Ask an expert - body - chest - coughing

3 questions

Q:  I have had a persistent cough for 15 years. I have seen A specialist at Kings College London and been to several cough clinics, none have provided a solution. The cough is very violent and puts a great deal of stress on my body. The problem has been diagnosed as nerve damage to my throat, which causes an overreaction to the slightest irritation resulting in severe bouts of coughing. Is there any form of acupuncture that may relieve or stop the problem.

A:  We are assuming that having been under specialist care you have had all of the available tests, and we are a little surprised that nothing has shown up. However, we have seen cases like this where the body seems to have developed a sensitivity reaction for which no obvious solution can be found. We answered a question about a similar problem some time ago, and the response we gave included the following comment and advice:

If none of these has been identified as a cause, or even if they have, there may be some merit in looking at acupuncture treatment. There is not a great deal of evidence for the treatment of coughing, but this is mainly a reflection of the many different causes of coughing and the difficulties of designing a trial which generates meaningful results. Persistent coughing has certainly be a symptom recognised within traditional Chinese medicine, and if it appears alongside other symptoms and alongside the diagnostic evidence which a trained practitioner will find using Chinese medicine techniques, there are a number of clearly defined syndromes which offer treatment protocols to address the underlying patterns.

Even where there is no recognised syndrome, it is important to remember that in its earliest forms Chinese medicine was asymptomatic, i.e. it treated the patient as a whole based on the diagnostic evidence and not necessarily with regard to what they reported. In this way the treatment could truly be said to be unique. The underlying premise was symptoms only appear when the system as a whole is out of balance, and because of the internal patterns of energy flow, a symptom may not necessarily arise where the actual problem lies. The skill and art of the practitioner is to go to the root of the problem and once this is treated, there should be an improvement in the symptoms.

On that basis, and given that the problem has not always been there, it may well be worth having a brief chat with a BAcC member local to you to determine what may be possible. What the earlier answer does not cover in detail is the fact that traditional Chinese medicine sees the whole system, body, mind and spirit, as a united whole, and there are quite often connections to what is happening in a patient's life which can make some sense of an unusual symptom. Even where this is not the case, however, there is some evidence, especially from the treatment of phantom limb pain, that acupuncture treatment may be able to turn off or reduce the volume of a nerve signal to the point where it becomes more tolerable.

The only caution we have about slightly less frequent problems is that it can be quite easy to have a great many treatments where the results do not justify the continuing expense. You are probably more likely than many to notice circumstances where the reaction is less extreme, but even so we would always recommend finding some relatively objective outcome measure to assess the benefits of treatment.

Q: Throughout this past winter I have suffered with chronic catarrh and an almost permanent cough-particularly in the morning when I bring up lots of mucus. I have a suspicion that I might have allergic rhinittus. I have seen my doctor, and respond well to antihistamine and a nasal spray. However,my GP is reluctant to send me for allergy testing, and therefore I wondered if acupuncture might be useful. Can you advise please?

A: We have been asked about similar problems in the past, and a recent typical response was:

Can acupuncture help chronic rhinitis?

There is a growing body of evidence that acupuncture treatment may help with a number of forms of rhinitis, as our factsheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/allergic-rhinitis.html
 
However, we know from our clinical experience that although there are some, indeed many, presentations which seem to respond well to acupuncture treatment, there are a number which have their root in some physical change or restriction in the nasal cavities, or from long-term sinus infections which have become resistant to treatment. If either of these is the case, there may be much more of a struggle involved in trying to reduce the impact of the symptoms.

From a Chinese medicine perspective, however, there are a number of clearly defined patterns involving a compromised defensive system (the Chinese didn't recognise the immune system as we do but certainly had a concept of defensive energy which when compromised generates the symptoms which we associate with rhinitis) and also digestive disorders which can manifest in the fluids of the body being excessive. A skilled practitioner will be looking at the symptoms someone has in the context of their whole system, and trying to ensure that treatment is aimed at the core of the problem, not simply the way in which it manifests.

Amongst the things which the practitioner would consider are also a number of digestive factors. From the Chinese medicine perspective the intake of too much dairy produce can often produce far too much mucus in the body, and it is not uncommon as a pattern. If this is the case, though, there will be a number of diagnostic signs which point clearly in this direction.

You would be well advised to visit a BAcC member local to you for face to face advice. Most are happy to give up a few minutes without charge to assess whether acupuncture treatment is the best thing for you. 

We think that this remains the most sensible advice that we can offer. It is not surprising to us that your doctor is unwilling at this stage to send you for allergy testing. His reasons may be budgetary or they may be based on his experience that they more often than not fail to provide a clear answer. From our perspective the tests may be useful, but once the immune system has been triggered in this way there is a tendency to see a huge number of short-term sensitivities which have been triggered by the more causally related one. The list of intolerances which people are handed means that they can end up with a serious restriction in what they eat to the point that it becomes difficult to ensure a balanced diet.

We think that it is probably likely to be worthwhile to visit a BAcC member local to you for an informal assessment of what may be possible. From a Chinese medicine perspective each patient is unique and different, so the symptom may arise from a totally different cause from someone with exactly the same presentation. The strength of the system, though, from our perspective is that it treats the person, not simply the condition, and as such offers a better chance of dealing with the symptom permanently rather than turning off the alarm bell which the symptom represents because we don't like the noise.

Q:  My 31/2 year old soon has chronic coughing, doctors are note sure if its asthma yet. But he coughs all winter and vomits with it so he has lost a lot of weight. Antibiotics, steroids etc don't seem to help and so I'm looking for safe alternatives. would acupuncture help with this? he also has an IGA deficiency. Im desperate .

 

A: As you can see from our quite detailed review paper on bronchial asthma
 
Please click here

in amount of evidence that acupuncture can benefit someone suffering from asthma, although as the introduction says, there are insufficient trials to be able to make positive recommendations and equally a number of methodological problems about setting up meaningful tests of acupuncture if there is insistence on using randomised controlled trials which are more appropriate for drug testing.
 
However, the most important point to make in this context is that children are not simply little adults for the purposes of making a diagnosis in Chinese medicine, and there are some quite sophisticated ways in which the developing child's energy is understodd in Chinese medicine terms. This can sometimes offer treatment possibilities which may not be applicable to adults, and may be able to offer a little more hope than one might want to give in the case of an adult. A fundamental problem is that once people are dependent on medication for the treatment of asthma it is very difficult to make a case for stopping the medication, since in western medicine this is perceived as increasing the risk of a potentially fatal attack.
 
Chinese medicine has been dealing with the same problems as western medicine for over two thousand years, and there are a number of different protocols for the treatment of breathing problems which a skilled practitioner might employ. Even treatment at a constitutional level, in the simply belief that a system in balance rights itself, may offer possibilities.
 
We do not recognise specialisms because we have a commitment to generalism - all of our members are capable of using Chinese medicine effectively with any patient they see. However, over the last thirty years a significant number have focused their work on specific target groups such as women in pregnancy or children, and there are a number of postgraduate courses which we are currently examining in detail to assess whether our members can lay claim to expertise in their advertising. We cannot give recommendations for individual practitioners until and unless we agree these standards, but there are two or three well-known courses which maintain databases of practitioners who have met the appropriate standards, and we are fairly sure that if you google 'acupuncture' and 'treatment of children' you will see the main ones. You might also usefully add your location to see if anyone who has undertaken this training works near you.
 
Based on what you have said we believe that there may be some benefit which your son may derive from acupuncture treatment, but there is no substitute for a face to face assessment, and if you can find someone suitably trained near you they will almsot certainly be able to advise you on the best options for your son, whether this involves acupuncture treatment or other forms of complementary medicine such as cranial osteopathy which is also used for many children's health problems.

 

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