Recognition and Treatment of Allergic Rhinitis in Children With Asthma Improves Asthma Control!

Asthma and allergic rhinitis are the two most common chronic disorders in childhood and adolescence. Asthma is a chronic disease of lungs, characterized by inflammation, airway obstruction and hypersensitivity of the airway. With asthma, airways are “twitchy” and become inflamed when they meet certain stimuli as allergens or cold air. When a kid or adult has an asthma attack, spasms of the bronchial muscles, along with the swelling of the mucous membrane lining the bronchi and excessive production of mucus, contribute to airway narrowing. Consequently, increased airway resistance causes wheezing and shortness of breath.

Allergic rhinitis or hay fever is triggered by allergens such as pollen or dust mites that induce release of histamines by the body’s immune cells. Current prevalence rates of allergic rhinitis in countries with a Western lifestyle may be as high as 40%! With allergic rhinitis, people may feel a constant runny nose, ongoing sneezing, swollen nasal passages, excessive mucus, weepy eyes, and a scratchy palate and throat. A cough may result from postnasal drip. Also, blocked ears and fluid in the ears because of blocked Eustachian tubes may be two common results of allergic rhinitis.

It has long been recognized that same patients may suffer from both allergic rhinitis and asthma, due to similar mechanisms of disease. Actually, surveys have shown that approximately 60–80% of children with asthma also have symptoms of allergic rhinitis!

A recent study by de Groot and coworkers tried to examine the prevalence of allergic rhinitis in children with asthma, and the impact of the treatment of this nasal disease on asthma control.

A total of 76% patients with asthma had symptoms of allergic rhinitis, 92% of which reported complaints during the last 12 months. Based on their results, authors concluded that allergic rhinitis in asthma patients is frequently unrecognized and undertreated. Recognition of allergic rhinitis in children with asthma and adequate treatment with nasal corticosteroid sprays are likely to improve control of asthma symptoms as well. This is particularly relevant in children with difficult-to-treat asthma.

REF: Eric P de Groot, et al. Thorax. 2012;67(7):582-587.