that hormones play a part. I believe they think testosterone helps asthma and oestrogen can have the opposite effect, which is why more girls/women have asthma after puberty and into adulthood than boys/men. Not a guarantee of course and I realise your son is some way off puberty currently, but thought it might help to know that could happen when he's older.

Meanwhile, might be worth asking for a review with his GP or asthma nurse to see if they can do anything to adjust his medication and reduce his need for oral steroids. You could also call the asthma nurses on the helpline and see if they have any advice on options to take to his GP: 0300 2225800 or WhatsApp [phone] Monday-Friday 0915-5pm

[Patk1 in reply to Lysistrata]

My son had really bad asthma from being a baby til 15-16.as lysistrata says,itimproved dramatically then + he's fine as an adult.still has awful rhinosinusitis,but can cope.his son 5yr old,also has asthma and rhinosinusitis,as have I.hes much worse whn weather changes and with viral infections& tonsillitis, whn he needs hi dose ventolin too.whn he's well, he's on steroid inhaler+ montilukast,and can run around,mainly OK with just a morning rattly cough.like u,I'm hopeful as he grows, he can get mucous up and it'll improve xxx

[Ollie1976]

Thanks all for the comments. I do think he will grow out of it as he matures but reassuring to read these other stories.

[Lilmix03]

Hi! I've never been told what form of asthma I have but I believe I have CVA as I never get particularly wheezy, from what I've seen on my medical records I had a few instances of wheeziness and crackles on my lungs but my symptoms mostly presented as Coughs, breathlessness and low peak flow when I was younger. My mum was always advised to step up my Ventolin inhaler and I often needed antibiotics, I sometimes needed steroids but that's been more the case as I got older. I'm 20 now and I have far from grown out of it, I probably wouldn't listen to anyone who tells you that your son will grow out of it because as far as I'm aware you can't 'grow out of' asthma but he will probably learn to manage it as he gets older. A few things I've learnt over the years are to take an antihistamine everyday during high pollen months if he knows his asthma is triggered by that, you can take them all year round if you find it helps, make sure that you have an up to date asthma plan and that his school is aware of it and has an inhaler and spacer for an emergency, Olbas Oil is very good for coughs and colds and helps to clear congestion - you can add it to water and inhale the vapor or put it on a tissue and sniff it/ Same for Vicks vapor rub, in colder months put a scarf over his mouth and nose so he breaths in warmer air which reduces coughing, You can also put Vaseline at the edges of his nose to stop any germs/ allergens getting up there when he breathes and also Find out if he can get the flu jab and any covid jabs they'll be worth it to protect his immune system, Also ask your surgery for a rescue pack of steroids and antibiotics to keep at home incase he gets poorly over the weekend/ bank holiday or anytime you can't get hold of your surgery.

[DDDoreMouse]

Just a thought, but I find Atrovent inhaler more effective in stopping coughing? I have also been on Uniphyllin since I was 12yrs which made me much more stable.