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Knowledge is power.
Northern Colorado Allergy and Asthma Clinic hopes that you will find the following topics helpful in managing your allergies or asthma:
Frequently Asked Questions about Allergies
What causes allergies?
What kind of problems do allergies cause?
Who will develop allergies and how long do they last?
How are allergies treated?
Strictly speaking, allergy is not “cured” but only kept under control so that it does not produce symptoms.
Environmental Control to Prevent Allergies and Asthma
The first method of treatment of allergies is environmental control. Obviously, if all allergens could be completely prevented from entering the body of the allergic individual, the symptoms would cease. This ideal is attempted in many ways. The amount of relief from symptoms that is obtained depends upon the thoroughness with which the allergens are removed.
Indoor Air Quality
The removal of the pet to the home of a caring, non-allergic friend or family member may be the best solution, but if this is not possible, minimize the allergic individual's exposure by keeping the pet out of the bedroom. Washing the pet on a regular basis (weekly for cats and every two weeks for dogs) may help. A non-allergic member of the family should brush the pet outside to remove loose hair and allergens.
Rodent pets such as rabbits, gerbils, and hamsters produce urine, which is the main source of the allergen. The allergic individual should not clean the cage and the animal should not be kept in the bedroom.
Although some dogs and cats produce less allergen than others do, all breeds produce allergens. Even if the allergic individual is not initially allergic to a new pet, symptoms may develop over time. A preferred pet for an allergic person would be a reptile, fish or animals without fur or feathers.
Allergy Shots (Immunotherapy)
Allergy shots, referred to as allergy immunotherapy is a vaccination program that can reduce an individual's reactions to an allergic substance such as animal dander, pollen or mold. Immunotherapy works like a vaccination. By injecting small amounts of a purified allergen, the body produces protective antibodies and prevents or reduces the allergic response. Beginning with small doses, the body gradually builds up immunity until a maintenance dose is reached. Immunotherapy generally lasts three to five years or longer and may greatly reduce or eliminate symptoms.
Nasal saline Washes
An important aspect of treatment in allergies and asthma is nasal saline irrigation. The nose is said to be the “beginning of the lungs” since substances, which affect the health of the lungs, first enter the nose. An allergic substance not only causes localized symptoms in the nose such as itching, sneezing and rhinitis (runny nose), but can also cause a cough and wheezing in the lungs. Nasal saline washes are recommended twice daily to wash out the allergens and bacteria and remove the layer of mucus prior to using nasal sprays. If done regularly, symptoms should significantly improve.
Make a solution of 8 oz. of warm water (use distilled water or boil water first, and let water cool), ½ teaspoon of sea salt or non-iodized salt and a pinch of baking soda. Mix in a specified mug and draw up the solution in a bulb syringe. Bulb syringes and plastic containers used to mix solutions should be changed once every three months, and should never be shared between persons. Lean over the sink, spray little puffs in each direction, hitting every aspect of the nose. Use all of the solution in the bulb syringe. Repeat and follow the same instructions on the other side of the nose. When finished with the washes, gently blow your nose. Wait a few minutes, then use the nasal spray prescribed by your physician.
Although prevention comes first, medication may be needed if symptoms persist or allergen exposure is unavoidable. Allergies are most commonly treated with antihistamines, nasal sprays, decongestants, and immunotherapy.
Antihistamines work by preventing the release of histamine. Traditional, older antihistamines cause many side effects including drowsiness, dry mouth and difficulty with urination. Newer antihistamines such as: Xyzal, Clarinex, Allegra, Zyrtec, and Claritin produce far fewer side effects. Nasal sprays containing steroids are very effective and may generally be used indefinitely. Antihistamine nasal sprays such as Astepro, Astelin, and Patanase reduce congestion as well as block histamine release. Over the counter decongestant nasal sprays should only be used for three or four days in a row due to rebound congestion, and should rarely be used. Decongestants help decrease congestion in the nose by their action on blood vessels. Side effects include increased blood pressure, sleeplessness and irritability. Check with your health care provider if you have high blood pressure or are taking other medications before you take decongestants. Singulair is a leukotriene modifier, which blocks both allergies and asthma and causes very few side effects.
Asthma is a chronic inflammatory disease of the airways affecting 14 to 15 million people in the United States. Asthma causes wheezing, cough, and difficulty breathing. Symptoms generally come and go and are at least partially reversible. During an episode of asthma, the airways become narrow because the muscles around them tighten (bronchospasm). The lining of the airways may become swollen and excess mucus is produced which can clog the air passage. Breathing gets harder as air is forced through narrower airways and the airflow may make a wheezing or whistling sound. Asthma episodes may be mild or severe. Most often they are mild and the airways will open in a few minutes to hours. Infrequently, asthma episodes can be severe or prolonged and need emergency medical treatment.
It is essential to make the diagnosis of asthma to rule out other medical problems that sometimes mimic asthma. In addition to a careful history and physical exam, pulmonary function testing is performed to measure the airflow in the lungs and the reversibility of the obstruction after the inhalation of a bronchodilator medication.
Although asthma cannot be cured there are many ways to control and prevent asthma attacks, allowing for a comfortable life with minimal interference in daily activities. Furthermore, many children have lessening symptoms as they grow older.
Determining an individual's asthma triggers is an important step in controlling the episodes. Some of the more common triggers to asthma are allergies to pollen, animals, dust, dust mites and mold; respiratory infections; smoke or air pollution; chemical fumes and exercise.
Asthma triggered by allergic factors can be prevented by avoidance of allergens. Allergy injections or immunotherapy reduce reactivity to the offending allergen. Whether asthma is triggered by allergies or not, medication will help prevent or reduce the symptoms. No one drug is best for every kind of asthma or every person. You and your doctor will work together to find the drug or combination of drugs that will work best for you.
Medical Treatment for Asthma
There are two kinds of asthma medications - those medications that relieve symptoms when present and those medications that control or prevent symptoms.
Relievers or bronchodilators such as Albuterol (Proventil, Ventolin) and Pirbuterol (Maxair) work quickly by relaxing the muscles surrounding the airways. Usually the medication is inhaled into the lungs from an inhaler, nebulizer or similar device for fast relief of symptoms. Patients experiencing daily or increasing symptoms need to begin a controller medication.
Controller medications do not relieve symptoms quickly. Instead, they control or prevent asthma symptoms by reducing airway swelling and the production of mucus. Controller medications include inhaled or oral corticosteroids, long-term bronchodilators, theophylline, and leukotriene modifiers.
Inhaled corticosteroids are the most effective anti-inflammatory medications available. Studies have shown that early use of inhaled corticosteroids can control asthma and prevent permanent airway injury. A possible side effect of higher doses of inhaled steroids in children is growth suppression. Because researchers are still investigating the possibility of this side effect, your physician will monitor the growth of your child on inhaled corticosteroids. All patients using inhaled steroids should rinse their mouth after using the medication to prevent an easily treatable yeast infection in the mouth. Sometimes steroids are given orally for prompt control of exacerbations. If taken for months or years at a time, oral steroids can have serious side effects; consequently, they are rarely prescribed long term.
Long-term bronchodilators such as Serevent or Foradil are used to prevent symptoms, especially nighttime and exercise symptoms. They should not be used for sudden asthma symptoms since they may take fifteen to thirty minutes to start working. The effect lasts twelve hours or more. Side effects are unusual and minimal but may include rapid heartbeat or tremor.
Theophylline provides long-term relief of symptoms, especially nighttime symptoms. Because of the adverse effects such as insomnia, stomach upset, shakiness, and hyperactivity in children, theophylline is rarely prescribed since newer medications have become available.
Leukotriene modifiers such as Accolate and Singulair work on the cellular level to improve lung functions and diminish symptoms. They may reduce the need for other medications including inhaled corticosteroids. They have found to be particularly useful in asthma, which is triggered by allergens. Generally, patients do not have any adverse effects with the use of these medications.
Allergic and asthmatic disorders rank first among children's diseases. With diagnosis and appropriate treatment, asthma can be a minor inconvenience. Once diagnosed the object of treatment is control of the disease so that a normal life is possible. Overall, the outlook is favorable for improvement as the child becomes older. However, it is impossible to make an accurate prediction for any particular child.
Treatment of the child with asthma involves evaluating the triggers of asthma and changing the environment whenever possible to avoid the precipitating factors. Medication works to prevent or control bronchospasm and allergy injections may be recommended to change the child's response to inhaled allergens, which trigger bronchospasm. Remember, allergy injections (immunotherapy) take time to show an effect and do not directly help the asthma, which is triggered by such factors as upper respiratory infections, cold air and exercise. Therefore, a combined program of avoidance, medication, and allergy injections (if indicated) achieves control of asthma.
If your child has asthma, you can help in the following ways:
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