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Allergic Asthma

Allergic or allergy-induced asthma is a type of asthma where the air paths constrict when breathing in response to allergens. These allergens are usually airborne, such as dust mites, animal dander, pollen, or mold spores.

When exposed to an allergen, your immune system perceives it as a threat and launches a defensive response. This triggers the release of chemicals that result in swelling, inflammation, and tightening of the airways, making it difficult to breathe.

Symptoms of Allergic Asthma

People with allergic asthma often experience symptoms similar to other kinds of asthma, such as:

• Shortness of breath
• Frequent coughing, especially at night
• Wheezing, a whistling sound when breathing
• Chest tightness, a sense of pressure or heaviness in the chest

Exposure to allergens may also cause additional symptoms, such as:

• Stuffy nose
• Itchy or watery eyes
• Nasal drainage
• Rash or hives

Allergens triggering allergic asthma

Allergens that can trigger allergic asthma are commonly found indoors and outdoors. Identifying and avoiding these triggers is essential for managing your condition. Common allergens include:

• Pets or animals: Allergies can be caused by pet dander (flakes of skin), fur, saliva, or urine.
• Pollen (powdery substance): Tree and grass pollen are more common in the spring, while weeds and ragweed release pollen during the fall.
• Mold: Basements and other damp areas are common sites where molds can be found. They also grow outside on hot, humid days following mulching or rainfall. Mold releases spores into the air that can cause asthma.
• Dust mites: These microscopic organisms that consume human skin live on soft surfaces, such as carpets, pillows, furniture, and mattresses. Both dust mites and their droppings are allergens.
• Cockroaches: Saliva, feces, and cockroaches body parts can provoke asthma symptoms.

Food allergies can occasionally trigger allergic asthma but are rarely the sole cause.

How Serious Can Allergic Asthma Be?

Allergy-induced asthma might lead to several complications, including:

• Sleep interferences.
• Missed work or school.
• Limitations in physical activities.
• Restricted social activities, especially outdoors or those involving lots of walks.
• Increased hospitalizations and illnesses.

Diagnosis

Doctors use various tests to confirm allergic asthma and identify potential triggers. The two common diagnostic methods include:

• Spirometry

This breathing test measures how well your lungs function. It involves taking a deep breath and exhaling into a tube connected to a computer. The test evaluates how efficiently air moves in and out of your lungs.

Spirometry could also be performed before or after using a bronchodilator (inhaler medication) to determine how well your air passage responds to treatment.

• Bronchoprovocation Testing (Methacholine Challenge)

Methacholine, a medication, is administered to see if it causes your air paths to shrink or tighten. This test helps confirm asthma if spirometry results are inconclusive.

If asthma is diagnosed, your provider may recommend one of the following tests to identify whether environmental allergens are the reason behind your asthma:

• Skin test: Small drops of liquid that contain specific allergens are placed on your skin. The top layer of your skin is then gently scratched to enable allergens to penetrate. Your skin will respond by swelling if you have an allergy to the chemical, or you might develop small, elevated pimples.
• Blood test: A blood test may occasionally be able to detect allergy triggers. Contrary to skin testing, a small fraction of allergies may be missed by allergy blood tests.

How to Treat and Manage Allergic Asthma

You can effectively manage your allergic asthma by taking the following proactive measures:

Avoiding the allergen

Identifying and minimizing exposure to your asthma triggers is key. Your healthcare provider can help you pinpoint these allergens and create a plan on how to avoid them. Based on your asthma triggers, steps to reduce exposure may include:

• Frequent house cleaning. Regularly mop, dust, and wash bedding and pillows using hot water weekly.
• Allergen-proof bedding. Use dust- and allergen-proof covers for mattresses and pillows.
• Pollen precautions. During peak pollen seasons, ensure that you always keep the windows of the house and car closed. Also, limit outdoor activities when pollen counts are high; or put on protective gear, like glasses or face masks, when outdoors.
• Air quality control. Use high-efficiency filters in air conditioners or invest in an air purifier.
• Seek assistance. Hire help for tasks like lawn care if allergens like grass or pollen trigger your asthma.
• Create an action plan. Develop a personalized asthma action plan with your GP. The plan should include steps to take during an asthma attack, when to use medications, and actions to take when they are ineffective, including who to contact.

Medical treatments

• Leukotriene modifiers: This class of drugs is used to treat asthma and allergies. One of the most widely used leukotriene modifiers is montelukast (Singulair®).
• Allergy shots (immunotherapy): Regular injections or shots of allergens help build tolerance with time, reducing allergic reactions and asthma symptoms.
• Rescue inhalers: Provide immediate relief by quickly opening air passages during an asthma attack to facilitate breathing.
• Antihistamines: These drugs lessen mild to moderate allergy symptoms, such as watery eyes or itchy skin. As part of your overall treatment strategy, your doctor could advise you to take an antihistamine.
• Corticosteroids: By lowering airway inflammation, oral and inhaled corticosteroids can help avoid the symptoms of allergy-induced asthma.
• Biologics: Your doctor may inject biologics, which are small proteins, to help address the root cause of asthma. Moderate to severe allergic asthma is treated with this medication.

Prevention

Although there is no way to prevent asthma, you can lower your chance of having an allergic asthma attack by being aware of and avoiding triggers. It’s also important to ensure you take the recommended medication to manage the condition.

Living with Allergic Asthma

When to consult your healthcare provider

Reach out to your GP if allergens are triggering your asthma symptoms so they can help develop a suitable treatment plan.

When to seek emergency care

If you’re experiencing a severe asthma attack and have no access to your inhaler or symptoms persist even despite using it, immediately head to the ER or dial 911 (or your local emergency number). Additionally, allergies can sometimes lead to anaphylaxis—a severe and potentially life-threatening reaction that requires urgent medical attention.

Conclusion

Allergic asthma is a common health problem that affects many individuals. While there is no cure, it is possible to manage the condition effectively. Identify and avoid your asthma triggers, and work with your healthcare provider to create a plan for managing your environment and reducing the risk of asthma attacks. If you feel that the condition is not well controlled, don’t hesitate to seek professional guidance to find a treatment plan that is suitable.