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Allergic asthma, also known as atopic asthma, is asthma which is triggered by allergens. 5.4 million people in the UK are currently receiving treatment for asthma, with allergy being the most common cause of asthma, occurring in about 80% of cases.
What is allergic asthma?
Asthma is a lung condition which can cause breathing difficulties. It can affect people of all ages; however, it normally begins in childhood although it can occasionally develop for the first time in adults.
If you have asthma, the condition can cause your airways to:
- Produce mucus in large amounts that can be thicker than normal.
- Become narrower than normal because the muscles around the airways tighten.
- Become swollen or irritated (this is called inflammation), which specifically happens in the lining of the airway.
For further reading about asthma, please see our knowledge base.
Allergic asthma is a breathing condition whereby your airways tighten when you inhale an allergen. When your allergies combine with the breathing condition asthma, this is called allergic asthma. The allergens are also called triggers as they can set off your asthma and even cause an asthma attack. An asthma attack is when someone experiences severe asthma symptoms.
Allergies in general can affect what products you use on your skin, what you eat and what you breathe. Allergic asthma, also known as allergy-induced asthma, is the most common type of asthma in both adults and children.
Types of allergic asthma
Common allergens that can trigger allergic asthma symptoms include:
- Pollen – This is a very fine powder which is produced by trees, flowers, grass and weeds used to fertilise other plants. Hay fever, also known as allergic rhinitis, is an allergic reaction to pollen. Many people are allergic to pollen and can experience hay fever symptoms; however, some people have asthma symptoms due to being allergic to pollen. There are approximately 30 different types of pollen that can cause hay fever and allergies. As different plants produce pollen at different times of the year, people experience hay fever and allergy symptoms at different times. However, hay fever and pollen allergies are usually more prevalent in the spring and summer months when the weather is warmer, and plants and flowers release more pollen. For further reading about hay fever, please see our knowledge base.
- Dander – This is flakes of skin in an animal’s fur or hair. When someone has a pet allergy, dander is usually what causes the allergy. Pet hair is often grouped with dander as a common allergen. For further reading about pet allergies, please see our knowledge base.
- Mould – Mould and damp are caused by excess moisture. This can be caused by leaking pipes, rising damp in basements or ground floors, or rain seeping in because of a damaged roof or window. Moulds produce allergens, irritants and sometimes toxic substances. Inhaling or touching mould spores may cause an allergic reaction. Moulds can also cause asthma attacks. It is important to address any mould or damp in your home as it can negatively impact on your and your family’s health. To find out your rights when it comes to having mould or damp repaired if you are a tenant, Citizens Advice offer some helpful advice around this.
- Cockroaches – These pests can be found in homes and buildings. Asthma can be triggered by the saliva, faeces and other parts of the cockroach’s body.
- Dust mites – These are shaped like spiders but are very small. They live on the soft surfaces of your home, for example soft chairs, curtains and carpets.
Certain foods can cause an asthmatic reaction in a small number of people.
Common food triggers for asthma can be:
- Soy products.
- Sesame seeds.
- Histamine and sulphites in alcohol products.
Irritants, such as air pollution, tobacco smoke, cleaning products, wood fires and other strong odours do not cause an allergic reaction but they may inflame your airways and make asthma symptoms worse.
What causes allergic asthma?
The specific cause of asthma is unknown. The cause of allergic asthma is related to allergens. The main difference between asthma and allergic asthma is that allergens are inhaled and this triggers asthma symptoms. Allergens are substances that cause an allergic reaction and are the most common asthma trigger. Allergic asthma is most common in childhood and steadily decreases through adulthood.
Allergens can enter the body by being inhaled, ingested, injected or touched. They can cause an allergic reaction as your body thinks that they are harmful which leads your immune system to overreact and make antibodies in order to protect you from what your body perceives as being harmful. Your immune system is a network of organs, cells and proteins (antibodies) that are in place in order to protect the body against infection, illness and disease.
You can become allergic to something when your body develops antigens against a substance. After repeated exposure, the severity of the reaction may increase. Immune responses can be mild or can be severe, even life-threatening in some cases.
Allergens are found all around us, in both indoor and outdoor environments. If these allergens are inhaled, this can trigger asthma symptoms.
Some people suffer from seasonal allergies, usually occurring in spring due to the change in weather and the blooming of plants. During spring there is more pollen in the air than during other seasons, for example winter or autumn.
You may find that your asthma symptoms get worse during certain seasons, due to increased pollen from trees, grass and weeds. However, allergic asthma symptoms can occur year-round, depending on what it is you are allergic to.
An allergy (allergic rhinitis) that occurs in a particular season is more commonly known as hay fever. Seasonal allergies are immune system responses triggered by exposure to pollen allergens. Allergies to things such as pets, dust mites and food are constant, and are categorised as perennial allergies. For further reading about seasonal allergies, please see our knowledge base.
What are the signs and symptoms of allergic asthma?
An asthma attack which is due to allergic asthma causes the same symptoms as any other type of asthma, the only difference is what has triggered your symptoms. Allergic asthma may also cause other symptoms which are directly linked to the allergy itself.
Symptoms of allergic asthma can include:
- Shortness of breath.
- Tightening of the chest.
- A blocked nose.
- Itchy eyes.
- A rash.
During an asthma attack, these symptoms can feel very intense.
If you have an allergy rather than allergic asthma, symptoms can include:
- A runny nose.
- Itchy eyes.
- A rash.
If you have an asthma attack which is triggered by an allergy, this will be a severe flair-up of your asthma symptoms. During an asthma attack, your airways tighten and this makes it difficult for you to breathe.
The symptoms of an allergic asthma attack are the same as if you had an asthma attack which is caused by something else. The only difference between the two is the reason for having the attack.
Signs that you may be having an asthma attack include:
- Your asthma symptoms, for example coughing and breathlessness, get suddenly worse.
- Breathing may be fast and erratic in nature.
- You feel too breathless in order to perform normal functions such as talking and eating.
- Your chest feels tight and you may experience pain.
- Your reliever inhaler does not help.
If you have asthma symptoms after breathing in an allergen, then this is likely to be allergic asthma.
How is allergic asthma diagnosed?
If you have allergic asthma, your symptoms are usually caused by breathing in an allergen. Determining which allergen is causing your asthma symptoms is the first step in the process. You may be asked to keep a journal of your symptoms in order to try to discover a pattern.
Determining what you inhaled before your symptoms were triggered will help your healthcare provider to get a treatment plan in place.
Your healthcare provider can perform tests in order to diagnose allergic asthma. This can involve a blood test or skin test. These will be used to determine what effect the allergens have on your body.
When completing a skin test, a small amount of the allergen will be placed on your skin and monitored to see what, if any, reaction is caused. Your healthcare provider may also do some tests in order to ensure that it is your asthma that is causing your symptoms, rather than another medical condition which may be causing you to suffer from similar symptoms.
Tests which are used in order to diagnose asthma can include:
- Spirometry – This is a simple breathing test which involves taking a deep breath and then breathing out into a tube. The tube is connected to a computer which is able to monitor how well the air moves when you breathe in and out. A spirometry may be carried out at your GP surgery by a nurse or a doctor, or may be carried out in hospital. There are several different lung conditions which can be picked up during a spirometry, asthma being one of them. If you have already been diagnosed with asthma, a spirometry can be used to assess the severity of the condition and create a treatment plan.
- Exhaled nitric oxide test – In this test, your healthcare provider will test the amount of nitric oxide in your breath when you exhale. This test may be used in more mild cases of allergic asthma.
- Bronchoprovocation test – Bronchoprovocation testing is a method used in order to evaluate airway hyperresponsiveness and can establish an initial diagnosis. It can be useful in evaluating the severity of airway dysfunction in people who have asthma symptoms. During the test, you will breathe in possible allergens in order to assess any reaction. Only small samples will be used and you will be monitored closely in order to prevent a serious reaction.
Not everyone with asthma will have allergies, if you have allergic asthma this should be diagnosed and treated by an allergy specialist.
How is allergic asthma treated?
There is no cure for asthma but treatment can help ease your symptoms and most people can live a normal life.
Treatment options are designed to treat either the asthma or the allergy; however, some treatments are designed to treat both.
If you have allergic asthma, some of the available treatments include:
- Inhalers – These are devices which allow you to breathe in medicine. Reliever inhalers can help to relieve asthma symptoms when they occur. You should use your inhaler when you feel your symptoms starting and it should relieve your symptoms within a few minutes. A preventer inhaler is used to prevent the symptoms from developing. It will usually be recommended that you use a preventer inhaler if you have to use your reliever inhaler more than three times per week. You will use your preventer inhaler every day to reduce the sensitivity and inflammation of your airways. This should stop your symptoms from occurring or in some cases reduce the severity of your symptoms. Preventer inhalers contain a steroid medicine that can cause some mild side effects, for example, a sore throat or a fungal infection of the mouth or throat. Some people use an inhaler that both relieves and prevents; this is called a combination inhaler. This is usually recommended if a reliever inhaler and a preventer inhaler are not helping your symptoms enough. A combination inhaler should be used every day and you should continue to use it even if your symptoms decrease or stop.
- Allergy injections (immunotherapy) – This involves getting regular injections of tiny amounts of whatever you are allergic to. Allergy injections can help to treat asthma by gradually reducing your immune system’s response to the allergy. This allows your immune system to build up a tolerance to the allergy over time, meaning your body reacts less and less to the allergen the more injections you have.
- Allergy medicines – Many allergy medicines are available without a prescription. Types of allergy medicines include nasal corticosteroid sprays, antihistamines and decongestants.
- Leukotriene modifier – This is a daily pill which works by helping to control your immune system. The medication can ease both the allergy symptoms and the asthma symptoms.
- Anti-immunoglobulin E therapy – This medication helps to prevent the allergic reaction symptoms that cause your asthma symptoms. This treatment is used for more severe allergic asthma.
- Theophylline – This medicine is taken every day in order to stop your symptoms from occurring. These may be recommended if other treatments are not helping to ease your symptoms.
- Steroid tablets – These may be recommended if other treatments are not helping to control your symptoms. They can be taken either as an immediate treatment if you are having an asthma attack, or they can be taken every day as a long-term treatment option in order to prevent symptoms from occurring. Long-term use of steroids can have side effects, including increased appetite leading to weight gain, mood changes, fragile bones, easily bruising and high blood pressure. Your healthcare provider should monitor you regularly to check for any side effects.
- Surgery – In rare cases a procedure called bronchial thermoplasty will be recommended as a treatment for severe asthma. The procedure involves passing a thin and flexible tube down your throat and into your lungs. Heat is then used on the muscles around the airways to prevent them from narrowing. This should lessen or stop asthma symptoms from occurring. The procedure is usually successful and is considered to be safe.
Sometimes alternative therapies have been suggested as a way to prevent asthma symptoms; however, there is no strong evidence that they are effective.
Alternative therapies can include:
- Breathing exercises.
- Traditional Chinese herbal medicine.
- Dietary supplements.
An alternative therapy, sometimes described as complementary therapies, should not be used instead of your medicine.
Recognising and avoiding what causes and triggers your asthma can be the most important step you can take in your treatment plan.
How to manage allergic asthma
The most effective way of managing allergic asthma is to understand your triggers and try to prevent your symptoms in the first place. This isn’t always easy; for example if you are allergic to pollen, it is almost impossible to avoid it during the spring and summer months.
Your healthcare provider should work with you in order to develop a plan to manage your allergic asthma. The main goal will be to keep your condition under control.
This may involve:
- Finding the best medication for your condition – This involves finding the best medication to manage your symptoms whilst having the least side effects. This may involve trying different medications to see which one works best for you.
- Learning what triggers your allergic asthma – Your healthcare provider should support you in learning what triggers your allergic asthma and support you to find ways to either avoid or manage the allergens.
- Developing an action plan – Your action plan should help you in understanding what you should be doing day to day in order to manage your allergic asthma, whether that be understanding what you should avoid, what medication to take and when and what to do if your asthma symptoms become severe, for example if you have an asthma attack. Your treatment plan should be regularly reviewed in order to ensure that it is still working for you.
Having asthma cannot be prevented or cured; however, understanding your triggers can help in reducing your risk of having an allergic asthma attack. It is important to have your inhaler with you at all times and that you know how to use it correctly and take any other medications recommended for you.
Allergic asthma is a common condition and with the right treatment plan and an understanding of your triggers, there is no reason why you cannot live a normal life.
You should always see your healthcare provider if you notice that your asthma symptoms are getting worse. Asthma & Lung UK recommend having an asthma action plan which will contain important information about your asthma triggers and is unique to you.