Do Nasal Allergies Affect Bronchial Asthma?

A number of long-term studies of large populations have shown that patients who have allergic rhinitis frequently have subtle narrowing and inflammation of the bronchial tubes in the absence of any asthma symptoms. When patients with isolated seasonal or year-around nasal allergies are followed over time, they are found to have an increased risk of developing asthma compared to the general population. In patients who have both allergic rhinitis and asthma, the severity of nasal symptoms and asthma are strongly correlated, and patients with severe rhinitis require significantly more medication to control their asthma.

There are a number of significant benefits that may occur when rhinitis is treated in patients who have nasal allergy and asthma. In patients with seasonal hay fever and allergic asthma, giving a nasal steroid or an oral antihistamine reduces asthma symptoms and causes small but significant improvements in breathing test results. In patients with allergic rhinitis and more severe asthma, taking a nasal steroid reduces the number of major asthma attacks that require treatment in an emergency room or admission to a hospital.

In children with exercise-induced asthma, a nasal steroid allows the child to exercise without developing symptoms or signs of asthma. Just as importantly, patients with nasal allergies who do not yet have asthma may benefit from some types of allergy treatment.

Allergy  shots administered for 2 or more years can significantly reduce the chances of developing asthma. All of these findings make a strong case for treating nasal allergies aggressively in patients with both rhinitis and asthma, and in using allergy shots in allergy patients who have not yet developed asthma.

Roger’s comment:

I’ve had spring allergies for a long time, probably since I was in college.

I’m 36 years old now, and over the past couple of years, my hay fever gets so bad that none of the over the counter medicines, like Benadryl or Alavert, help that much. Last year, I became more concerned because I noticed wheezing in my chest, especially when my nose was plugged up.

This past spring season, the same problem started happening, and I saw a doctor who prescribed Omnaris spray and a pill called Singulair. I was worried that the Omnaris is a steroid, but the doctor explained that steroids sprayed into the nose do not have any significant side effects. The two medications really helped clear up my nose, and I stopped wheezing too.