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Sniffles and Wheezes

"Is your runny nose causing your asthma?"
By: Ivan Olegario, MD, MDevComSniffles and Wheezes

Growing up in the town of Montalban, Rizal, beside the Sierra Madre Mountains, we would always have our own version of snow during December. As the breeze begins to turn chilly, the mountainside would turn white, covered by acres of flowering cogon grass. Oh, what a sight to behold!

But all of the joy would be ruined quickly, because with the coming of the white cogon flowers follows their pollen, which would wreak havoc to those with hay fever. And then, the asthma attacks would come.

Hay fever, known medically as allergic rhinitis or allergic rhinosinusitis, is an allergic reaction to a variety of allergens, but the most common would be grass pollen. When the pollen comes into contact with the sensitive lining of the nose, it triggers a dramatic (over)reaction, making the lining swell, leading to a clogged nose. The reaction also causes repeated sneezing as well as a very itchy nose and throat.

Asthma is a similar reaction to the same allergens, but this time, the reaction happens in the lining of the deeper airway passages within the lungs (the bronchi and bronchioles).

The allergic triad

The association between allergic rhinitis and asthma has been known to medical science for a long time. In fact, these two are part of the allergic triad which also includes eczema (also known as allergic dermatitis). Eczema is also like the other two previous conditions. It is also an allergic reaction, but this time, on the skin. The result is an itchy rash and dry skin. They are all the same: allergic reactions, manifesting in different ways.

The allergic rhinitis-asthma connection

While all three conditions are related in varying degrees, the relationship between allergic rhinitis and asthma is the most intimate. Asthma is present in 50% of people with allergic rhinitis, and allergic rhinitis is present in up to 80% of people with asthma.

Because of this intimate connection, when the lining of the nasal passages become inflamed during a bout of allergic rhinitis, the inflammation can easily spread to the lining of the bronchi and bronchioles. This is no small deal. Many people with allergic rhinitis have one bad case of hay fever a week, and a few people can have it almost every day.

Taking back control

The control of asthma is mainly composed of avoiding asthma triggers and taking maintenance medications, mostly in the form of inhaled prescription medications and add-on oral medications.

Once you know your allergies, try to avoid them. Though this is not always possible because many allergens are carried in the air, here are a few tips in avoidance:

  • If your allergen is dust or house duse mites:

o   Avoid dusty places.

o   Make sure your room is cleaned at least once a week. Have someone else clean your room for you, because cleaning can whisk the dust into the air, which you can then inhale.

o   If that is not possible, wear a high filtration efficiency (HFE) face mask, which is available in most drugstores.

o   Do not place curtains and carpets in your room. If you need them, make sure they are cleaned at least every two weeks.

  • If your allergen is pollen: 

o   Avoid going to grasslands or places with flowers, especially during pollen season.

o   Weather apps and websites, such as www.accuweather.com, gives pollen reports that you can check to find out the pollen content of the air every day.

o   If your home is air conditioned, stay indoors.

o   If you really cannot avoid pollen, take over-the-counter allergy medications. Be warned that many of these medicines can cause drowziness, so avoid driving or operating heavy machinery when taking these medicines.

  • Some people are allergic to cockroaches. When cockroaches die, their bodies can decompose into dust particles that can cause allergies. You should:

o   Keep your home clean and free of cockroaches.

o   Avoid keeping food or trash exposed that will attract cockroaches. Keep their storage bins well sealed.

o   Killing cockroaches with insecticide may worsen your allergies, because insecticide will also kill cockroaches that are hidden. This means you will not be able to sweep them away, and their decomposed bodies can lead to worse asthma and rhinitis.

  • Most people are not allergic to dog fur. They are usually allergic to pet dander. This is the microscopic flecks of their shed skin. If your allergen is pet dander:

o   Avoid keeping pets.

o   If you are an animal lover, how about taking care of fish instead.

o   If you like furry animals, at least make sure they are regularly groomed and both their fur and skin are kept healthy.

o   If your dog has signs of skin disease, such as excessive shedding, areas with no hair, or dry, scaly skin, bring your pet to the vet.

For some people, these measures may not be enough. In these cases, visit a doctor who can do additional tests and prescribe you with more potent medications, including oral medications and nasal sprays.

By taking control of your rhinitis, you can breathe more freely, without the sniffles and wheezes.

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