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Understanding Allergies
By: Sanjeev Jain, MD, PhD
Sitesh Roy, MD, FAAP, FAAAAI
Columbia Asthma & Allergy Clinic
According to the Asthma & Allergy Foundation of America, 1 out of 4 people in America suffer from asthma and allergies (see bar chart). The most common allergy symptoms are: runny or itchy nose, coughing, wheezing, congestion, itchy skin, sinusitis, hay fever, hives, eczema, vomiting and stomach aches.
Often, the suffering prolongs because symptoms are overlooked or misunderstood. With recent technological advancement, an experienced Allergy & Immunology specialist can properly diagnose the cause and offer customized treatments for faster and long lasting relief.
Parents often notice that their child's asthma becomes worse when they go back to school in fall. Increased coughing, wheezing, chest congestion or chest tightness with increasing need for rescue medications are the typical signs of such a problem. Even sleep disturbances and fatigue can be signs of this problem.
Going back to school can be an exciting time for students -- trendy clothes, old friends and a new school year. On the other hand, the season can also be a dangerous time for some, especially those who have asthma. Asthma-related hospitalizations and emergency room visits peak in the fall, according to a 2009 study published in the Journal of Allergy and Clinical Immunology.
One of the reasons that we think asthma flares up in the fall is that roughly two weeks after school starts, there's a huge increase in viral infections, specifically rhinovirus, which is the common cold virus. As soon as the kids start going to school, they get sick and their parents get sick and thus the asthma inflammation flares up.
As groups of people convene, viral infections worsen and spread more rapidly. Using preventative or daily controller medications such as inhaled steroids or leukotriene antagonists, during the summer and/or the weeks preceding fall, helps to prevent fall flare-ups in all age groups. In general, using an asthma controller during the summer is beneficial in preventing fall flare-ups, especially for kids who tend to stop using their medications during the summer when their routines relax and they have fewer asthma symptoms. It gives people some sense that asthma really is a long-term disease, hence it may in fact say that what you do over the previous three months really has an important effect over the next three months. This highlights the need for long-term controller medications that manage asthma over time instead of patients relying on rescue inhalers (albuterol or levalbuterol) when they have asthma symptoms.
Seasonal allergies can also play an important role in causing asthma flare-ups. For example, the beginning of ragweed/other fall weeds season happens to be about when students are getting ready to head back to school in mid-late August.
Mold also peaks in the fall and these are common triggers for asthma symptoms. With all the moisture in the air, outdoor mold on fallen leaves, drying grass and other vegetation tends to be high.
Additional Facts
Tips for parents
Asthma is the narrowing, inflammation and hyperactivity of the airways.
Here are some tips for parents to help students avoid any asthma-related complications this fall:
- Recognize that a persistent cough could be asthma. If a child is coughing when running or playing, the child could have asthma. If the child is coughing at night and the cough lingers beyond a few days, then the child might have asthma. At this point, the parent should consider whether the child needs medical attention.
- For students who are heading back to school who have asthma, they should be taking their preventative medications on a regular basis as recommended by their doctor.
- Allergy related medications should also be continued as prescribed by your child's physician.
- There should be no restrictions placed on children or adults who have asthma, if they are being appropriately treated. If children have flare-ups, they may need to abstain from athletic activities for a few days, but they should be able to be active without asthma holding them back.
- See an Asthma and Allergy Specialists (ca-ac.com) to get guidance regarding specific triggers for your child's asthma based on allergy testing they can perform. Also breathing tests help assess your child's lung function to guide their treatment better.
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