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Dr. Manoj K Goel
Director & Head
Dept of Pulmonology, Critical Care & Sleep Medicine
Fortis Memorial Research Institute,Gurugram(Delhi & NCR)

What is Respiratory allergy?


The term allergy is used to describe an overreaction to substances in the environment that are harmless for most people, but induce an immune response that causes a variety of symptoms in predisposed people. The respiratory allergies mainly present with allergic rhinitis which affects nasal passages and allergic asthma which affects the airways within the lungs.


What causes Respiratory allergy?


The most common sources of allergens are house dust mites, pollens, pets, cigarette smoke, air pollution, perfumes, aerosol sprays such as hair lacquer or furniture polish, change in temperature - especially going from a warm to a cold environment - paint or cooking odours, fungal or mould spores which occur in ill maintained old houses and furniture etc.



What is global impact of Respiratory allergy?


Respiratory allergies are increasing worldwide. Around 20% of people  suffer from allergic rhinitis, whereas asthma is estimated to affect 5%-12% of people. These diseases cause loss of workdays and may even impair school performance in children. Despite the significant social and personal impact of the disease, respiratory allergies are neglected and underestimated. 


What are the symptoms of Respiratory allergies?

The patients with Allergic rhinitis present withblocked or running nose, sneezing, itching and watering eyes. Allergic rhinitis can progress to asthma if not well treated.  Allergic asthmais a commonly occurring and potentially life-threatening illness where the respiratory airways become inflamed and swollen.  The patient presents with shortness of breath, tight chest, cough or wheezing which is a whistling noise while breathing. These symptoms are usually associated with widespread but variable airflow limitation in the lungs that is at least partly reversible with medication.


How to diagnose Respiratory allergies?


The diagnosis of respiratory allergies is based on clinical history,physical examination and specific tests. Asthma is characterized by variability in the airway narrowing and symptoms as it is an episodic disease. The patients usually have varying intensity of symptoms.  However, there are periods when the patients are symptom free.  This   variability of airflow obstruction can be  measured by home monitoring of lung function with a peak flow meter - a simple device to measure the flow of air out of the lungs. If, over a period of time, the morning and evening values vary by more than 15%, this is indicative of asthma.  This home monitoring is especially useful in children who may not complain of their symptoms. Lung function tests are useful in assessing the severity of narrowing in the bronchi.  Lung function tests also help in differentiating asthma from other respiratory disorders which present with similar symptoms.  Allergy tests which include skin prick tests and blood tests  are useful to confirm allergic sensitization of the patient, but not routinely indicated as most of these allergens may not be avoidable like  pollens in the environment.


What is the management of Respiratory allergies?

Effective management of respiratory allergies is crucial in keeping control of the condition to avoid exacerbation; and ultimately to improve the quality of life of the patients. Too often patients tend to adapt to and to live with their symptoms. The lack of appropriate control may cause exacerbations that, in asthma, may even cause irreversible damage to the lungs in the form of severe irreversible obstruction of the airways which may cause decrease in oxygen content and rise in carbon dioxide in blood.  A variety of measures   are available to keep allergic rhinitis and asthma under control.  The first line therapy is in the form of inhalers for asthma and nasal sprays for allergic rhinitis.  The inhalers deliver drugs in much less doses directly in the air passages which causes rapid control of the disease. The inhalation therapy has several advantages over the tablets as the onset of action is quick and side effects are negligible. The inhalers contain drugs to reduce swelling in the airways and also for relieving bronchial spasm.  The inhalers and nasal sprays may be advised as long term therapy for treatment as well as prevention of asthma and allergic rhinitis.  Guided self-management helps patients recognize the start of exacerbation of their lung and nose symptoms, so that they can immediately act according to their individual treatment plan in consultation with a doctor.  


How to prevent Respiratory allergy and Asthma?


Avoid known triggers such as deodorants, perfumes, specific food items, smells, pets etc if you have tendency of allergic rhinitis and asthma.  Maintenance of hygienic and clean home environment is essential which will control house dust mite and fungal spores and moulds.  Effective measures are required by government and society to control outdoor pollution.    A regular check up with a doctor will help you optimize your medication. You may require prolonged inhalation therapy even during symptom free periods as use of inhalation therapy is very important for prevention as well as control the disease.













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