Breath easy. You can keep asthma and hay fever at bay

Summer should be a time for outdoor fun in the sun – but for those suffering from asthma or hay fever it can also be a time for concern.

The symptoms of hay fever can be unpleasant enough but can hay fever actually trigger an asthma attack and what can you do without restricting time in the open air.

Mr Vikas Malik - Ear, Nose and Throat Consultant Surgeon at Fylde Coast Hospital answers some common questions:

What is the difference between hay fever and asthma?

Both conditions are on the ‘Atopic’ spectrum and are usually caused by release of intrinsic enzymes/factors such as histamine or cytokines.

Asthma symptoms occur due to inflammation of upper airways causing a partial obstruction during exhalation and presents with a typical musical sound called as 'wheeze' and/or in difficulty in breathing.

Hay fever symptoms are produced due to inflammation of nasal mucosa and usually present with nasal stuffiness, sneezing, runny nose and blocked nose. The eyes can also be affected causing itchiness with occasional redness, watery discharge and swelling around eyes. Symptoms normally occur after the person is exposed to a trigger such as pollen.

If someone suffers from hay fever are they also more likely to suffer from asthma?

Someone suffering with hay fever may have predisposition to asthma but this is not always the case. People can suffer with one or the other.

How important is it that someone continues their inhaler regime – is there any case for asking a GP to assess inhaler dosage over the summer months?

Once diagnosed with asthma it is important to continue with inhalers as prescribed. There are usually two types of inhalers prescribed - blue and brown. Blue is a reliever and used 'as and when’ someone feels wheezy or breathless, the brown inhaler is a preventer and once started should be continued every day as per prescription unless doctor has reviewed the condition and decided to stop it.

It is quite common for people suffering with asthma to have a worsening of their symptoms as seasonal triggers such as pollens and grass come into play, so doctors can provide an 'Asthma Treatment Plan' to address such symptom fluctuations and this could mean a change of inhaler dosage.

However if after being given a ‘Plan’ if the symptoms are not settling or even getting worse then the patient should revisit their GP to discuss the possibility of further changes.

What precautions can you take to protect yourself from the effects of hay fever?

Avoidance of triggering factors such as exposure to grass and pollen can help but it can be extremely difficult in day to day life to implement this.  

The general precautions recommended are:

• Avoid high pollen count areas
• Shake or even wash clothes after coming in from outdoors
• Keep windows closed
• Dry the clothes inside or in a dryer, rather than hanging them on the line where they may be exposed to various ‘triggers’
• Take regular showers and keep hair clean and free from pollen that may have been picked up while outdoors
• Try not to rub itchy eyes, instead wash the entire face with a clean cloth and a gentle cleanser
• People are often advised to avoid histamine-producing food such as smoked and cooked meat, fish, cheese and nuts and take more of Omega-3 fatty acid though green vegetables, carrots, beans, and fish oil. However, the evidence around this is variable and I would only consider taking this option in very severe cases.

We often think it is hay fever causing the problems but are there other allergies we should be aware of?

Hay fever typically presents with localised symptoms such as nasal congestion, stuffiness, eye irritation in combinations, and has very seasonal occurrence at certain specific times of the year.

Other localised conditions such as an allergic conjunctivitis (eyes go red and sore), or perennial rhinitis (nasal symptoms round the year) can often be confused with hay fever. They are usually isolated and need some specific treatment. Consult a doctor if symptoms are not settling with normal day to day remedies. 

Are there any over-the-counter medicines that can offer good hay fever/allergies relief?

Anti-histamine tablets and syrup are available as well as non-medicated nasal sprays. However one should not use it without discussing with your pharmacist.

Are there any lifestyle changes such as diet or exercise that could ease the problem?

A good and active lifestyle often boosts the immunity. Avoidance of histamine releasing food and taking more of Carotene and Omega-3 fatty acid has been shown to provide some relief, although, as said earlier, the evidence is variable.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.