Ways to Fight Back When Allergies Trigger Asthma

Dr. Travis Stork of "The Doctors" offers tips to identify asthma triggers and get treatment.

By Amanda Hoffstrom, Editor

Have you ever had trouble breathing? Or heard yourself wheezing? Have you had unexplained coughing?

If you have experienced any of these symptoms, see your doctor. One possible reason? You may have asthma.

Asthma is a common chronic, inflammatory lung disease that affects nearly 26 million Americans. Its cause is unknown. More than half the people living with it have allergic asthma. It is sparked by an allergic reaction.

“Most people have never even heard of the term ‘allergic asthma.’ They may be walking around with it and not even know it,” says Dr. Travis Stork (pictured), emergency room physician and host of the talk show “The Doctors.”

“If people can better understand their asthma or recognize their symptoms, they can better manage it,” he explained.

Asthma attacks can be serious. In 2009, there were 1.9 million asthma-related emergency department visits. Most patients can manage their asthma under the care of their family doctor, pediatrician or internist. If needed, they can also see a pulmonologist or allergist.

We spoke to Dr. Stork and Angel Waldron, an Asthma and Allergy Foundation of America patient advocate, to get a better understanding of this condition. They offer this information for consumers:

What is the difference between allergic asthma and non-allergic asthma?
Waldron:
Asthma can be triggered by a number of things: your environment, exercise, triggers in your home. But allergic asthma is specifically for those allergens that also cause allergies. They can be year-round. It is not just a springtime disease.

Every time you come home you can be exposed to things like pet dander, dust mite allergen and even cockroaches. It is important to know what your triggers are. You could be exposing yourself every day and not be aware of it. Even when the air quality is great outside, you could be experiencing symptoms when you come home.

Are seasonal allergies associated with allergic asthma? Does it make it worse?
Stork:
Anything that is an allergen could potentially trigger an attack. Seasonal allergies certainly can play a role just like year-round allergens. Asthma is an inflammatory disease, so you get inflammation in your airways. Allergens are a big trigger of inflammation.

Asthma has a spectrum that goes from mild to very severe. By the time I see people [in the emergency department], they are often in severe distress. Asthma kills 5,000 people a year. For people who suffer from severe asthma, they may have multiple triggers. It is important for people with allergic asthma to recognize what your triggers are so you can avoid landing in the ER.

If I think I have allergic asthma, what should I do?
Stork:
You need to have a discussion with your doctor. Part of controlling and managing one’s asthma is figuring out the severity and your triggers. Bring up to your doctor when your symptoms seem to be worse. There are objective tests that are done. But a lot of it is also investigative. Log when and where your symptoms are worse. Maybe every time you go into your office at home your symptoms seem to start. For other people, it may be every time they exercise in a cold environment.

If you can keep track of when your symptoms are better versus worse, your doctor will have a very good sense of what your triggers may be. They can follow that up with objective tests, if needed. Then that leads to avoidance of triggers and a management plan that can also decrease your airway inflammation year round.

What is involved in an objective test?
Waldron:
Years ago there was the painful skin prick test. It is still used. But we have really easy thumb pricks that you can get [and should be interpreted in light of the person’s health history]. There is no reason why people should avoid getting diagnosed. There are new and improved ways to find out exactly what kind of asthma you have. Once you have that information, you will be able to learn how to manage it and how to improve your quality of life.

Do you think most people with allergic asthma know they have it and are taking action to control it? Or does it often go undiagnosed?
Stork:
What I have noticed is a lot of people don’t have a really good understanding of what they’re suffering from. If you’ve never had asthma, or you don’t have a child who’s had asthma, you may not recognize it. You may not notice the subtle wheezing. You may not notice that your child is short of breath because they may be used to feeling slightly short of breath. Or they may not be able to tell you.

When we go outside and we run, or you’re a child in physical education class, all we know is our normal. If every time you run in gym class, you’re short of breath, you may not know that’s not normal. It is time to go get evaluated if there are any symptoms of an unexplained cough. Or if you are short of breath maybe more than you think you should. Or if you hear any hints of wheezing that’s audible without a stethoscope.

With the objective tests [and pulmonary function tests], your doctor will be able to tell pretty quickly if asthma is causing your symptoms. There are great treatment options. Diagnosis is really the first step.

What tips do you have for controlling allergic asthma?
Waldron:
There are lots of different options. Once patients are diagnosed and given a management plan, we encourage them to stick with it. It is important for patients to stick with that program even if they are having a good day and not necessarily coughing or wheezing when they wake up. Sticking to that management plan can prevent the asthma attack from happening as frequently or as severely. [Treatment is] going to be tailored to your own disease, triggers and medical history.

Is this something that can develop at any age?
Stork:
Asthma can occur at any age. Asthma can be very prevalent in childhood. Symptoms may get better over time. Or they may get worse over time. If you’re an adult, you can develop asthma later in life. As we get into adulthood, there are a multitude of causes for shortness of breath and even wheezing.

Not all wheezing is asthma. If you develop any of the telltale symptoms of asthma, do not wait to get evaluated. Whether it is asthma, allergic asthma or some other illness, it is not normal to just develop shortness of breath and wheezing. That means something is wrong and you need to get it checked out.