Navigation

Lingering cough after bronchial flare up

my daughter has a chronic cough after a bronchial flare up.  Even after all the meds are done, she can continue to cough for days or more.  It can also sometimes seem like a habit cough stemming from the original illness.  Any suggestions on ways to break the cough cycle?  Thank you. 

15
175

Comments 15

  • Melissa G

    Hi and Welcome to AAFA! 

    Have you contacted her doctor about the lingering cough?

    My son went through something similar but he ended up having post nasal drip, and we needed to change his antihistamine. 

  • K8sMom2002

    Hugs and welcome  Rachelleahk! Those lingering coughs can be so hard and hang on so long!

    How old is your daughter? And could you put a call in to your doc's office to see if they have suggestions?

    One thing that has helped me figure out what to do next is to follow my doc's plan. It goes along with AAFA's "Know your zones" chart.

    Where would she land in these three zones?

  • Melanie Carver

    Hi @Rachelleahk, welcome to AAFA's community!

    I'm sorry to hear about your daughter's continued coughing. What I have experienced with my asthma is that sometimes I catch respiratory illnesses that take my lungs a long time to recover from. Last year, I caught an infection that went into my lungs. Even after numerous medications, an ER trip, etc., that lingering cough took months to go away.  To the people around it me, it probably seemed like a habit – during every meeting and phone call, there I was – *cough* *cough*. But it was that my lungs and bronchial tubes were twitchy and still irritated and the cough was uncontrollable. 

    Generally, it is fairly common for people with asthma to have a lingering cough after bronchitis or illness. If it continues for weeks, it is probably time to see a doctor – they may need to do a chest Xray or other tests to make sure there isn't an ongoing infection. 

    "Dozens of conditions can cause a recurrent, lingering cough, but the lion's share are caused by just five: postnasal drip, asthma, gastroesophageal reflux disease (GERD), chronic bronchitis, and treatment with ACE inhibitors, used for high blood pressure. Many people have several of these conditions, but in nonsmokers, the first three, singly or in combination, account for nearly all chronic coughs. " 

    Hope it clears up soon for her!

  • Christopher Casteel

     

    Rachelleahk,

    I absolutely agree with Melanie that some residual coughing can be expected after a bad flare up. If it continues on for more than a couple days or she presents with increasing breathing difficulty then you definitely should put a call to your primary care doctor. Your daughter's airways are going to be a bit more hyperresponsive to allergens and irritants immediately after a flare. So some coughing can be expected. This doesn't mean that you should keep her from doing any activities unless your doctor has said otherwise, but just be mindful of where you go and what she around until things get back to normal. 

    It is also a great idea keep a log of how often she is coughing (a couple times a min, hour) and the progression ( getting better, staying the same, and getting worse) and what you are doing and what time it is when it gets worse. I know that sounds overkill, but it can help monitor what is normal post flare for her versus what is not in the future.

    Unfortunately, doctors don't always get to see whats going on at home, so being the eyes and ears can give them the information they need to make any changes. I will post a link that you can use to do this It will take all the guesswork out of it. It is much easier to do than people think. I would recommend that you should keep a folder and track 5 days after each bad episode she has or until you feel she is normal.  This can really help the doctor understand how well controlled the asthma is and help guide adding or changing medications. 

    You are awesome for being engaged in your daughter's health! 

    All the best,

     

  • K8sMom2002

    Christopher, thanks! It's good to hear from a health professional such great information! The "getting better, staying the same, getting worse" tip is especially useful, and I'll definitely keep that in mind for my own family going forward.

  • Tiffany F.

    @Rachelleahk I did not read the other responses yet, just replyign to yours.  My daughter goes through the exact same and we are coming out of a spell now.  She is over the initial infection but she still has a mucousy cough. I worry because of this humidity.  (very hard on anyones lungs let alone someone with mucous in their lungs)

    I recommend checking with her ped after a week or 2 of lingering and see if she shouldn't do a round of antibiotics. Sometimes that plegm can sit in there and become infected.  My daughter just had to do a course about 2 months ago for a cough that lingered for an entire month.   Antibiotics cleared it up in days!  So apparently it needed treated.

     

    Other times antibiotics do nothing.  Have you tried chest/back percussion?  Works wonders on pediatrics.  Doesnt work as well for adults although I've seen some adults try it.  Studies show it works great for ped population though.  We use a percussion device (you need a suction) and tap her back with it three times a day.  When we do that, she always coughs after for a few minutes but you can tell she is coughing a lot up.   It helps a TON, they use it very often for kids with pneumonia.

    Here is a li (similar info for toddlers and young kids out there) but just google or Youtube "kids CPT percussion"  for your daughters age.

    Really

     

    If she's over 4, I recommend Childrens Mucinex (if you can give it with her other meds, ask doc).   My nephew also has asthma and had this ugly lingering cough.  Mucinex cleared him up in 2 days.  Broke all of that crap up and let him get it out.

  • Christopher Casteel

    There definitely is a significant correlation between asthma exacerbations and kids getting respiratory infections. I see a lot of kids in the ER with colds and influenza that flare up asthma symptoms. Tiffany brings up a good point that if a cough is productive, meaning that the child is coughing up green or some other color mucus, that should be investigated further. In the pediatric population, respiratory infections tend to me mostly viral, so antibiotics won't be helpful in those cases. When is a bacterial infection, antibiotics can usually start improving symptoms in 48 to 72 hours. Unfortunately, the only way to know for sure is to go see the doctor.

    With that being said, there are differences in the types of coughs that you can look for.

    It can be very hard to tell whether or not your child's persistent coughing is normal after a flare-up. Unusually, the post asthma flare coughing is: dry, and not productive (meaning nothing gets coughed up). It also tends to be more shallow or not as strong of a cough since is it mainly caused by residual irritation of the airways. Usually, an oral steroid burst along with the regular use of the controller med inhaler will get this under control fairly quickly. It can just take time for the airway inflammation to get back to normal, and while the airways are inflamed, they will be a bit overreactive and of cause the dry coughing. It is usually more of an annoyance and shouldn't stop your kid from normal activity. It should also get a little better each day after.

    When there is a much stronger deeper sounding productive cough, you should absolutely pay attention because that can be a red flag. If your child is coughing colored mucus up with persistent coughing and asthma-like symptoms you should go to the doctor. That is not the normal dry persistent cough after an attack. One thing that I find is often overlooked in most cases with asthma, or respiratory infections is hydration. Dehydration will always make for thicker secretions that can make them harder to cough up. This is especially true when using decongestant medications like Mucinex. They tend to lose their effectiveness with dehydration. That is the reason that most say to take with a glass of water. I agree that CPT is great for helping move secretions around with pneumonia and we use it all the time in the hospital. It is generally well tolerated, but you should still ask your doctor about it before instituting it at home. Some kids with heart conditions and other medical conditions don't tend to tolerate it very well. I have stayed up on a lot of the studies and we are trialing some new CPT vests that are absolutely amazing. I think that Tiffany definitely brings up a great point about it being very helpful with pneumonia.

    I feel like I am getting a bit long-winded here, but my main point is good hydration is probably the most helpful and overlooked thing we can do in helping with controlling mucus. At the end of the day, parents know their kids better than anyone else. If you think there is an issue I would not think twice about calling the doctor. 

     

     

     

  • LK

    Chris,  I enjoy reading your posts and find the information helpful and a good reminder of what to look for in even ourselves as adult asthmatics.  Thank you for sharing your practical medical experience and knowledge!

  • Tiffany F.

    Yes definitely. I mean antibiotics are for bacterial infections but sometimes whenever fluid or mucus in the lungs for too long it can go from being caused by a viral source to them becoming something bacterial pneumonia. So you do have to be careful with mucus sitting the lungs too long which can unfortunately happen with these long-term cough. That's why I definitely think you should take your little one to the doctor. If it has been excessively long they will probably treat her with a round of antibiotics just to be sure that pneumonia doesn't set in. You can't be too careful with those youngins. if we ever run into this our doctor only has ever prescribed our child amoxicillin. They stick to one type of antibiotics so that your child doesn't become resistant to all of the types. So personally I wouldn't be afraid to treat if it's been a while. But of course your doctor Bowl give you the best recommendation but be sure to share your thoughts with them. best of luck to you!

  • Kathy P

    I actually just had that happen – I was in a cycle of being flared. Allergies or a cold would start things off. The lingering mucus would wind up breeding a bacterial infection. Doc would throw a round of antibiotics at it and things would (mostly) clear up. Rinse and repeat! Finally, the doc had me do back to back to back rounds of antibiotics to make sure everything really was wiped out! We'd had to do this with my son for his chronic sinus issues as well.

    I've been great for a while now. But my allergies are bad and I can feel something settling in my chest  I'm trying to be aggressive with my meds to see if I can get it cleared out.

  • Christopher Casteel

    @Tiffany 

    I apologize if I was unclear or it came off that I disregarded your opinion in my previous post. Some kids will absolutely need antibiotics, and I totally agree with you on that. I was just trying to make the point that most, not all,  upper respiratory infections in the pediatric population are viral and should be self-limiting. There are some viral infections that can lead to a bacterial co-infection as well. The influenza is particularly well known for making kids susceptible to a bacterial pneumonia of some type after the initial viral insult. I thought that you brought up great points.

    There is some very interesting research that links recurrent viral respiratory infections associated with wheezing in infancy is a major risk factor for the development of asthma. If anyone is interested, I will post a clip of a research article I found interesting. 

    This next section is copied from a research article from FEMS Microbiology Letters. The link to the original article is 

    Development of asthma

    The effect of respiratory co-infections during early childhood may extend beyond immediate disease presentation and resolution. Events during the first years of life can lead to persisting immunological phenotypes that determine the risk of allergic disease and asthma (Vuillermin et al.), and both viruses and bacteria are capable of inappropriately modulating key immune pathways. It is therefore conceivable that paediatric viral/bacterial co-infections may play a role in the induction or progression of asthma. Recurrent viral respiratory infections associated with wheeze during infancy, particularly infections with RSV and hRV, are recognized as major risk factors for the development of asthma (Sigurs et al.; Lemanske et al.), as is early colonization of the respiratory tract with S. pneumoniae, H. influenzae and M. catarrhalis (Bisgaard et al.). While the COPSAC cohort found that these factors were independently associated with wheeze (Bisgaard et al.), few studies have explicitly examined the effect of viral/bacterial interactions on the respiratory system. Kloepfer et al. () have shown that co-detection of hRV with S. pneumoniae or M. catarrhalis increased the likelihood of asthma exacerbations in school-aged children; however, studies of wheeze in young children are lacking. The long-term consequences of multipathogen infections during early life represent a neglected area of research that deserves future investigation.

  • K8sMom2002

    Chris, very interesting! As always, you are terrific when it comes to giving us great background and info! Hydration is definitely a key point in managing mucus! 

    Tiffany, what a great idea about prescribing one antibiotic! Sounds like you have a doc who really thinks things through!

    Our pediatrician is very conservative with antibiotics — you know not to go to him until it has been two weeks and things aren't better. He was the first doc I knew who was worried about antibiotics resistance, and I appreciate him educating me on that.

    Still, there were times when he would prescribe antibiotics earlier in the game because he knew my DD's history — often things that started out viral wound up setting up a secondary bacterial infection which turned into bronchitis and a huge asthma flare.

    I still remember the very long six weeks straight DD was on antibiotics at 18 months. I was so glad when she got better!