Allergic Asthma: What It Is, How to Beat It

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What is allergic asthma? Of the more than 22 million adults and children in the United States who have asthma, at least half of adults and about 80% of children have allergic asthma. In any kind of asthma, the lungs overreact to triggers by 'tightening up' airways, which causes persistent coughing (particularly at night), wheezing, shortness of breath, and difficulty breathing.

But in the case of allergic asthma, those triggers are substances?animal dander, dust mites, pollen, mold, cockroach proteins, or other allergy-causing particles?that don't bother most other people.

Non-allergic asthma triggers, on the other hand, can include exercise, cold air, pollution, and stress. Many people have a combination of both types, and the treatments are often similar for both?mostly to ease the swelling and inflammation in the lungs and open up the airways.

So why does it matter what's causing your symptoms? Well, the more you know about your triggers?allergic or not?the better your chances of avoiding breathing problems.

James Thompson's graduate studies in biopsychology required him to spend a lot of time working with rats. Already plagued by seasonal asthma attacks due to a pollen allergy, he became sensitized to rodents too. His lung function became so compromised that he nearly died of pneumonia at age 25. (Respiratory infections can make asthma worse.)

Two decades later, Thompson is still allergic to rodents, but he's also learned a whole lot more about how to cope with his allergic asthma.

"Over the past 10 years I've just been trying to understand the triggers more," he says. Thompson has found he has a combination of both allergic and non-allergic asthma. The Maplewood, New Jersey-based non-profit manager knows auto exhaust is a problem for him too. Now he tries to make sure his home is free of dust-collecting clutter and he'll cross the street to avoid inhaling bus exhaust. "When you're in your 20s you really don't notice, you don't make all these connections with your environment."

What's causing your asthma?
The first step to figuring out how to treat your asthma is to realize that you have it. That's harder than it sounds. Do you have persistent nighttime coughing or shortness of breath? It's easy to dismiss it as due to a cold, lack of exercise, postnasal drip, or just about anything else other than an allergy to the pet sleeping in your bedroom.

Many people with allergic asthma attribute their symptoms to a garden-variety cold, says John Winder, MD, an allergist based in Toledo, Ohio and the chair of the American College of Allergy, Asthma and Immunology's Nationwide Asthma Screening Program. The free screening, offered at about 200 sites across the United States, includes a breathing test and an interview with an asthma specialist.

To date, more than 100,000 people have been screened through the program, Dr. Winder notes, and half of them were referred to a specialist for further diagnosis.

If you do indeed have allergic asthma, the next step is to find ways to limit your exposure to the allergens that affect you. "Avoidance is the best defense," Dr. Winder says.

To nail down the specific triggers, it's best to see an allergist, says Robert A. Nathan, MD, director of the Asthma and Allergy Associates and Research Center in Colorado Springs, Colo. While primary care doctors may suspect that a person has allergic asthma, they typically do not delve deeper to confirm the diagnosis with a skin or blood test.

Skin prick testing is the most common way to determine if someone is allergic to a particular substance. This in volves placing a tiny amount of a specific allergen (like pollen protein) into a person's skin. If redness or swelling develops within 20 to 30 minutes it indicates an allergy to the substance.

Some allergens are easier to avoid than others, and sensitivity varies widely among individuals. For example, some people can nip a pet allergy in the bud by living in an animal-free home and taking medication for their symptoms when they visit a friend or family member who does have pets.

"Other people are so reactive that they just have to go out to dinner with people who have dander on their clothes to have a reaction," Dr. Nathan notes.