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When you have asthma, thoughts about your condition are never far from your mind. There are usually a number of triggers, some of which you may not really be aware of. You may know, for example, that your asthma is often worse at night, or perhaps staying with friends, but may not have looked into why that might be. Or it may be cold weather induced or coincide with the hay fever season.
When you do feel well you live a normal life and may forget to be aware of triggers. You may forget to take your preventative which can then leave you unprepared. Winters can be particularly hard and you may be under the weather for a long time. Catching a cold can turn into real illness.
You may believe there is not much you can do about your condition other than take the preventative. We realise that asthma can be a debilitating and even life threatening condition triggered by different things in different people. However, through our work with asthmatics we have found that many respond very favourably to reducing the allergens in their indoor environment. Read on for more information on asthma, its symptoms and triggers...
Asthma is a common chronic inflammatory condition of the lung airways, affecting many of us in the UK. Symptoms can include:
Symptoms can often be worse at night time.
Bronchospasm is the key event in asthma; a sudden, but reversible, tightening of the bands that surround the airways. The narrowed airways stop the air from leaving the lungs at the normal speed. This means that the lungs are still half full when it is time for the next inhalation. Taking more air in produces pain and tightness in the chest. Insufficient oxygen reaches the bloodstream because there is so much stale air in the lungs. This causes a feeling of breathlessness. Even when the muscles relax after an asthma attack, the underlying inflammation still remains. This may be caused or partially caused by allergy. Among asthmatic children, allergies are thought to be detected in 80-90%. Inflammation makes the lining of the airways swell up. The inflamed airway lining often makes more mucus than usual which can clog up the airways even more. The inflamed airways send nerve impulses direct to the airway muscles telling them to contract.
More research needs to be done into this topic. However, it is believed that a predisposition to asthma can be partly inherited. Asthma may also be partly caused by lifestyle. A poor diet and too much cleanliness have previously been suggested as potential causes.
Inflammation of the airways can often begin with an allergic reaction to something in the air; such as house-dust mite or pet allergens. It could also start with a viral infection or a large dose of an irritant such as chlorine.
Once inflammation of the airways has begun, they become oversensitive and may contract at the smallest provocation. Triggers vary from one asthmatic to another and could include one or more of the following:
If you think you may have asthma you should go for a consultation with your doctor. In order for a diagnosis of asthma to be given two tests need to be carried out. The peak flow test is the top speed of the outgoing air from your lungs measured with a peak flow meter. Because of inflamed airways, asthmatics tend to have a lower than normal peak flow. The reversibility test measures peak flow before and after inhaling a beta-2 reliever drug which relaxes the airway muscles. If the improvement is more than 15%, this strongly suggests asthma.
Asthma may be affected by and combined with other diseases which include allergic problems in the nose, sinusitis, the fungi causing athlete's foot and gastro-oesophageal reflux, emphysema and bronchitis.
Your doctor may send you for skin prick tests to determine which airborne allergens are the basic cause of airway inflammation. Alternatively you can use simple detective work to determine which allergens may be affecting your asthma. Keeping a diary to record your symptoms can help with this. In some cases food sensitivity is the initiating cause of asthma but because the reaction is delayed the link may not be obvious and an elimination diet (with your doctor's consent) may be necessary to identify the offending food. It has been suggested that as many as 60% of brittle asthmatics have a food sensitivity. Asthma that is unstable and difficult to manage is described as brittle asthma. Despite extensive and careful treatment with drugs, it can very easily develop into a severe asthma attack.
The most important factor in the treatment of asthma is to follow your doctor's advice regarding your medication. Following this you need to look at environmental control, minimising contact with triggers, allergens and irritants. Remember that bronchospasm needs to be addressed with your doctor, who may recommend the use of reliever drugs as part of a treatment plan.
Allergic reactions can cause asthma symptoms. The same triggers that set off dust mite allergies, eczema, hay fever or even some food allergies can also sometimes set off signs of asthma. This is known as ‘allergic asthma’.
Alongside your medication and reducing your exposure to allergens, you can help yourself by treating associated conditions. These may include sinusitis, rhinitis and hay fever, dust mite and mould allergy. It is always a good idea to see where you can improve your diet. Addressing these issues may help to reduce the inflammation in the airways.
Here’s a brief overview of the allergic conditions that can be linked to worsened asthma. Always seek your GP’s advice in the first instance, but you can also try the following measures to avoid the triggers:
House dust mite allergy
The protein allergen within house dust mite droppings can cause issues for some asthma sufferers. House dust mites are extremely common and are present in virtually every home (even very clean ones!). If house dust mite droppings are an asthma trigger for you, you might notice that your symptoms flare up when you are in dusty places, when making the bed or when you first wake up in the morning. Click here to read more about this particular condition.
If you know that dust mites are an asthma trigger for you, then you can take steps to reduce your exposure to the allergen, including:
Moulds can be found both indoors and outdoors. They release thousands of microscopic spores, which, when inhaled or in contact with the skin, can trigger allergic reactions in some people. Moulds can irritate the bronchial membranes and provoke asthma symptoms. You can read more about mould allergy here.
To reduce your exposure to moulds, try the following measures:
Pets are a common asthma trigger. You can read more information about pet allergy here. Proteins in animal saliva, skin flakes and urine can cause reactions in some people and make asthma symptoms worse. If you find that this is the case with you, the following allergen avoidance measures may help:
Pollen is a common asthma trigger. It is thought that between 20% and 60% of hay fever sufferers are also asthmatic. Around 80% of asthma sufferers are also allergic to pollen. (Source: asthma.org.uk).
There are a variety of different types of pollen, which are released at different times of the year and in different areas of the UK. Grass pollens are the most common hay fever cause, and are prevalent from around May to July. Tree and weed pollens can also cause problems. You can read more about hay fever here.
If pollen affects your asthma symptoms, you can try the following steps to reduce your exposure to the allergens:
If your drinking water is heavily chlorinated you may wish to drink filtered water and use a shower filter to prevent inhalation of chlorine from the shower steam. View a selection of water filters here.
Also take care with the toiletries and cleaning products that you use. Avoid aerosols, harsh chemicals and synthetic fragrances and opt for gentle alternatives.
Please note: Information included in this website is intended for information purposes only and is not to be used as a substitute for consultation with a medical practitioner.
References: The Allergy Bible, Linda Gamlin
Clinical Medicine 4th edition, Kumar and Clark.
Professor Jonathan Brostoff and Linda Gamlin: Asthma The Complete Guide.