Allergies And Asthma: Get A Breath Of Fresh Air
With the change in seasons, allergies and atopic asthma become more prevalent. Allergies can make you feel as though you have been hit by a head cold – sneezing, fatigued and with a killer headache – while asthma can be difficult to resolve until you have identified what type it is.
You may feel as if nothing has worked to alleviate your symptoms, and you’re not sure what to do next. We spoke to Dr Ismail Kalla, a pulmonologist from Charlotte Maxeke Johannesburg Academic Hospital, to provide you with a guide to the fundamentals of allergies and asthma.
What are allergies?
“An allergy is the reaction that takes place when a specific molecule comes into contact with the lining of your body. This reaction can be inherent – in other words, you could be born with it – or you can be primed to develop an intolerance to the molecule,” Kalla explains.
“Common allergens include foods, aero- inhalants, topical products, clothing fabric, or things which permeate the clothing structures, such as detergents.”
How do you treat allergies?
“Treatment for allergies centers around avoidance, followed by sublingual immunotherapy in the cases where an allergy cannot be avoided. This form of treatment attempts to get your body to build up a tolerance to the allergen. After this we treat symptoms with antihistamines and/or use omalizumab (an anti-IgE antibody),” Kalla says.
When combined with treatment, lifestyle interventions also assist in improving your quality of life. “Lifestyle interventions for allergies include avoiding seasonal fruits such as litchi, mango and watermelon, as well as incorporating any form of regular, moderate exercise, as this helps to build the immune system.”
What is asthma?
“Asthma is defined as an inflammatory airways disease, with features of airway narrowing, coughing and wheezing,” Kalla explains. “The inflammation in the airways is aggravated by various triggers. The most common triggers are emotions, infections, inhalants and medication.” Click here to find out more.
In up to 50% of asthma patients, especially in the paediatric group, there is usually an atopic/allergic reaction.
There is also an allergic – or atopic – variant of asthma. “We know that you have an atopic variant of asthma if we can identify a specific allergen which is causing an asthmatic response. However, the majority of adults have non-atopic asthma.”
The different types of asthma include atopic, non-atopic, exercise-induced, obesity-associated, occupation-related and smoking-related. Occupation-related asthma usually applies to individuals who work in mining, wood factories, hairdressing, and bakeries.
While the cause of asthma remains unknown, there are clues to what we can focus on in early childhood development.
Kalla elaborates: “While it is uncertain as to what causes asthma, there is a feeling that it may be linked to viral infections in early childhood, especially rhinovirus. This may increase a child’s risk of becoming asthmatic.”
Did you know?
“Reflux is also associated with asthma, as the gastric contents can enter the upper airways and damage the lungs, giving one a predisposition towards asthma.”
– Dr Ismail Kalla
How do you treat asthma?
“Treatment for asthma centers around anti-inflammatory medication. This is split into two categories: controllers and relievers. Controllers include anti-inflammatory medication and long-acting bronchodilators,” explains Kalla. “Relievers include short-acting bronchodilators. Relievers are important for instances when you are doing sports or have climbed up a flight of stairs and need instant relief.”
However, a holistic treatment plan always fosters the best results. “Lifestyle interventions for asthma include any form of regular, moderate exercise, especially in childhood, as this can increase one’s lung capacity. We recommend swimming, as it is the best activity for the lungs. We also suggest that certain dietary factors be considered, especially in the case that the asthma is obesity-related. Many people with obesity also experience reflux, which has an impact on their asthma.
“So, we suggest not having late meals, engaging in moderate exercise after meals and avoiding fatty foods. Maintaining a healthy, balanced diet is also important for lowering inflammation levels in the body, and can be of benefit.”
Kalla says asthma treatment has made great strides. A new method of treatment is providing patients with an asthma treatment plan. “With regard to treatment, we have moved from symptomatic control towards suppression of inflammation. The mainstay of this target therapy is to give patients an asthma treatment plan. This plan works to ensure that if a patient’s symptoms get worse, they can increase their own dose of medication (within reason) without having to visit their doctor. This speeds up the treatment process.”
Kalla recommends that patients pay attention to and use all courses of prevention available to them. “We also strongly advocate the use of the pneumonia and u vaccines if you are asthmatic. The flu vaccines should be taken yearly and the pneumonia vaccine should be taken once every five years, until the age of 55.” He adds: “We can test whether or not a person has severe asthma by seeing how they respond to breathing in certain known allergens or by seeing how they respond to a regular lung test. In cases where the patient is wheezing, coughing up blood or has lost weight, we recommend that they go for an x-ray to determine if a greater problem is at play.”
Should you use the pills or a pump?
Kalla shares his concern around the growing trend of patients using oral treatment in preference to pumps.
“We discourage the use of oral therapy. Most patients prefer to take a pill rather than to use their pump. The trouble with this is that the pill is a much higher dosage of medication. As a result, the side effects are also much worse. So, overall, the pump is a better treatment option.”
According to Kalla, while there is a genetic element to allergies and asthma, your environment also has an important role to play in determining your risk.
“There is a link between urbanization and allergies/asthma. It is known as the Hygiene Hypothesis. Researchers have conducted studies which show that children who grow up in urban settings, remaining indoors a lot of the time, are more likely to get allergies or asthma than children who grow up in rural settings and play outdoors a lot.
“This is because children who play outdoors are exposed to a number of different molecules during their developmental stages and, therefore, are more likely to build up a tolerance to them, whereas children who have had limited exposure to these molecules have less opportunity to develop this tolerance.”
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Written by Savannah Freemantle