People can have allergies or asthma; many people have both. Allergy symptoms may include runny nose, itchy and watery eyes, nasal congestion, skin reactions such as eczema or hives, or potentially a more severe anaphylactic reaction that can cause swelling in your mouth or throat. Allergies increase your chance of having asthma and can make asthma symptoms worse. It’s important to control both asthma and allergies to experience the least amount of symptoms.

What is an Allergen?

Allergens can be anything that causes an allergic reaction and vary person to person. Animals, pollen, medication, and some foods are common allergens for people with asthma. If you are allergic to a certain allergen, your body’s immune (defence) system has become ready to react to that particular allergen. People with allergies and asthma experience inflammation (swelling) and airway narrowing when exposed to certain allergens. 

How are allergies diagnosed?

To find out what you’re allergic to, pay attention to your symptoms and talk to your doctor about further testing. Skin prick testing, done by a specialist doctor called an allergist, can show what you're allergic to.  Learning your other triggers may be a little more difficult. It helps if you pay attention to when and where your asthma gets worse. Keeping an Asthma Diary may be helpful. 

Why should I avoid my allergies?

Reducing or eliminating exposure to allergic triggers is very important because:

• it can reduce asthma symptoms
• it can reduce the need for medications
• continued exposure can worsen swelling in the airway and contribute to poor asthma control

Allergic Symptoms and Treatment

Rhinitis

Nasal symptoms such as a runny, stuffy nose, sneezing and itching of the nose (rhinitis) commonly occur in people with asthma. They may be triggered by allergens (allergic rhinitis) or occur because of non-allergic reasons (non-allergic rhinitis). Allergic rhinitis is more commonly associated with sneezing and itching of the nose, and with allergic eye symptoms (itchy, red, watery eyes). Non-allergic rhinitis usually causes a stuffy, runny nose without a lot of itching or eye symptoms. Uncontrolled rhinitis can also trigger asthma.

Your nose is connected to your lungs, if your nose symptoms are not treated it out of control because of allergies, it can cause your asthma to not be well controlled. Discuss possible rhinitis treatments with your health care provider.

Treatment for allergic rhinitis:

• Avoid allergic triggers
• Saline nasal rinses
• Protect yourself from allergens. These should be used regularly and as needed to keep your nose clear and may reduce symptoms. (e.g. Neilmed Netipot, Navage)

Medications

Speak with your doctor about allergy medications. There are different options depending on your symptoms – from antihistamines to nasal sprays to allergy shots. Work with your doctor to find right solution for you and stick to it.

• Nasal corticosteroid (anti-inflammatory sprays - Daily symptoms are often treated with a nasal corticosteroid spray on a regular basis to reduce the swelling in the nose. These need to be used at least 2 weeks straight to get full, beneficial effects.
• Antihistamines (medications that help control allergies) are often used daily to help with a runny nose, itching and sneezing, and allergic eye symptoms.
• Decongestants (medications that reduce stuffiness in the nose) can be useful for a stuffy nose, but should not be used if you have high blood pressure, glaucoma or problems with your prostate. These are usually not taken on a regular basis.
• Combination pills of antihistamines and decongestants are also available.

Allergy shots

Allergy shots are a type of treatment called immunotherapy. Regular injections are given over a few years to stop or prevent allergy symptoms. A small amount of allergen is in each shot which helps expose your immune system slowly to that allergen. Overtime, the dose in each shot increases to help desensitize your immune system to the allergen, therefore decreases your reaction and also your allergic symptoms.

***Discuss any of these options further with your health care provider, allergist, or Certified Respiratory Educator.

Nasal Polyps/Sinusitis

Nasal polyps can worsen asthma. Nasal polyps (areas of swollen tissue in the nose) can occur both in allergic and non-allergic rhinitis but are most common in people with aspirin sensitivity. Rhinitis and especially nasal polyps can get in the way of good drainage of the sinuses and can lead to sinus pain/pressure and sinus infections (sinusitis). Nasal rinses can also help improve symptoms of sinusitis. Surgery may be required to remove the nasal polyps.

Eczema (atopic dermatitis)

Eczema is closely linked with asthma and allergic rhinitis. Symptoms of eczema include extreme itching and dry, red, inflamed skin. Learn more about eczema treatment from the Eczema Society of Canada.

Anaphylaxis

Anaphylaxis (pronounced a-na-fil-ax-is) is an extreme and serious allergic reaction that can be life threatening. Food is the most common cause of anaphylaxis, but insect stings, medicine, latex or exercise can also trigger a reaction. The most common food allergens (allergies) are peanuts, tree nuts, seafood and fish, milk, eggs, soy, wheat and sesame seeds. Sulphites, a food additive can cause anaphylaxis in some people. Sulphites are commonly found in foods such as dried fruits, wine, bottled lime or lemon juice, prepared potatoes and shrimp. Most often, anaphylaxis is diagnosed in childhood, but it can also happen later in life. If you have asthma, you have a higher chance of having allergies and anaphylaxis. And if you have both asthma and anaphylaxis, you have a much higher chance of having a severe asthma flare-up during an anaphylactic reaction.

Anaphylaxis can affect multiple body systems: skin, upper airway (nose and throat) and lower airway (windpipe, lungs), stomach and intestines (digestive), and heart and circulation (cardiovascular). Anaphylactic shock is an extreme overreaction of the body’s immune system to an allergen. Swelling, difficulty breathing, abdominal cramps, vomiting, diarrhea, coma, and even death can happen.

If you are uncertain as to whether or not you have food allergies or are at-risk for life-threatening allergies, you should be followed by an allergist To help identify possible allergens, you may want to keep a record of anything you eat or drink so you can discuss this with your health care provider to try to find the cause.

Anaphylaxis treatment:

Once you have had an allergic reaction to a food product or drink, you absolutely must avoid it. Even a tiny amount of that item could cause a life-threatening allergic reaction.  Always carry an emergency kit containing your epinephrine auto-injector (e.g., EpiPen®), your asthma reliever medication (usually blue or red/white), and an antihistamine.  Ask your doctor, pharmacist or other health care provider to teach you how to use your epinephrine auto-injector.  Wear a medical identification bracelet/necklace (e.g., MedicAlert®) stating: “Anaphylaxis: carries Epipen” and “Asthma” so that others can help you in an emergency.

Tips to Control Asthma and Allergies

5 tips to control seasonal allergies

1. Pay attention to pollen counts. On days when pollen counts are high, limit your time outdoors. Pollen counts tend to be highest during the early morning hours, on windy days, and on stormy days.
2. Protect yourself from allergens. Using saline rinses for your nose regularly can help keep your nose clear and may reduce symptoms.
3. Speak with your doctor about allergy medication. There are different options depending on your symptoms – from antihistamines to nasal sprays to allergy shots.  Work with your doctor to find the right solution for you and stick to it.
4. Take your allergy medication as prescribed. Many allergy medications, including nasal treatments, work best if taken on a regular basis to help not only treat symptoms but prevent them.
5.  Make your environment as allergy-proof as possible. Shut your windows at home (especially where you sleep), take your shoes off at the door, minimize clutter that collects dust, use a vacuum cleaner with a HEPA (high-efficiency particulate air) filter, wash your bedding with hot water to kill dust mites weekly, and avoid any exposure to smoke.

5 tips to help you control your asthma

1. Take your asthma medications as prescribed. Everyone with asthma should have a rescue medication. Always have your rescue/emergency inhaler with you.  Many people will also have medications that prevent asthma symptoms and should be taken daily.
2. Identify and avoid environmental triggers as much as possible (dust, pollen, mold, smoke, air pollution).
3. Know what to do if your asthma symptoms worsen. Have an updated asthma action plan.
4. Maintain a healthy weight and active lifestyle. Obesity has been tied to worsening of asthma symptoms and can limit the effectiveness of some medications.
5. If you have asthma symptoms or need your rescue inhaler 2 or more times/week, contact your health care provider or Lung Saskatchewan to speak to a Certified Respiratory Educator today.