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Allergy and asthma: an informational brochure.

What it is...

Not everybody with asthma has allergies. Not everybody with allergies has asthma. But there is a connection. For instance, 80% of children with asthma have allergies while 50% of adult asthmatics are affected.

In all asthmatics that have allergies, allergies (to things like pollens, molds, and animal dander) may be significant triggers of an asthma attack. Allergies also make asthmatics more susceptible to nonallergic asthmatic triggers, such as viral infections.

Asthma is a complex disease involving a reversible constriction of the muscles lining the human airways. It is most often associated with allergy immune cells and can progress through stages to become life-threatening if not properly controlled. Asthma can be treated more effectively when diagnosed early by qualified physicians specializing in allergy and asthma. It should be possible to control your symptoms, so that your symptoms do not control you, by following several common sense allergy and asthma tips.

What causes it...

One out of every six Americans suffers from an allergic condition. Allergy is an inherited trait, a genetic susceptibility towards the production of an allergy anti-body called IgE. These allergy antibodies act like fuses on the outside of the allergy mast cells (see illustration next page). Once the fuse, IgE, comes into contact with the foreign materials like pollens or cat dander (which caused it to be formed), then the mast cell explodes. This allergic explosion releases the chemicals of the allergy cell into the surrounding area, and produces immediate symptoms of sneezing, wheezing, hives and itching so characteristic of all allergy.

These symptoms are due in large part to the mast cells releasing histamine and other chemical factors. In asthmatics who are allergic, these chemicals can trigger an asthma attack.

Asthma and allergy are family diseases not only because of their genetic causes, but also because of the family disruption which may occur when a child or parent is continuously and repeatedly ill.

When asthma is out of control, the entire family suffers.

What it does to you...

Most often when someone has asthma, allergy is an important contributing cause. Allergy has different names. Allergy reactions occurring in the nose or sinus are called "sinus" or "hay fever" or "allergic rhinitis." When allergy reactions occur in the chest we call it "asthma." Allergy reactions in the skin are named "hives" or "angioedema." So you see, allergy has different names depending upon where in your body it occurs.

Allergic reactions in the lungs are associated with spasm of the bronchial tubes, and the production of mucus which is thick and sticky. So, when asthma is out of control, patients feel tight chested and full of mucus which doesn't want to come up. Most patients with asthma feel as though they have ticklish, twitchy lungs.

There are many different triggers of asthma besides pollens, molds and animal dander. Other examples are exercise, cold air, viral infections and air pollutants such as ozone and sulfur dioxide.

Today there is a worldwide epidemic of asthma involving all ethnic groups in all industrialized nations in which accurate information is available. No one yet knows exactly why, but asthma is now more common and more deadly. Asthma and allergies cause over 130 million school days to be missed each year in the United States, and occupational asthma is now a frequent occurrence.

Asthma is something serious, and must be better understood by all of us.

How to diagnose it...

Surprisingly, many parents realize that their children have asthma before their physicians do. An accurate diagnosis, however, is most important in helping to determine an appropriate individualized treatment program. Physicians specializing in allergy/immunology have special skills in the area of asthma management. The allergy and asthma specialist will detect and determine those environmental elements (pollens, molds, dust mites, animal danders, workplace chemicals) which may be causing a patient's asthma condition. A careful medical history, physical examination, selective allergy skin testing and lung function studies are typically performed.

On occasion, allergy blood tests, home and workplace evaluations, and X-rays of the sinuses and lungs are required as well.

The most important step in the initial treatment of asthma is making the right diagnosis.

How to treat it...

Asthma is a disease which is associated with both spasm of the bronchial tubes and too much mucus. Consequently, the amount of medicine you may require to control your asthma depends upon how much bronchial spasm you have and how much mucus you are making. Asthma is a dynamic changing condition. It may worsen during the pollen seasons or with viral infections. Since asthma symptoms may vary, so will your requirement for asthma medicines. Each patient is unique, and for that reason, each individual patient may need slightly different medicines to remain symptom free.

Asthma and allergy treatments are aimed at either preventing the allergic reaction, or cleaning up the allergic reaction once it has taken place. Preventive therapies include the use of inhaled cromolyn, theophylline, inhaled corticosteroids and allergy immunotherapy (allergy injections) when allergic. Cromolyn is a compound which covers the mast cell, and prevents it from releasing histamine and other chemicals into the lungs. Inhaled corticosteroids are effective blockers of asthma inflammation. (In some cases, sustained release theophylline medications can help to prevent asthma attacks.)

Allergy immunotherapy for the allergic individual involves the injection of increasing amounts of allergy vaccine in order to bring the affected patient's immune system under better control. Allergy injections should be supervised by a physician specifically trained m allergy and immunology. This form of therapy can help to defuse the allergy cell, and can allow for greater tolerance of one's local environment. Allergy immunotherapy can help to prevent the progression of the patient's allergies.

The best therapy of all, however, is AVOIDANCE of those things which produce asthma symptoms. This includes allergens, such as house dust mites, cats and irritants, such as tobacco smoke and chemical fumes.

Active uncontrolled asthma requires active drug therapy. Medicines commonly used to open or dilate the bronchial tubes include theophylline (a cousin of caffeine) and beta-agonists (cousins of adrenaline). These medications are quite safe when used under your physician's supervision (even during pregnancy), although occasional patients will notice side effects of nervousness, agitation, mood swings or muscle tremors. Close follow-up and consultation with your allergy and asthma specialist will help to maximize your benefit from these bronchodilators.

Inflammation is an extremely important aspect of asthma. Active anti-inflammatory agents frequently used by allergists include either inhaled or oral corticosteroids, such as beclomethasone and prednisone. Your allergy and asthma specialist will guide your individual treatment program so as to minimize your potential steroid side effects.

So, you can see now that asthma can be a complex disease to treat. You should expect to receive preventive therapy (avoidance, preventive medications, allergy immunotherapy) and active therapy (bronchodilators, anti-inflammatory agents) to better control your breathing.

Taking control...

In order to control your asthma, it is helpful to discover its causes. When an accurate diagnosis is made, the correct treatment program can be chosen.

How to get the best care...

The American Academy of Allergy Asthma and Immunology sincerely hope that you may benefit from this brief asthma brochure. If you would like more information on allergy and asthma treatments or need a referral to an allergy/immunology specialist, lay organization or support group in your area, please do not hesitate to call us at:


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Copyright 1995 Gale, Cengage Learning. All rights reserved.

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Publication:Pamphlet by: American Academy of Allergy and Immunology
Article Type:Pamphlet
Date:Apr 1, 1995
Previous Article:Outpatient treatment of asthma.
Next Article:Anaphylaxis.

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