Persistant Dry Cough At Night

[tim armstrong]

My wife has a persistant dry harsh cough , mainly at night that disturbs her sleep and won't go away. She is normally a fit, healthy person and is a non smoker. We live in the country but not obviously near any flowering trees or plants that may cause an allergy. She has been to our local Dr. who has given her the usual injection and a bucket full of medication, to little effect. My step son (13yrs) sometimes gets the same thing. . My wife has no other flu or cold symptoms with it except an occasional runny nose. It seems to happen mainly in the dry season at this time of year. Maybe its an allergy, but I don't know to what ? We don't really have a dust problem although sugar cane trucks are going past 24/7 about 50 metres from the house for the next month or so. At night we sometimes close the windows and use aircon. or leave them open and use fans. The fans may not help, but its getting to our hottest time of year. Curiously, I don't get any similar symptoms. Maybe this is a Thai only illness? I would really appreciate any ideas or treatment suggestions. Thanks.

[FBN]

It seems like an allergic reaction presenting as "Reactive Airways Disease" or subclinical asthma.

This is difficult to confirm with any test; usually a PFT or Pulmonary Function Test will show some restricted airflow but if this test is done when there are no symptoms, it may be normal. Still worth performing though as well as chest X-ray if this has not been done yet.

The treatment for this would usually be something like a Ventolin (salbutamol) inhaler at night when coughing is worse; not much else really helps except getting away from the irritant, humidifying the air, avoiding AC, cleaning filters etc etc.

[tim armstrong]

Thanks for that FBN. I will try those options. Yuwadee does sometimes complain of a breathing problem when she has the symptoms. I know Ventolin has been around a long time - how safe is it to use regularly ?

[RobotTeacher]

Dust. Tiny particulate in the air. Lungs trying to expel it. Might try wearing a bandana or mask when motor biking around or just out and about until it begins to rain in a few months.

[FBN]

Tim,

It is quite safe to use within the recommended dosage; side effects include a fast heart rate etc. Best that she be just checked by a physician and given a prescription for this. Very important to be well instructed on how to use the inhaler to get the desired effect.

[tim armstrong]

Thanks again. Yes dust might be a culprit. Now for the challenge of convincing her that she doesn't need another bucket load of antibiotics. Funny since posting this it seems to have improved a bit, but maybe fewer cane trucks also.

[mommysboy]

Yes, the hot, dry season seems to accentuate this, and probably it's just the heat and dryness. I know quite a few friends with the same.

Let's also not rule out pollution from these trucks. I'd shut any windows that face the road.

FBN comes up with some good advice.

[VitalGirl]

Thanks for that FBN. I will try those options. Yuwadee does sometimes complain of a breathing problem when she has the symptoms. I know Ventolin has been around a long time - how safe is it to use regularly ?

Ventolin is only a broncho-dilator and actually doesn't improve anything - sometimes has horrible side effects too like a racing heart. I too have suffered this problem since being in Thailand for over 5 years - after trying everything (including unsuccessful attempt with the Ventolin) I went to an asthma/allergy specialist who put me onto a one-puff-at-night "new generation" asthma drug called Seretide. Amazing! Problem gone. Ironically none of the top class "farang" hospitals here in Chiang Mai had a clue how to help, including their asthma "specialists". The lady who got it sorted is a humble Thai doctor who studied in Hong Kong and Singapore - luckily I speak Thai and she spoke a smattering of English. Might add cost a fraction of the farang doctors here. PM if you would like more help.... Good luck.

[Lazy Sod]

Ventolin is only a broncho-dilator and actually doesn't improve anything - sometimes has horrible side effects too like a racing heart. I too have suffered this problem since being in Thailand for over 5 years - after trying everything (including unsuccessful attempt with the Ventolin) I went to an asthma/allergy specialist who put me onto a one-puff-at-night "new generation" asthma drug called Seretide. Amazing! Problem gone. Ironically none of the top class "farang" hospitals here in Chiang Mai had a clue how to help, including their asthma "specialists". The lady who got it sorted is a humble Thai doctor who studied in Hong Kong and Singapore - luckily I speak Thai and she spoke a smattering of English. Might add cost a fraction of the farang doctors here. PM if you would like more help.... Good luck.

Seretide works for me as well (I had the same symptoms as OP described). Don't know what I'd do without it. Most chemists sell it over the counter, except Boots for some reason. Often takes a few days use for full effect.

[mommysboy]

Ventolin is only a broncho-dilator and actually doesn't improve anything - sometimes has horrible side effects too like a racing heart. I too have suffered this problem since being in Thailand for over 5 years - after trying everything (including unsuccessful attempt with the Ventolin) I went to an asthma/allergy specialist who put me onto a one-puff-at-night "new generation" asthma drug called Seretide. Amazing! Problem gone. Ironically none of the top class "farang" hospitals here in Chiang Mai had a clue how to help, including their asthma "specialists". The lady who got it sorted is a humble Thai doctor who studied in Hong Kong and Singapore - luckily I speak Thai and she spoke a smattering of English. Might add cost a fraction of the farang doctors here. PM if you would like more help.... Good luck.

Seretide works for me as well (I had the same symptoms as OP described). Don't know what I'd do without it. Most chemists sell it over the counter, except Boots for some reason. Often takes a few days use for full effect.

But what's the cause of all this?

Time and again I hear of adults who weren't particularly allergenic in Farangland but then start to develop rhinitis, asthma, or bronchial problems when in Thailand for any length of time. It's not 'normal' IMHO.

Smog/pollution is my best bet.!

[coventry]

I think she just coughs due the drop in the atmospheric pressure, which occures at night. This also is the reason why it rains more at night time than during the day.

Seriously, check to see if she coughs when a 'Barometer' shows a drop in atmospheric pressure during the daytime. If she does, then you've found the cause. Unfortunately there's no cure.

Edited March 12, 2009 by coventry

[mommysboy]

I think she just coughs due the drop in the atmospheric pressure, which occures at night. This also is the reason why it rains more at night time than during the day.

Seriously, check to see if she coughs when a 'Barometer' shows a drop in atmospheric pressure during the daytime. If she does, then you've found the cause. Unfortunately there's no cure.

There is a hint of truth in this perhaps for some people. But hardly the sole cause I think.

[VitalGirl]

Ventolin is only a broncho-dilator and actually doesn't improve anything - sometimes has horrible side effects too like a racing heart. I too have suffered this problem since being in Thailand for over 5 years - after trying everything (including unsuccessful attempt with the Ventolin) I went to an asthma/allergy specialist who put me onto a one-puff-at-night "new generation" asthma drug called Seretide. Amazing! Problem gone. Ironically none of the top class "farang" hospitals here in Chiang Mai had a clue how to help, including their asthma "specialists". The lady who got it sorted is a humble Thai doctor who studied in Hong Kong and Singapore - luckily I speak Thai and she spoke a smattering of English. Might add cost a fraction of the farang doctors here. PM if you would like more help.... Good luck.

Seretide works for me as well (I had the same symptoms as OP described). Don't know what I'd do without it. Most chemists sell it over the counter, except Boots for some reason. Often takes a few days use for full effect.

But what's the cause of all this?

Time and again I hear of adults who weren't particularly allergenic in Farangland but then start to develop rhinitis, asthma, or bronchial problems when in Thailand for any length of time. It's not 'normal' IMHO.

Smog/pollution is my best bet.!

The one thing all the many doctors I consulted agreed on was that is was probably started by a viral infection. Why more in Thailand? Temperature (happy little viruses like the warmth), rampanmt use of antibiotics in Asia and, according to the Chinese doctor, a huge influx of viruses Westerners have never been exposed to via Burmese people... we just have no immunity. My troubles all started after a one week trip to Burma which ended in 3 months of viral pneumonia. Some of the doctors maintain the virus stays in the system at low levels, others argue super-sensitivity of the bronchial system. Not especially smog induced... more irritated by air conditioning, changes in temperature and dry air. My worst times are not the smog season here, but the cold nights and mornings of the cool season.... and yes, the barometric pressure drop at night. Chinese docor swears this is the major cause of night coughing.

[mommysboy]

Ventolin is only a broncho-dilator and actually doesn't improve anything - sometimes has horrible side effects too like a racing heart. I too have suffered this problem since being in Thailand for over 5 years - after trying everything (including unsuccessful attempt with the Ventolin) I went to an asthma/allergy specialist who put me onto a one-puff-at-night "new generation" asthma drug called Seretide. Amazing! Problem gone. Ironically none of the top class "farang" hospitals here in Chiang Mai had a clue how to help, including their asthma "specialists". The lady who got it sorted is a humble Thai doctor who studied in Hong Kong and Singapore - luckily I speak Thai and she spoke a smattering of English. Might add cost a fraction of the farang doctors here. PM if you would like more help.... Good luck.

Seretide works for me as well (I had the same symptoms as OP described). Don't know what I'd do without it. Most chemists sell it over the counter, except Boots for some reason. Often takes a few days use for full effect.

But what's the cause of all this?

Time and again I hear of adults who weren't particularly allergenic in Farangland but then start to develop rhinitis, asthma, or bronchial problems when in Thailand for any length of time. It's not 'normal' IMHO.

Smog/pollution is my best bet.!

The one thing all the many doctors I consulted agreed on was that is was probably started by a viral infection. Why more in Thailand? Temperature (happy little viruses like the warmth), rampanmt use of antibiotics in Asia and, according to the Chinese doctor, a huge influx of viruses Westerners have never been exposed to via Burmese people... we just have no immunity. My troubles all started after a one week trip to Burma which ended in 3 months of viral pneumonia. Some of the doctors maintain the virus stays in the system at low levels, others argue super-sensitivity of the bronchial system. Not especially smog induced... more irritated by air conditioning, changes in temperature and dry air. My worst times are not the smog season here, but the cold nights and mornings of the cool season.... and yes, the barometric pressure drop at night. Chinese docor swears this is the major cause of night coughing.

It's a good post. Certainly a virus or strep. throat can and does cause an aggravating cough particularly at night and it can go on and on. I'm sure barometric pressure plays its part too. One of my friends suffered quite a bit in the UK, where it is cold and damp in general, but not in Thailand. Me the opposite so it is personal disposition too.

It's usually one, possibly two main causes personal to the sufferer, and then just about everything becomes a source of irritation, eg, strong air conditioning.

Perhaps smog is more about nasal symptoms, sneezing and swollen eyes. Certainly it doesn't make me cough that much, but it could take others that way.

But I'd still cite environmental causes as being the most important factor here above viral/bacterial causes IMHO.

[coventry]

If it were a viral/bacterial problem then that could easily be confirmed with a throat swab.

[samuibeachcomber]

If you have an airconditioner on at night,this could cause a dry throat and cough,as the a/c dries out the air that you breathe.

[pmcd8243]

This type of cough can be the result of chronic sinusitis. It is "positional" in that it occurs while laying down. A post nasal drip causes the cough. A cat scan of the sinus will confirm if this is the cause. In the mean time try nasal douche with a saline solution. Saline irrigation bottles are available at Watson,s and Boot,s. It comes in a green 1-2 liter plastic bottle. I prefer to atomize the saline by putting small holes in the top of the bottle and squeeze it up each nostril. Don't be shy and give it a real go, enough to make you cough and sputter. You should see dramatic improvement fairly quickly. If done right before going to bed you will sleep much better. The saline douche will treat the symptoms but may not fix the underlying problem. Good luck.

P

[Lazy Sod]

My coughing was due to allergic asthma (tree and grass pollens), diagnosed by an allergy specialist at Bumrungrad following skin tests and examination. Not expensive (about 2,500 baht) for the skin test which covers pollen, dust, mites, mold, etc., etc. They prick your skin with about 20+ common allergens and 15 minutes later you know what you are allergic to because the area swells. He gave me Seritide for the asthma and Nasonex (nasel spray) for the sinuses. He told me that there is now a widely held belief among allergy doctors that treating the sinuses as well as the lungs is beneficial for asthma. I googled it and and it seems to be true. Anyway, it worked for me. The coughing has stopped but I also feel better overall.

[mommysboy]

My coughing was due to allergic asthma (tree and grass pollens), diagnosed by an allergy specialist at Bumrungrad following skin tests and examination. Not expensive (about 2,500 baht) for the skin test which covers pollen, dust, mites, mold, etc., etc. They prick your skin with about 20+ common allergens and 15 minutes later you know what you are allergic to because the area swells. He gave me Seritide for the asthma and Nasonex (nasel spray) for the sinuses. He told me that there is now a widely held belief among allergy doctors that treating the sinuses as well as the lungs is beneficial for asthma. I googled it and and it seems to be true. Anyway, it worked for me. The coughing has stopped but I also feel better overall.

A very good post. The skin prick test is quick, cheap(ish) and not painful, and it very quickly rules in or out a number of allergic causes. it's really what we should all start with.