ASTHMA – THE DANGEROUS SIDE OF ALLERGIES
I recently wrote an article informing you about newest treatment of allergies. In that I mentioned that I don’t like to use the term “It’s only allergy” because some forms of allergy, including asthma can be very dangerous. In fact, in 2014 over 3500 Americans died from an asthma related problem.
As a fellowship certified allergist I see many patients who have developed asthma as the result of allergies. Because of the continuum of problems from the tip of the nose to the base of the lungs I am familiar with the steps and medical therapy that are recommended for the treatment of asthma.
Asthma is defined as reversible swelling or inflammation of the airway at and below the vocal cords including the trachea and the lungs. Because it is a reversible swelling asthma is different from chronic lung disease usually caused by smoking frequently called COPD or emphysema.
When we hear the word asthma, most of us think of wheezing in the lungs. While that is the most common presentation of asthma sometimes it only affects the windpipe at the area of the vocal cords. This causes a chronic tickle and dry cough. In fact this form is termed cough variant asthma.
While occasionally anxiety for emotional stress can trigger an asthma attack, it is almost always caused by inhaling something that results in allergic swelling of the lower airway and the lungs. This is why controlling allergies is a major portion of controlling asthma.
Fortunately, controlling as well with medications is usually successful. There are steps in control of asthma that start with using an inhaler for mild intermittent episodes then increase to other types of medications on a daily basis for prevention.
The first step for mild intermittent asthma is the use of a rescue inhaler. Usually this is a medication called Albuterol. It is inhaled and starts working quickly to open the airways and relieve difficult breathing, wheezing or cough. Albuterol is frequently given at the first sign of tightness of the chest or occasionally prior to exercise to prevent exercise induced spasm of the airways. Overall it is a safe and rapid acting medication. It can have side effects of jittery feeling and shakiness. It does not last long and frequently wears off in 4 to 6 hours.
For patients who need Albuterol or a medication like a rescue inhaler on a daily basis we recommend using other types of inhalers, which are usually, considered long acting bronchodilators along with inhaled steroids. These medications are very effective in preventing asthma attacks.
Another type of asthma medication is a tablet called Singulair or its generic Montelukast. This medication came out approximately 20 years ago for blocking lung inflammation. It also has a role in nasal and sinus allergy control. This is a once a day tablet with occasional but rare side effects and I find it very effective in controlling both nasal allergies and asthma.
Because asthma is a condition almost always caused by underlying allergies, control of allergies through immunotherapy is often the best and safest way to eradicate the problem. Allergy testing can identify the source of the reaction whether it is in your nose or in your lungs. With modern immunotherapy not only are allergies better controlled but your immune system is stronger so you have less infections.
As part of my continuing education in the field of allergy management I have spent many hours keeping up with the latest advancements in the therapy of asthma. In my office my Physician’s Assistant, Kristin Fitzgerald PA, also has extensive experience in the management of asthma. Prior to working in my practice, Kristin worked as an asthma specialist in other allergy clinics.
Asthma can be an extremely scary medical condition for the parent of a child who suffers with it. I feel that early control of asthma in children absolutely includes allergy testing. Numerous studies have shown that allergy immunotherapy given to children can prevent the development of serious life-threatening asthma as they get to young adulthood.
If you or a family member has asthma and wishes consultation for up-to-date control measures we would be happy to see you in our office. We perform lung function studies as well as medical therapies and allergy control measures to help combat this difficult problem.