MedicineNet.com

About Us|Privacy Policy|Site Map
February 10, 2012

Asthma Complexities (cont.)

Medical Author:
Medical Author:
Medical Editor:
Medical Editor:

The allergic rhinitis-asthma connection

There is a clear association between allergic rhinitis (hay fever) and asthma. The question of which comes first -- the allergic rhinitis or the asthma -- is not easily answered. Many patients recall developing their asthma and nasal symptoms at or about the same time. Others developed their asthma either before or after the onset of their allergic rhinitis. We now know that almost all patients with allergic asthma also have allergic rhinitis. Additionally, roughly one-third of people with allergic rhinitis will develop asthma. Patients with both conditions can expect to suffer more severe asthmatic attacks and require stronger medications to treat their asthma. Patients with allergic rhinitis should be vigilant about reporting any persistent coughing or wheezing to their doctors. The presence of asthma can easily be determined with pulmonary function tests.

The following are possible reasons why allergic rhinitis and asthma are related:

  • The nasal and bronchial membranes are made up of almost the same type of tissue.


  • The nerves of the upper airway (nasal cavity) and the lower airway (bronchial tubes) are connected. Both the upper and lower airways are exposed to the same external environment during breathing. When allergens reach the nasal cavity, there is stimulation of nerve endings in the nasal cavity. This stimulation causes reflex neural signals to be sent to the tissues of both the nasal cavity and the lower airways. In the nasal cavity, these signals cause accumulation of fluid and the formation of mucus, while in the bronchial tubes they cause bronchial constriction and possibly acute asthma. This is sometimes referred to as the naso-bronchial reflex.


  • Nasal congestion causes mouth breathing. During mouth breathing, air bypasses the nose. It is not filtered for allergens and irritating particles, and it is not warmed or humidified. This non-conditioned air is more likely to cause bronchial hyperreactivity and produce asthma symptoms.


  • Mucus from the nasal cavity may drip from the back of the nose into the bronchial tubes, especially during sleep. This dripping mucus increases bronchial inflammation and causes episodes of asthma at night.


MedicineNet Doctors

Suggested Reading on Asthma Complexities by Our Doctors

  • Related Diseases & Conditions

    • Sinus Infection
      • Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
    • Chronic Obstructive Pulmonary Disease
      • COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
    • Asthma
      • Asthma is a common disorder in which chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness, cough and wheezing.
    • Emphysema
      • Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
    • Chronic Bronchitis
      • Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
    • Steroid Drug Withdrawal
      • Corticosteroid drugs such as prednisone and prednisolone are commonly used to treat asthma, allergic reactions, RA, and IBD. Steroids such as these do have serious drawbacks such as steroid withdrawal symptoms such as: fatigue, weakness, decreased appetite, weight loss, nausea, vomiting, abdominal pain, and diarrhea. Speak with your healthcare provider prior to tapering off steroid medications.
    • Asthma: Over the Counter Treatment
      • Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
    • Asthma in Children
      • Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
    • Asthma Medications
      • There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
    • Reflux Laryngitis
      • Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
    • Biorhythms
      • Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
    • Exercise-Induced Asthma
      • Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
    • Secondhand Smoke
      • Secondhand smoke can cause illness and disease in nonsmokers. Some of these conditions include lung cancer, heart disease, respiratory illnesses such as asthma, SIDS, bronchitis, and pneumonia. Learn how you can protect yourself and your family from secondhand smoke exposure in the home environment and workplace.
  • Medications

  • Procedures & Tests

  • Pictures, Images & Illustrations

  • Doctor's & Expert's Views

  • Health News

  • Health Features

Allergies & Asthma

Improve treatments & prevent attacks.



Symptom Checker: Your Guide to Symptoms & Signs: Pinpoint Your Pain





Use Pill Finder Find it Now

Pill Identifier on RxList

  • quick,
    easy,
    pill identification

Find a Local Pharmacy

  • including
    24 hour
    pharmacies