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How adult asthmatics can cope during allergy season

Allergies and asthma can trigger a spring of itching, sneezing and wheezing for millions of Americans. About 26 million Americans suffer from asthma, which is a chronic or long-term lung disease that inflames and narrows the airways, causing coughing, shortness of breath, wheezing and tightness of the chest, according to theNational Institutes of Health.

Around two-thirds of Americans who have asthma also suffer from an allergy, according to a study in the April 2013 issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

There’s also evidence that allergies can worsen asthma in individuals. When inflammation occurs in the upper airway (nose), it affects lungs, says Dr. Richard Weber, president of the ACAAI, based in Illinois.

Asthma often starts in childhood, and as many as 80 percent of kids with asthma also suffer allergies, researchers say. The large number of children with allergies and asthma has been recognized for years, but study also found a surprisingly large number of asthmatic adults suffer from allergies. The researchers’ data, from a National Health and Nutrition Examination Survey of 2,573 adults, shows:

• 75 percent of asthmatic adults aged 20 to 40 years old have at least one allergy.

• 65 percent of asthmatic adults aged 55 years and older have at least one allergy.

Weber, an allergist, chatted with about the rise of asthma and allergies and how asthmatics can stay healthy during allergy season.

How adults with asthma stay healthy during allergy season

How was the recent study surprising?

Usually allergic asthma – which is asthma triggered by exposure to things that have allergic antibiotics, such as dust mites, cats and dogs, cockroaches and pollen – is higher in kids and young adults. Then it gradually subsides through life.

What this paper tells us is that you’re foolish to ignore (allergies) because people don’t become totally un-allergic as they get older. Allergies can easily make asthma worse, partly because pollens can release smaller particles loaded with allergenic proteins (which can induce an allergic reaction) and these can be inhaled deeply into the lungs, causing an allergic reaction in the chest. Also, irritating the nose can worsen asthma.

Why is asthma on the rise?

There’s no easy answer; it’s probably a mix of culprits (such as an increase in education and raising children in extremely clean households which fails to expose them to germs, so their immune systems can learn to fight off infection).

We have spent a lot of time honing in on indoor exposure. People are spending more time inside. They’re not outside getting fresh air. So maybe it’s a bigger exposure to indoor allergens (such as dust mites, pets and cockroaches).

How can asthmatics stay healthy during allergy season?

It is useful to know what you’re sensitive to. It’s a good idea for someone to be evaluated by an allergist if they have a feeling that they’re worse at a particular time of year. Or if their wife’s cat drives them nuts and they know it, but there’s no way that cat is going to leave the house. We know that a lot of times the severity of (a person’s) asthma is linked to how much of the upper airway (nose, sinuses or throat) is giving them trouble. That will have an impact on the lungs. It’s not unusual that when a person’s allergies are cranked up, his asthma gets worse.

What’s the next step?

Be proactive as opposed to just reacting when you have symptoms. Using a nasal steroid preparation [before the season] will decrease the amount of allergic antibiotics being produced in the nose during the season.

We all wait until we’re miserable and can’t understand how we got that way. It’s really important to take appropriate asthma medicines during the season.

If you’re sensitive to ragweed or grass pollen, (people may say) just don’t go out. That’s kind of dumb. You don’t want people to have to do that.

What about alternative forms of treatment?

Acupuncture may be as useful as taking a couple of puffs on your inhaler.There have been reports on whether certain Chinese remedies are useful. I don’t dissuade people from doing those things as long as they’re not paying an arm and a leg for it.

Immunotherapy (treatment of disease by inducing, enhancing or suppressing an immune response) is very useful. If someone has pure allergic asthma – like cat dander asthma or dust mite asthma, immunotherapy would be expected to work well.

The tricky part is if (the patient’s) asthma is bad, immunotherapy can be dangerous. When asthmatics have reactions to allergy shots, it often is in the form of an asthma attack. You have to get their asthma under control before it’s reasonable to institute something like immunotherapy.

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