Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective...

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Does sneezing lead to wheezing ? What allergic patients should know about the link between allergic rhinitis and asthma Does rhinitis lead to asthma ?

Transcript of Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective...

Page 1: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

Does sneezing lead to wheezing ?What allergic patients should know about the link between

allergic rhinitis and asthma

Does rhinitis

lead to asthma?

Page 2: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

Allergy is the most common chronic disease in Europe, and its prevalence is growing. Today, 80million adults in Europe suffer from allergies and it is estimated that by 2015, every second per-son might be suffering from at least one form, including allergic rhinitis, asthma, eczema andfood allergies.

In close collaboration with scientific societies and patient associations, the European Union hasexpressed its commitment to addressing this important public health issue by supportingGA2LEN.

GA2LEN is a European network that brings together the best experts, research centres and patientorganisations from across Europe. The aim of this “network of excellence” is to enhance the qua-lity of research on all aspects of the disease and to rapidly communicate the findings with a viewto reducing the overall burden of allergy and asthma.

The network approach recognises the need for constant dialogue between researchers, doctors,patients and policy makers. Effective prevention and treatment rests on raising awareness amongall these players and the rapid translation of research findings into clinical practice.

For a better management of allergies in Europe

www.ga2len.net

Page 3: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

Does sneezing lead to wheezing?

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Sneezing and Wheezing

Do you - or members of your family - suffer from allergic rhinitis (also knowas “hay fever” when caused by pollen)?If yes, we suggest you read the follo-wing brochure carefully.

If the patient has both allergic rhinitisand asthma, the effective treatment ofallergic rhinitis can help manage asthma better.

Allergic rhinitis is a major risk factorfor the development of asthma.

This means that any person who hasallergic rhinitis is much more likely todevelop asthma than a person whodoes not have allergic rhinitis.

Typically, the symptoms of allergicrhinitis are sneezing, nasal blockage,runny and itchy nose and redness ofthe eyes.

Rhinitis and asthma can also be non-allergic.

“I can't breathe through my nose.

I'm short of breath.

Is this related?”

Page 4: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

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Does sneezing lead to wheezing?

Thinking about symptoms

Tell your doctor about any symptoms that may indicate

allergic rhinitis or asthma. Review the checklist to prepare

yourself for your consultation with the doctor. See if you

can work out what some of the causes may be.

Sneezing - Do you have allergic rhinitis?

■ Are the problems related toyour nose?

Ask yourself the following questions.Your answers will be helpful in elimi-nating alternative diagnoses, such asthe common cold.

1. During the past year, have you haddaytime blocked nose, an itchynose, mucus secretion in throat,sneezing and a runny nose/rhinorrhea- or at night - a blocked nose, sleepdisorder, awakenings during thenight with symptoms, which do not seem to be caused by a com-mon cold?

❑ yes ❑ no

2. When do the symptoms mentionedabove occur?

❑ winter ❑ spring ❑ summer ❑ autumn❑ no clear variation, the

symptoms are persistent

While for the majority of the popula-tion, contact with certain allergens in dust or from a dog, cat or tiny animals or from pollen in the airdoes not create a problem, it can leadto allergy and asthma symptoms in others. Such people are “allergic”.

The symptoms of allergy can vary innature (sneezing, coughing, wheezing,breathlessness and skin rashes) andin severity. They are an exaggeratedresponse from the immune system.

The disease often progresses fromatopic dermatitis to allergic rhinitisand then to asthma. This evolution,known as “allergy march”, needs tobe carefully followed and treated.

3. For how long do the symptomsoccur?

❑ less than 4 days a week orless than 4 weeks in a year(intermittent) or

❑ more than 4 days a week ormore than 4 weeks in a year(persistent) ?

4. Do these symptoms restrict yourregular activities at home or atwork, your hobbies or your sleep?

❑ yes ❑ no

What are allergies?

Allergic rhinitis - also known as hayfever when triggered by pollen - isallergy with nasal symptoms causedby outdoor allergens (such as plantpollens or mould) and by indoorallergens (such as animal danders,indoor mould or house dust mites)in people who are allergic to thesesubstances. Symptoms may be per-sistent. In some cases, the eyescan also be affected.

Allergic rhinitis

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Wheezing - Do you have asthma?

It is important that you have your condition properly diagnosedby your doctor before starting any medication.

Inflammation increases, and the air-ways become more swollen and even narrower. Cells in the airways may alsomake more mucus than usual. This extra mucus also narrows the airways.These changes make it harder to breathe.

Taking care of your asthma is animportant part of your life. Controllingit means working closely with yourdoctor to learn what to do, stayingaway from things that bother your air-ways, taking medicines as directed byyour doctor, and monitoring your asth-ma so that you can respond quickly tosigns of an attack.

By controlling your asthma every day,you can prevent serious symptoms and take part in all activities.

■ Do you suffer from wheezing, shortness ofbreath, cough and chesttightness?

If you suffer from one of the followingsymptoms - wheezing (a whistlingsound when you breathe), shortness ofbreath, coughing and chest tightness -it can mean that you also have a con-comitant allergic inflammation in yourlower airways, called asthma.

If you have asthma, you will need tolearn what things cause your asthma symptoms and how to avoid them. Yourdoctor will also prescribe medicines tokeep your asthma under control.

When your asthma symptoms becomeworse than usual, it is called an asthma episode or attack. During anasthma attack, muscles around theairways tighten up, making the airwaysnarrower so less air flows through.

Asthma is a chronic disease thataffects the airways (bronchi) of thelungs.

Asthma is caused by inflammationin the airways. The inflammationirritates the muscles around the air-ways, and causes them to tighten(constrict). This causes narrowing ofthe airways.

It is then more difficult for air to getin and out of the lungs. This leadsto wheezing and breathlessness.

The inflammation also causes thelining of the airways to make extramucus, which causes a cough creating further obstruction to airflow.

Asthma

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Thinking about symptoms

■ Do you have any signs ofskin allergies (rashes, hivesand itchy skin) or have youhad such problems in yourchildhood?

■ Do any of the allergicsymptoms occur at particulartimes or in particular places?

■ Do other members of yourfamily suffer from allergies?

Attentive management of allergicrhinitis in children and adults cancontribute to better management ofasthma, which is increasingly commonin Europe.

Children are particularly vulnerable toallergic rhinitis. The prevalence ofallergic rhinitis is between 10-20% in young school children and rangesfrom 15-30% in teenagers. While thecondition may have its onset when thechild is 3 or 5 years' old, peak inci-dence occurs later in childhood andearly adolescence.

Never consider allergic rhinitis as trivial!

They can vary depending on what iscausing the reaction and the part ofthe body where the reaction occurs.Symptoms can include:

■ red, watery, itchy eyes

■ sneezing, congestion, blocked nose,runny and itchy nose

■ throat clearing (mucus secretion inthroat)

■ coughing

■ shortness of breath

■ wheezing

■ hives (skin wheals) - skin rashes

Allergy symptoms

Eczema is sometimes called dermati-tis which means “inflammation of theskin”. There are different types ofeczema. The most common type isatopic eczema. In this type ofeczema there is a typical pattern ofskin inflammation which causes thesymptoms.

The word “atopic” describes peoplewith certain “allergic” tendencies.However, atopic eczema is not just asimple allergic condition. People withatopic eczema have an increasedchance of developing other “atopic”conditions such as asthma and hayfever.

Atopic eczema

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Medical historyIt is the basis of allergy diagnosis: discus-sion between patient and doctor about the symptoms and patient experience.

Physical examination on different organs ■ Nose: For swollen nasal mucous

membranes and structural defects.

■ Eyes: To check if they are swollen,watery or red, or to assess whetheryou have other signs of long-term(chronic) allergies.

■ Sinus areas: For tenderness andsigns of infection.

■ Mouth: To see whether you havesigns of physical changes as a resultof breathing only through your mouth.

■ Chest and lungs: For signs of infection or asthma.

■ Skin: For signs of allergy, such as hives or eczema.

Tests Tests can be done to confirm the diag-nosis. Allergy testing involves having askin or blood test to determine whatsubstance (allergen) may trigger yourallergy (Skin-prick tests / Specific IgEin vitro tests / other in vitro tests).

These involve no risk and are painless.

Treatment A wide range of treatment optionsexists for allergic rhinitis and the diagnosis made by your doctor willenable prescribing the most appropriate for your needs:

■ Medication to be taken by mouth:antihistamines, antileukotrienes.

■ Medications to be applied locally:nasal glucocorticosteroids, ophthalmicantihistamines, intranasal H1 antihis-tamines, cromones, decongestants.

■ Treatment using other forms ofadministration: immunotherapy(sub-cutaneous, sublingual).

■ Avoidance measures - when possible -are also part of the treatment.

Co-existing conditions Allergic rhinitis and asthma often co-exist. Indeed, about 80% of asthmatics have some form of rhinitisand approximately 15-30% of allergicrhinitis patients have asthma.

In some studies, patients with bothconditions showed asthma symptomsimproved with an efficient treatmentof allergic rhinitis.

Combination therapies In some cases, a combination of medications can be prescribed toachieve treatment goals.

Tests and treatments

Accurate diagnosis of allergies will lead to appropriate therapeutic options.

To help diagnose allergic rhinitis, your doctor will examine you and will make some tests.

Page 8: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

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Does sneezing lead to wheezing?

Playing your part

■ Allergen avoidance is effectivewhen total avoidance of the aller-gen can be achieved. This is thecase of pollen allergy, sincepatients do not experience symp-toms outside the pollen season orfor food allergy.

■ However, even for mite allergy,total avoidance (e.g. patients staying in a mountain area for several months) is incompletelyeffective because most patients arepolysensitized and inflammationcan often persist without miteexposure.

■ Single measures of mite controlsuch as mite encasing or vacuumcleaning are usually insufficient toreduce the allergen load.

■ In patients with a demonstratedsensitization and with symptoms ofallergy to furred pets kept indoorsat home it is recommended to getrid of the animal in order to reduceallergen exposure at home.

Avoidance measures You can help in the manage-

ment of your allergies!

To ensure optimal care, you

can take an active role in your

treatment by asking questions,

learning about the triggers of

your condition, and under-

standing the reasons for

various methods of treatment.

Open communication is a nec-

essary, successful part of aller-

gic disease management. The

best results are achieved when

patients or carers are fully

informed and involved.

Allergy prevention

Avoid smoking and exposure to tobaccosmoke, particularly during pregnancy.Do not expose children to tobbacosmoke.

The quality of indoor air at home, inschool and at the workplace also playsan important role.

When possible, breast-feed exclusivelyuntil 4-6 months.

Allergen avoidance

If you can identify what may be causingallergic rhinitis or any other allergy, itmay be possible to reduce the symp-toms by avoiding or lessening contactwith the “allergen”. It is thereforeworthwhile to give this some thought.

If you have ideas on what might becausing the allergy and how you couldhelp avoid exposure, tell your doctor.

Page 9: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

■ GA2LEN [email protected]

■ EFAwww.efanet.org

■ National contact

Contact info

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Does sneezing lead to wheezing?

■ Learn about your disease.

■ Proper use of medication is essential if control of your diseaseis to be improved.

■ Be sure to take the correct dose of prescribed medication at thecorrect intervals.

■ Do not stop taking your medicationwithout consulting your doctor!

■ Remember that the treatment of allergic disease is mostly long-term!

Playing your partGaining control with writtenplans for asthma

Once you have started on your medica-tion, it can be very helpful for yourfuture visits to the doctor to writedown the following information to helphandle or avoid future exacerbations:

■ Any cases of your forgetting to takeor use the medication and the con-sequences.

■ Any changes in symptoms

■ Any side effects of the treatment

Medication

If you have received a prescription fortreatment, make sure you understandhow and when to use the medication.

The effectiveness of your treatmentand the safety of the medicationshould be evaluated with your doctor.

If your doctor has given you an emer-gency plan, share it with a familymember or friend who can help youduring an emergency. You must beprepared for rapid action.

If you are prescribed long-term treat-ments, be aware that even if they donot produce immediate relief of symp-toms, they are very important.Troublesome consequences may resultfrom stopping a prescribed treatmenton your own.

Remember, following yourtreatment is the best way to improve control of your disease!

Page 10: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

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Does sneezing lead to wheezing?

“Quality of life” focuses on patients’ perception of their disease and measures impairments that have a significant impact on the patient's well-being or activities.

Quality of life also analyses the socialrepercussion of a disease.

Similar symptoms may vary in theeffects they have on different individuals.

Tools, such as validated question-naires, assess the severity of the disease.

The goal is to prescribe a therapy thatreduces those impairments thatpatients consider important and toprevent developing complications.

Quality of life

Page 11: Broch Patient 2007 - ucb.com · If the patient has both allergic rhinitis and asthma, the effective treatment of allergic rhinitis can help manage asthma better. Allergic rhinitis

References of this document are available at www.ga2len.net or upon request at [email protected]

Photo credits: ccvision.de

© GA2LEN Dissemination

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GA2LEN Dissemination

T. +32 2 640 77 80 • F. +32 2 647 89 [email protected]

www.ga2len.netThis campaign is conducted by GA2LEN and EFA (European Federation of Allergy and Airways Diseases Patients Associations - www.efanet.org).

Supported by an educational grant from Phadia and UCB