<human>: Hi My son of 13 year old has allergies and asthma related condition. it is been 5 months now that he has a chronic cough, I took him to pulmonologist and long doctors, we tried taking albuterol, allergy pills, it helps but nothing seams to be good enough to cure him from that cough. we live in Maui hawaii, he had to change his lifestyle, he was an outdoor boy and now he always has to stay inside......please can u help? I did some researches on line and came across sensory neurophatic cough, or cough-variant asthma how can be diagnosed? . What about Xolaris Omalizumab can it help?
<bot>: Hello, Thank you for asking at Chat Doctor. I went through your sons history and can understand your concern. I would like to make suggestions for him as follows:1. There are many causes of chronic cough. I would like to know more about him like - a. Has he ever had wheezing/breathing difficulty? b. Has he ever required nebulization? c. Does he have nose symptoms like running nose, nose obstruction, sneezing, etc.? d. Does he have regurgitation of sour fluids after taking heavy/spicy foods? e. Does he have headache, post-nasal Chat Doctor?  Does he have any family member with allergies/asthma? g. Is he routinely exposed to dusts, smokes or air pollution? h. Does he have weight loss, loss of appetite, etc.? Above details would help me to think of possible causes of chronic cough. Further investigations could be suggested based on the details.2. As your current diagnosis is asthma, I would like to mention that asthma can be diagnosed by spirometry with post-bronchodilator reversibility test. 3. I would also suggest him allergy testing, which will help you identify the substances he may be allergic to and also to know the measures to avoid them.4. Based on allergy testing, an Allergist-Immunologist may prescribe him allergen specific immunotherapy which gradually improves allergy symptoms by working on immune system.5. For asthma, I would also suggest him taking montelukast regularly as a controller medication.6. Personally, I would not suggest him to avoid outdoor activity and restrict him life for many reasons - a. physical activities are very important for improving immunity and lung capacity, which help improve asthma control. b. Restrictions at his age of 13 could have psychological consequences. c. With proper use of controller medications and management of allergies, most of the asthma patients can live life without any limitations.7. Sensory neuropathic cough or cough variant asthma are better diagnosed by experts, usually pediatric pulmonologists. I would suggest you not to be confused by the ocean of information that is available on internet. Thorough history taking, physical examination and prompt use of investigations is required for making diagnosis of a chronic cough.8. Omalizumab can be helpful in some subsets of allergic asthma/rhinitis, but it is not the first 