Asthma page 4

There is a good chance that children will outgrow their asthma attacks around the age of puberty.

The biggest myth about asthma is the belief that emotions can be the cause of attacks. Luckily, most people, including doctors, are becoming better informed and realising that this is not so. Asthma attacks always have a physical, not an emotional, cause (or combination of causes). However, in someone already suffering from an underlying allergy, any stress trigger, emotional ot otherwise, can be anough to tip the balance. The converse applies also, in that when someone is already under stress, a smaller amount than usual of the particular allergen is all that is necessary to start an attack. This applies to other allergies as well, but especially to asthma. Emotional upsets make things worse but are seldom the only cause. A happy family life and relief of stress. will help the sufferer a great deal because emotional factors lower general resistance and can cause respiratory changes which can more readily lead to an asthma attack when an allergen presents itself.

Although asthma is mainly an allergic disease, viral or bacterial in- I fections can cause inflammation (and therefore narrowing) of the tubes and will induce asthma in susceptible people. Children are more prone to viruses as they have not yet had a chance to build up their immunity. Colds can lefd to coughing and wheezing. The membranes lining the tubes and at spaces of the lungs become increasingly irritated; this provides an ideal environment for bacteria or the germs which cause bronchitis. If the patient develops a chest infection, this too will worsen the asthma. It follows, therefore, that asthma attacks can follow other infections also. In some people asthma may be associated only with respiratory infections. Such people suffer from asthma which is caused by infections rather than allergy. They should seek prompt medical attention for coughs and colds.

Similarly, in others, asthma symptoms may be brought on only by exercise, cold weather, dampness and so on. Their over-sensitive airways react to these stimuli by narrowing. Once they stop exercising or remove themselves from the damaging environment, their asthma will abate in a relatively short time. Any of these situations can aggravate an underlying allergy to other things. So often these present themselves in combination.

The most common form of asthma, therefore, is allergy-induced asthma. The term 'extrinsic asthma' means entering the body from outside. The term 'intrinsic' means inside the body (hereditary disposition, state of immune system, etc); this term is now used less often as doctors realise that there always has to be an external trigger, too - something the patient has eaten, drunk, inhaled or been injected with. People who wheeze constantly are allergic to something they are coming into contact with all the time e.g. house dust. Although this condition is sometimes treated with steroids it is better to try to improve the environment, discover the cause or causes through reliable testing and try to be desensitised.

Always have your inhaler and/or other prescribed medical treatments to hand wherever you go. If you come into contact with something you know will trigger an attack, such as cigarette smoke, say so, and avoid at all costs. If this is quite impossible, do make use of modern drugs. , in doubt, consult your doctor.

The inhaled types of drugs are considered quick, safe and the most effective. They are less likely to contain colouring agents and other causes of side-effects. For severe reactions, cortisone - a steroid - works quickly and there are few side-effects when used on a one-off basis; in long-term use it will cause irreversible side-effects such as moon-face, excess hair and so on. Nevertheless, cortisone is very effective, and its use must be balanced against the patient's needs. lntal (sodium cromoglycate) is an excellent preventative, safe and free from side-effects as it is not absorbed into the blood stream. It can be tolerated by most people. When asthma is anticipated (such as when visiting a house where there is a cat, for example) a cat-sensitive person can take a puff of lntal and go visiting without fear of developing asthma - in most cases. lntalstabilises the mast cells, which are one of the many types of cells making up the immune system. Antihistamines are generally regarded as being not so effective except for pollen-induced asthma. Orthodox tests are reasonably accurate for the limited number of allergens available, but are no good for foods. Orthodox desensitisation is disappointing for asthmatics, but the intradermal testing and neutralisation used by many clinical ecologists is good - as is EPD (enzyme-potentiated desensitisation) used by others. Sleeping tablets should not be taken by asthmatics. Caution should be used with all drugs, and those with artificial colourings should be avoided. Aspirin is a common offender and can cause serious asthma attacks. It is safer to use paracetamol if a pain killer is needed.

© Food & Chemical Allergy Association