The A to K of asthma triggers

A few years ago I wrote an article for Current Therapeutics about the A to K of asthma triggers. It proved popular so I have updated it for this site.

Deaths from asthma have fallen dramatically in Australia in the last 20 years, from about 800/year to about 400/year. That is the good news, but the tragedy of asthma deaths continues. Most of this improvement is related to effective preventer therapy using inhaled corticosteroids. These have saved lives. The first line of asthma management remains the control of asthma symptoms and optimising lung function.

Everyone with asthma will know that they have certain triggers that make them wheeze or cough or get tight in the chest. This knowledge can supplement and complement therapy with drugs. That is why knowing your triggers is so important. Also, it may open up avenues for other treatment, such as allergy shots or drops.

So, let’s run through this list:

Allergy – dust, pollen, cats, dogs, your pet rabbit, your pet rat, lots more. A full allergy assessment may be helpful. Studies suggest that controlling chronic nasal allergy can result in easier asthma control

Bronchial infection or inflammation which means wheezing with colds and flu. An asthma action plan is necessary

Cold air and exercise can be important even if asthma is well controlled, many elite sportspeople have exercise-induced wheezing. There are ways to help control this problem

Drugs which include aspirin, other anti-inflammatories, beta-blockers. And let’s not forget ‘natural’ drugs – for example Royal Jelly can rarely trigger asthma or even anaphylaxis

Emotion and stress, often neglected, but important

Foods – yep, some foods trigger asthma. For example, a combination of peanut allergy and asthma can be dangerous. A food and symptom diary is often helpful to sort this out.

Gastric reflux (GERD is the USA and GORD in Australia) can trigger asthma. Some studies suggest that controlling reflux can help control the asthma

Hormones, for example, increased asthma pre-menstrually (called catamenial asthma). Some women also develop worse asthma in pregnancy, although others lose their asthma when pregnant

Irritants – this encompasses cigarette smoke and pollution

Job – we often forget occupational asthma as a trigger. Sorting this out can be difficult

Know any others??

So, run through this A to K for you or your child or your relative. Discuss these triggers with your GP or your allergist or your respiratory physician.

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