It is uncertain what causes some people to have nasal allergies and asthma. We are still learning what is going on in the body when people have either of these conditions or other autoimmune disorders. But we do know that allergies and asthma have a lot in common.
Nasal allergies occur in the upper airways (the nose, sinus cavities, and throat), while asthma occurs in the lower airways (the bronchi and bronchioles). Though the locations are different, allergies and asthma appear to cause the same sorts of inflammatory reactions: swelling, tenderness, sensitivity, coughing or sneezing, and difficulty breathing. Roughly 30% of people who have one of these disorders will have the other one as well. We also know that allergies in the upper airways can aggravate asthma in the lower airways, and vice versa.
If your patients have allergies or asthma, the most important thing to know is how to keep these disorders under control. This is particularly important in the case of asthma, since poorly-controlled asthma can result in permanent lung injury and even death.
Here are the absolute basics clinicians should know to help patients keep their allergies and asthma under control:
1. Patients should know their triggers, and avoid them as much as they can. Get allergy testing if possible, as this will pinpoint triggers that patients may miss or overlook.
2. Use nasal hypertonic saline irrigation (such as a neti pot or other nasal lavage technique) to help keep allergies under control and keep sinuses clean. http://www.dynamicclinic.com/nasal_lavage.php
3. Use “controller medication” each day as directed by a doctor. Be sure to emphasize to the patient not to stop taking their medication just because they feel better! The controller prevents the allergic or asthmatic reaction from occurring. (Note: Controllers can take 2-4 weeks before they are fully effective.)
4. If your patient smokes, please help them consider quitting. Motivational interviewing techniques are great for this. (1-800-QUITNOW)
5. If your patient becomes more congested than usual, figure out if the cause is viral or bacterial, and with their doctor’s help, treat their symptoms accordingly.