Asthma, COPD and Chronic Cough: Specialist in Dubai
Wheeze, breathlessness and a cough that lingers have a short list of common causes and a long list of rare ones. Asthma and COPD are the common ones, diagnosed by measuring the airways rather than guessing; a cough that has lasted more than eight weeks usually comes from the nose, the airways or the stomach. At Smart Care Polyclinic in Deira, an internal medicine specialist diagnoses, sets up treatment, and checks the thing that fails most often: how the inhaler is actually used.
For: wheeze, breathlessness, cough beyond eight weeks, inhalers that do not seem to work
Takes: a 30-minute consultation; spirometry and chest examination
Price: consultation AED 125
Book the internal medicine specialistor call +971 (0) 4379 3562
What it is
Asthma is variable airway narrowing that comes and goes; COPD is fixed narrowing, almost always from smoking, that progresses. Both are confirmed with spirometry, which measures how much air you can blow out and how fast, before and after a bronchodilator. The Global Initiative for Asthma and the Global Initiative for Chronic Obstructive Lung Disease strategy reports are the references for diagnosis, staging and stepwise treatment, and the specialist works to them.12
Inhaler technique is checked at every visit, because most people use theirs incorrectly and most "treatment failure" is technique. Asthma treatment now centres on inhaled corticosteroid, with reliever-only treatment no longer recommended for adults; COPD treatment centres on long-acting bronchodilators, stopping smoking, vaccination and pulmonary rehabilitation.
A chronic cough is classified by duration. The CHEST guideline defines acute cough as under three weeks, usually a viral infection; subacute as three to eight weeks, usually post-infectious; and chronic as over eight weeks, where the commonest causes are upper airway cough syndrome from the nose and sinuses, asthma, gastro-oesophageal reflux and eosinophilic bronchitis, alone or in combination.3 The work-up follows that list: a chest X-ray to exclude the rare serious causes, then trials of treatment for the common ones in turn.
Dubai's air
Dust, sandstorms, air conditioning and indoor humidity all provoke airways, and asthma that was quiet elsewhere often flares here. Allergen avoidance, a written action plan for flares, and knowing when to step treatment up and down are part of the consultation.
Red flags
Coughing blood, weight loss, night sweats, a cough with fever that is not settling, or breathlessness at rest need prompt assessment and imaging, and are the reason a chronic cough starts with a chest X-ray.
The consultation, and what follows from it
Internal medicine consultation
Assessment, examination and a plan with every cost stated before anything further is done.
AED 125 was AED 200
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Questions patients ask
By the history plus spirometry showing airway narrowing that improves with a bronchodilator, or variability on peak flow monitoring. A trial of treatment is used where spirometry is normal but the story is typical.
A cough over eight weeks is usually from postnasal drip, asthma or reflux, often in combination, rather than the chest itself. The specialist works through the causes in order after a chest X-ray has excluded the rare serious ones.
No, but its progression slows dramatically when smoking stops, and symptoms and flare-ups improve substantially with the right inhalers, vaccination and exercise.
This guide is general information, not advice about you. Long-term conditions are managed on your own results and history, which is what the specialist consultation is for.
References
- Reddel HK, Bacharier LB, Bateman ED, et al.. Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes. Journal of Allergy and Clinical Immunology: In Practice. 2022;10(1S):S1-S18. PMID 34718211. doi:10.1016/j.jaip.2021.10.001The Global Initiative for Asthma strategy: diagnosis, assessment and stepwise treatment of asthma, including inhaled corticosteroid-containing treatment rather than reliever-only treatment for adults.
- Agustí A, Celli BR, Criner GJ, et al.. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine. 2023;207(7):819-837. PMID 36856433. doi:10.1164/rccm.202301-0106PPThe GOLD strategy for diagnosing COPD by spirometry, assessing it, and treating it in steps with bronchodilators, smoking cessation, vaccination and pulmonary rehabilitation.
- Irwin RS, French CL, Chang AB, et al.. Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2018;153(1):196-209. PMID 29080708. doi:10.1016/j.chest.2017.10.016Cough classified as acute (under 3 weeks, mostly viral infection), subacute (3-8 weeks, mostly post-infectious) and chronic (over 8 weeks, most commonly upper airway cough syndrome, asthma, reflux and eosinophilic bronchitis, alone or combined).
Sources are listed for the specific statements they support. They are published research and guidance, not a substitute for a consultation — what applies to you is decided by a doctor who has assessed you.