ALLERGENS THAT SHOULD BE SUSPECTED IN ASTHMA AND RHINITIS: GENERAL POINTS

• Infections

Infections can trigger asthmatic attacks, so attacks that are worse in the winter do not necessarily point to a particular allergen. In some children, wheezing only occurs during infections and there is probably no allergen involvement. The viruses involved appear to produce substances that directly trigger mast cells in the bronchi.

• Salt and MSG

Too much salt in the diet may make asthma more likely – try reducing the amount of salt eaten to see what effect this has. Monosodium glutamate (MSG) may have similar effects. The most common sources are tinned and packet soups, convenience foods and Chinese food.

• Irritants

Various airborne irritants can provoke both rhinitis and asthma, eg:

Smoke from cigarettes, bonfires, incinerators etc

Perfume and even strongly scented flowers

Industrial fumes, especially those containing sulphur dioxide Sulphur dioxide is also given off by some foods and drinks (p291). Chewing and swallowing quickly can help to reduce the amount of sulphur dioxide released, but avoidance is probably a better solution.

If possible, reduce exposure to these irritants before trying to work out which allergens may be involved. Once allergens are identified and dealt with, the asthmatic may be able to cope with these irritants again because the bronchi are less sensitive.

• Other non-specific triggers

Cold air, exercise, fear, anger and other emotions can also trigger attacks, so you should consider the possible involvement of these factors. However, there is likely to be some other factor that is the primary cause of the asthma. It is only when the bronchi are already sensitized that they respond to triggers such as these.

• Multiple triggers

Remember that there may be more than one allergen producing the same symptom – food may be one cause and inhalants or contactants another. Where foods are involved they may make the bronchi more sensitive, so that an airborne allergen then triggers an attack. In such cases, the food alone may not bring on an asthmatic attack.

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