Sometimes asthma comes in a form called cough variant asthma, which doesn’t have typical asthma symptoms. You can treat it the same way as other forms of asthma, but if it persists longer than six weeks, contact your doctor.

Asthma is one of the most common chronic conditions in the United States. It usually presents itself through distinct symptoms that include wheezing and a cough.

Below we detail the differences between cough variant asthma and regular chronic asthma.

Cough variant asthma is only defined by one symptom: a chronic cough that can’t be explained by other causes. This cough is usually dry and lasts at least six to eight weeks. It doesn’t include some of the other defining symptoms of asthma, such as:

Even though cough variant asthma doesn’t present symptoms other than coughing, it often causes increased inflammation in the airways. So, it’s very important to manage cough variant asthma properly.

If left untreated, cough variant asthma can progress into more severe, chronic asthma. A 2011 study notes “30 to 40 percent of adult patients with cough variant asthma, unless adequately treated, may progress to classic asthma.”

A more recent review notes that cough variant asthma is the most common cause of chronic cough in China and Japan and the second most common cause in Europe and the US, accounting for 25 to 42 percent of chronic cough cases worldwide.

Persistent coughing can also indicate other conditions such as postnasal drip and GERD.

Just like with standard chronic asthma, scientists don’t know what causes cough variant asthma. One potential reason is that allergens such as pollen may cause coughing. Another is that infections in the respiratory system may trigger coughing episodes.

Scientists believe that cough variant asthma in some people may be associated with taking beta-blockers. These drugs are generally used to treat a variety of conditions that include:

  • heart disease
  • heart failure
  • migraines
  • hypertension
  • abnormal heart rhythms

Beta-blockers are also found in eye drops used to treat glaucoma. Aspirin may also contribute to the cough associated with cough variant asthma.

Diagnosing cough variant asthma can be challenging. It only has one notable symptom. People with CVA may also have normal results for pulmonary tests, such as spirometry, used to diagnose regular asthma.

Doctors often use the methacholine challenge test to diagnose cough variant asthma. In this test, you inhale methacholine in the form of an aerosol mist while doing spirometry.

Your doctor then monitors the airways as they expand and narrow. If your lung function declines by at least 20 percent during the test, then the doctor will diagnose asthma.

The methacholine challenge test is often done in a special facility. If a doctor suspects cough variant asthma, they may start asthma treatment without a definitive diagnosis. If it helps manage your cough, this can confirm cough variant asthma.

Cough variant asthma can be treated with treatments for chronic asthma. These methods include:

  • Inhaled corticosteroids (inhalers): One of the most important methods of treating cough variant asthma is to use inhaled corticosteroids, also known as inhalers. This medication controls cough, prevents the onset of wheeze, and reduces airway obstruction in people with cough variant asthma. If you have cough variant asthma or chronic asthma, it’s best to take inhalers daily as prescribed. Examples include budesonide (Pulmicort) and fluticasone (Flovent). You can learn more about which corticosteroid is best for you at Partners Healthcare Asthma Center.
  • Oral medications: Doctors often supplement inhalers with oral pills called leukotriene modifiers. They help relieve asthma symptoms for 24 hours. Examples include montelukast (Singulair) and zileuton (Zyflo).
  • Bronchodilators: These substances relax the muscles that tighten around the airways, leading them to open. They can act short-term or long-term. Short-term bronchodilators, such as albuterol, are used to relieve asthma symptoms during an attack or before intense exercise. They aren’t used in the daily treatment of asthma. In contrast, long-term bronchodilators are used with inhaled steroids on a daily basis to manage chronic asthma. Beta-2 agonists are another example of bronchodilators, and can be short-term or long-term acting.
  • Nebulizers: Sometimes doctors will prescribe a nebulizer if other medications aren’t working for you. Nebulizers automatically spray medication in a mist through a mouthpiece. This allows the lungs to easily absorb the medication.

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Cough variant asthma is an unusual, but common form of asthma. It can be managed like regular chronic asthma. If you have a persistent, dry cough that lasts for six weeks or longer, visit an asthma specialist to get a proper diagnosis.

There are several ways to help prevent asthma attacks if you have cough variant asthma:

  • Be consistent with your medication. This is perhaps the most important thing you can do to manage your asthma. Taking daily medications, such as inhalers, is essential for making progress. If you’re having coughing attacks, taking strong, short-acting medications is also important.
  • Avoid allergens. Certain allergens can trigger or worsen asthma symptoms. These can include air pollution, animal fur, and pollens in the air. Allergens including pollen, dust mites, animal dander, or mold can increase inflammation in the air pathways of people with cough variant asthma.
  • Make lifestyle changes. Humidifiers can improve moisture in the air, which is favorable for people with asthma. An analysis of research in the Cochrane Review suggests that yoga may improve asthma symptoms. However, more trials are needed to confirm this.
  • Avoid smoking. Smoking will trigger coughing if you have cough variant asthma, and other symptoms if you have chronic asthma. It will also increase your risk for other lung and breathing conditions.
  • Use your peak flow meter. This is a great way to see your progress with asthma and whether or not you should see you doctor for a follow-up.
  • Exercise regularly. Exercise improves blood flow and lung capacity, and reduces anxiety. Many people who take the proper medication find exercise to be a wonderful way to manage their symptoms of cough variant asthma.