Asthma

Allergies and asthma frequently exist together.  Allergy reactions can lead to the release of similar chemical mediators and mobilize inflammatory cells that can react and affect both the adult or childs nasal symptoms and breathing.  With repeated exposures those cells and chemicals are deposited in both the nasal and lung tissue so that during a profound release of the hypersensitivity chemicals an asthma attack can take place.

According to the leading experts in asthma, the symptoms of asthma and best treatment for you or your child may be quite different than for someone else with asthma. The most common symptom is wheezing. This is a musical or whistling sound when you breathe. However, other symptoms may include:

  1. Shortness of breath
  2. Cough
  3. Chest tightness
  4. Fatigue with exercise
  5. Symptoms that recur with specific exposures.

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen or mold. Non-allergic triggers include smoke, pollution or cold air or changes in weather.  Asthma symptoms may be worse during exercise, when you have a cold or during times of high stress.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing and shortness of breath. In some children chronic cough may be the only symptom.

If your child has one or more of these common symptoms, make an appointment with an allergy specialized otolaryngologist:

  1. Shortness of breath
  2. Cough
  3. Chest tightness
  4. Fatigue with exercise
  5. Symptoms that recur with specific exposures.
  6. Problems feeding or sleeping due to breathing symptoms
  7. Avoidance of social activities due to breathing symptoms.

Asthma Diagnosis

An allergist diagnoses asthma by taking a thorough medical history and performing breathing tests to measure how well your lungs work.  One of these tests is called spirometry. You will take a deep breath and blow into a sensor to measure the amount of air your lungs can hold and the speed of the air you inhale or exhale. This test diagnoses asthma severity and measures how well treatment is working.  Many people with asthma also have allergies, so your doctor may perform allergy testing. Treating the underlying allergic triggers for your asthma will help you avoid asthma symptoms.

Asthma Treatment & Management

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them.

Controller medications are taken daily and include inhaled corticosteroids (fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), flunisolide (Aerobid), beclomethasone (Qvar) and others).

Combination inhalers contain an inhaled corticosteroid plus a long acting beta agonist aka LABA’s are symptom-controllers that are helpful in opening your airways. However, in certain people they may carry some risks.

LABAs should never be prescribed as the sole therapy for asthma. Current recommendations are for them to be used only along with inhaled corticosteroids. Combination medications include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera).

Leukotriene pathway modifiers are oral medications that include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR).

Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. These include: beta agonists These inhaled bronchodilator medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). Quick-relief medications do not take the place of controller medications. If you rely on rescue relief more than twice a week, it is time to see your allergist.

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. Examples include prednisone and methylprednisolone. They can cause serious side effects if used on a long term basis.