FAQ
What is Bronchial Hyper-responsiveness?
Bronchial hyper-responsiveness is exaggerated airway narrowing in response to a wide range of stimuli such as allergen, virus, smoke and other pollutants. Otherwise known as “twitchy airways”, it commonly occurs after a viral infection and persists for up to 6 weeks. It is one factor used in diagnosing asthma ( others are wheeze and mucosal eosinophilic inflammation) Dr Adrian Morris
Should I be taking my inhaler medication even when I am free of asthma symptoms?
Even in mild persitant asthma, low grade inflammation will eventually lead to lung fibrosis and damage. To prevent deterioration in lung function, anti-inflammatory inhaler medication should be taken on a continuous basis. Anti-inflammatory medication includes inhaled cortico-steroids and the cromolyns. Far too often asthma sufferers are misdiagnosed as having bronchitis and treated with antibiotics and cough suppressants. Dr Adrian Morris
What is “Exercise Induced Asthma”?
Physical exercise causes rapid cooling and dehydration of the airways. The airway lining fluid becomes concentrated and this hyperosmolality stimulates mast cells in the lungs which then release chemicals which cause airway narrowing. There is no allergy involved in this mechanism. It can be prevented by using inhaled bronchodlators or chromolyns before exercise. Inhaled steroids have little effect on this condition. Dr Adrian Morris
Do all small children who wheeze have asthma ?
About 60% of small children under the age of 6 wheeze especially after a viral chest infection. Two thirds will stop wheezing and never develop asthma, while a third may go on to develop asthma. Those most likely to develop asthma will have a family history of asthma (especially if the mother has asthma) and will have positive skin or blood tests (RAST) for allergy. Dr Adrian Morris
My 3 year old has been prescribed an oral steroid course of 6 days for a bad flare-up of eczema on her face. Can you tell me if there are any side-effects for the oral steroids, especially if she may need to have this prescribed again if we cannot find what is causing her flare-ups.
This is a common concern expressed by parents. We recognise more and more the influence of inflammation in the allergy process. The best treatment to reduce this during acute episodes is to use a steroid orally. It is safe if used for a few days such as in your child’s case. We sometimes have to use it for 1 month or even longer in some children, and then we balance the possible side effects against the effects of the disease. There are many children on long term steroids, but these children are monitored very carefully and the vast majority do not have side effects. Again, a course of 6 days is relatively safe. Dr Harris Steinman
Being someone who suffers quite badly from cat allergies I was disappointed that there are no remedies or cures. Are they not effective or are there none? I have heard about an injection that is available, can you recommend it?
There is no cure for cat allergy. There is no difference between allergy to long or short haired cats as it is the protein in the cat’s saliva that you react to. It is important to wash your hands after touching the cat and then yourself. However, the protein dust is so fine that it gets carried everywhere. The newer antihistamines (Zyrtec, Hismanol, Clarityne, etc.) will give you great relief. The usually get taken once daily, but some individuals may require one tablet twice daily. Injections (desensitisation) only works if you are allergic to a single allergen e.g. cat. Most individuals are allergic to more. So a blood or skin test will be required. Dr Harris Steinman
What is the Oral Allergy Syndrome? (OAS)
Certain fresh fruits, vegetables and spices may cause an immediate local allergic tissue reaction on the lips, the mouth and in the throat. This presents with a burning sensation, itching and hoarseness within several minutes of oral food contact. Dr Adrian Morris
What is food related Exercise induced Anaphylaxis
Up to 30% of food allergic adults may develop hives, runny nose, itching, flushing, shortness of breath and fainting following strenuous exercise – this food related Exercise Induced Anaphylaxis or “Runner’s Anaphylaxis” can occur up to 24 hours after ingesting certain offending allergens (such as shellfish, wheat and celery). Dr Adrian Morris