Respiratory and allergies
Cough & asthma (respiratory)
For asthma, long-lasting coughs and ongoing inhaler prescriptions
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Cough & asthma (respiratory)
You can consult us about breathing problems such as asthma and lingering coughs, and about continuing your inhaler. Feel free to contact us if you've run out of your usual medication abroad.
Why it happens
Asthma is a condition in which chronic inflammation makes the airways oversensitive, so they suddenly narrow and cause coughing, breathlessness and wheezing. Triggers include allergens such as dust mites, house dust, mold and pet hair, as well as colds, air pollution, cigarette smoke, exercise and changes in temperature. In treatment, it's important not only to control attacks but also to keep the inflammation itself under control.
What's happening in the body
In asthma, the airways are chronically inflamed. Inflamed airways are oversensitive, so when triggered by allergens, cold air or smoke, the muscles around them tighten and the passage narrows. At the same time, the lining swells and more sticky mucus is produced, narrowing the airways further. Breathing out through these narrowed tubes makes a wheezing or whistling sound. The key point is that the inflammation continues even when you're not having an attack. If you only use reliever medication and stop anti-inflammatory medication on your own, the airways stay oversensitive and attacks are more likely to keep coming back. That's why some treatments are meant to be continued even when you have no symptoms.
Main symptoms
- Wheezing or whistling sounds when breathing
- Breathlessness, shortness of breath
- A cough that gets worse at night or early in the morning
- Repeated coughing fits
- Tightness in the chest
- A cough triggered by exercise or cold air
- Phlegm in the throat
When you can wait and see
What you can do yourself
- Keep using your prescribed inhaler and don't stop on your own
- Wash and dry bedding often, and remove dust
- Avoid air conditioning blowing directly on you
- Identify and record what triggers your attacks
- Avoid strenuous exercise when you're unwell
Please consult us
If any of the following apply
- You're wheezing
- You want to continue your usual inhaler
- You have coughing fits at night or during exercise
Seek care right away
If any of the following apply
- So breathless you can't finish sentences or lie down
- Lips or nails turning bluish-purple
- No improvement even after using a reliever inhaler
- Drowsy or confused, or extremely weak
- Suddenly unable to breathe in, with swelling of the face or throat
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Asthma
Cough and wheezing that get worse at night or early in the morning and come in repeated attacks
You can discuss options such as inhalers
Cough-variant asthma
Only a cough, without wheezing, lasting 3 weeks or more
Treatment similar to that for asthma may help
Post-infection cough
After a cold, the cough stays even though other symptoms have gone
Most get better on their own, but it needs to be assessed if it gets worse
Allergic cough
Worse in certain places or seasons, with nasal symptoms and itchy eyes
We identify the cause and consider anti-allergy medication
Reflux-related
Worse after meals or when lying down, with heartburn
We review lifestyle habits and consider treatment as needed
Pneumonia, tuberculosis and similar conditions
Fever, colored phlegm, weight loss, night sweats, blood in phlegm
Assessment including imaging is needed. Please consult us early
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- During an attack
Wheezing and breathlessness get worse
Follow the attack plan you agreed with your doctor
- Minutes to hours
If the reliever medication works, symptoms ease
If severe breathlessness doesn't improve after using it, consider emergency services
- Days to weeks
The airways stay oversensitive for a while after an attack
Avoid triggers and keep taking the medication as instructed
- Ongoing management
Continuing anti-inflammatory treatment can reduce attacks
It's important not to stop on your own, even when you have no symptoms
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
In hot, humid Southeast Asia, dust mites and mold thrive all year round, so allergy symptoms that were seasonal in Japan can become year-round. Mold inside air conditioners and insufficient dehumidifying can make things worse.
When haze raises fine particulate matter (PM2.5), wheezing and breathlessness are reported to get worse in people with asthma. Always carrying your reliever inhaler is recommended.
The exact inhaler you used in Japan may not be available locally, so it's reassuring to discuss alternatives with equivalent ingredients or in the same class in advance. Your medication record or photos of the medication will help.
The temperature gap between hot, humid outdoors and strong indoor air conditioning can irritate the airways and trigger coughing.
Care
What Cotovia can do
- Assessing your symptoms and how they've developed through a consultation
- Prescriptions for bronchodilators and inhalers (prescribing is at the doctor's discretion)
- Guidance on where to go if you're severely short of breath
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Consultation and listening to your chest
Checking for wheezing and understanding when symptoms occur
Lung function test
Assessing how narrowed the airways are
Peak flow measurement
Recording your daily condition yourself
Allergy blood test
Identifying allergens that trigger symptoms
Chest imaging
Ruling out other conditions such as pneumonia
Treatment options
Anti-inflammatory inhalers
Keep airway inflammation itself under control over time
Continuing even when you have no symptoms is the foundation of treatment. Prescribing is at the doctor's discretion
Reliever medication
Opens narrowed airways and eases symptoms during an attack
Using it more often is a sign that your management needs to be reviewed
Anti-allergy medication
Eases airway reactions caused by allergies
May be used together with other treatment
Adjusting your environment
Reduce the triggers themselves
Examples include dehumidifying, cleaning air conditioners and caring for bedding
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- The inhaler you used in Japan (the actual item or a photo)
- Medication record
- Your peak flow record, if you have one
What to tell us
- When, where and what triggers your symptoms
- How many times a week you use reliever medication
- The treatment you had in Japan and the names of the medications you used
- Air conditioning, mold and pets in your home
- Smoking or exposure to secondhand smoke
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Control dust mites and mold indoors (dehumidify, clean air conditioner filters)
- Avoid outdoor exercise on days with bad air pollution
- Don't smoke and avoid secondhand smoke
- Prevent colds and flu (handwashing, consider vaccination)
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Children
Seek care urgently if your child can't finish sentences, heaves their shoulders to breathe or has bluish-purple lips
Pregnant women
Keeping asthma under control is important for both mother and baby. Please don't stop treatment on your own
People who exercise
Some asthma is triggered by exercise. Please discuss with a doctor what to do before exercising
During haze season
Always carry your reliever medication and avoid exercising outdoors
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QCan I continue the inhaler I used in Japan?
If you show us your medication record or details of the medication, you can discuss prescribing an equivalent. Availability may vary by country.
QI've had a persistent cough since moving here.
Environmental factors may be involved, such as more dust mites and mold due to heat and humidity, air conditioning and air pollution. We'll advise you after hearing how things have developed and about your living environment.
QWhat should I do if I have an attack?
It's important to agree with your doctor in advance on what to do during an attack. If severe breathlessness doesn't improve with your prescribed medication, consider local emergency services.
Common misconceptions
Myth You can stop medication when you have no symptoms
Fact Airway inflammation continues even without attacks. Stopping on your own can lead to attacks coming back
Myth Using lots of reliever medication is fine
Fact Using it more often is a sign that your asthma isn't well controlled. Please tell us how often you use it
Myth Inhalers are bad for your body
Fact Inhalers deliver medication directly to the airways, so they're designed to need only small doses
Myth You don't get asthma in hot countries
Fact There are factors specific to this region, such as year-round dust mites and mold, haze and temperature gaps from air conditioning
Myth You can always get the same medication as in Japan
Fact Availability varies by country. Please ask in advance about alternatives with equivalent ingredients or in the same class
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE