Asthma and Hay Fever: “Partners in crime”

This article presented in the community interest by Hibiscus Private Hospital in Port Shepstone.  Based on material supplied by Dr Ayoob Bux, Founding Director Hibiscus Private Hospital and Chairman of the Independent Practitioners Association (IPA).

Worldwide, asthma affects about 300 million people including sufferers living in KwaZulu-Natal.  A chronic inflammation of the airways of the lungs, asthma is characterised by sensitive airways that narrow easily when triggered by certain stimuli.

Some patients are under the impression that using an inhaler is unsafe, especially in children. This is simply not true since an inhaler is only a mechanism for delivery of medication.  If you or your child needs an inhaler for asthma, don’t be afraid to use one.

Asthma triggers and symptoms
When these trigger stimuli are present, the airway lining swells from inflammation and mucous develops which results in wheezing. Other asthma symptoms include breathlessness, tight chest and coughing particularly at night and in the early morning. For this reason child asthma sufferers generally appear to be well during the day.

The triggers which can cause asthma symptoms to recur are to be found in the sufferer’s environment.  For some, animals with fur, such as dogs and cats, are the asthma trigger. Other triggers may be dust such as house dust with mites or certain types of fumes.  Mattresses, pillows, carpets and upholstered furniture, which don’t cause the slightest reaction in non-asthma patients, may be a great source of discomfort to the asthmatic.

Certain medicines such as aspirin or beta blockers can act as a trigger for some individuals as well as pollen, exercise and tobacco smoke – even second hand.  This means that identifying the trigger factors is crucial in successful management of asthma. Reducing ones exposure to risk factors may improve the control of asthma symptoms and reduce your need for medication.

Asthma and hay fever
Up to 80% of people who suffer from asthma also suffer from hay fever.  Individuals with hay fever are about 3 times more likely to develop asthma than those without hay fever.  This is because asthma and hay fever, though different conditions, share similar triggers. Inflammation is common to and plays a key role in both conditions.

In asthma, the main underlying cause is inflammation, therefore medications are needed to reduce the inflammation in the airways and help keep asthma under control.  The control of hay fever also improves the lot of the asthmatic.

Control of asthma symptoms
There are two groups of controllers used with asthma patients as long term therapy, those with anti-inflammatory actions such as corticosteroids and leukotriene blockers, and those with a sustained bronchodilator action like long-acting Beta-2-agonists and slow-release Theophyllines.

Relievers are medications used in the short term which act quickly to reverse narrowing of the airways and relieve symptoms like wheezing, coughing and tight chest. Relievers are used when and as symptoms arise.  When relievers, such as.rapid-acting bronchodilator inhalers, are used more and more often, especially daily to control symptoms, then this is a sign that asthma control is worsening and that treatment may need to be reassessed by your doctor.

Your doctor’s co-operation
Asthma control is enhanced when you enter into a ‘partnership’ with your doctor who will guide you into effective symptom control. Your doctor will also assist you with hay fever control, if necessary, because this will improve your asthma control. This can reduce asthma symptoms and lessen the need for emergency care or hospital visits. When asthma is controlled, there should be no more than occasional symptom flare-ups and severe attacks should be rare.