Allergy Attacks? Fight Back: Lily Pien, MD
By Lily Pien
Spring has sprung! But if blooming flowers and trees make you sniffle and sneeze, read what with allergy and asthma expert Lily Pien, from The Cleveland Clinic, had to say about allergy and asthma treatments.
The opinions expressed herein are the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Welcome to WebMD Live, Dr. Pien.
Pien: Hello, and I'm happy to be here.
Member: My daughter has indoor and outdoor allergies, what is the medication you recommend for her? She is 14 and also has asthma. She has allergies to dust mites and pigweed and a few others. What do you recommend?
Pien: She would essentially be considered an adult and could use medications typically used by an adult. The non-sedating antihistamines are well tolerated and cause minimal drowsiness. Antihistamines are safe for people with allergic rhinitis and asthma. And nasal steroid sprays help control rhinitis symptoms, which can help prevent asthma flare-ups. Depending on severity of her asthma, intermittent rescue medication such as albuterol can be used. If her asthma symptoms occur on a daily basis, daily preventative asthma medication can be used.
Member: We have tried almost everything on the market, I mean over-the-counter. The doctors gave her nasal sprays, which dry her nose up too much. She also has been given albuterol for an inhaler. What I need to know is would a breathing treatment machine help her at all?
Pien: Breathing treatment machines, nebulizers, are primarily used for albuterol medication. There is also a steroid nebulizer solution available for preventative measures to treat asthma. If your daughter is having daily nasal and chest symptoms, I suggest a regular daily preventative medication for both her nasal and chest symptoms. Some examples are nasal steroid sprays, Singulair, and inhaled steroid medication for the chest as well.
Member: I am having problems with my eyes; they itch all the time and stay red, they also have a stringy white discharge coming from them. I thought it was my eye make-up, but it does it even when I don't wear it. I don't sneeze all the time but I do have sneezing fits, where I sneeze for 10 or 15 minutes non-stop.
Pien: Eye symptoms are a common manifestation of aeroallergen sensitivity. So I would suggest anyone with sneezing and eye itching and drainage to be skin tested to determine if there is a particular allergen to avoid. There are antihistamine eye drops available to decrease symptoms, and most of them are prescription.
Member: I think I'm allergic to salad; I can't eat a salad without having to "run " to the bathroom five minutes later because of diarrhea. I know it's the salad because it's been going on about a year. The funny thing is, I can eat lettuce without any problems. I don't eat salad much, but it's great if I'm constipated. Is this normal? What ingredients in it could I be allergic too?
Pien: True lettuce allergy is unusual. There are intolerances people can develop to foods and we all know vegetables are a high source of fiber. If you don't have any other symptoms besides diarrhea I would be cautious to say it is a true lettuce allergy. More typical signs of a true food allergy would include itching in the mouth, nasal congestion, hives, some chest tightness, as well as nausea, vomiting, and diarrhea. Some people have difficulties with preservatives used in vegetables such as sulfites, which may cause some adverse reactions to lettuce.
Member: What is the best way to stop the cough before it starts an asthma attack?
Pien: If you know you are going to be exposed to an irritant or allergen and there is no way to avoid the exposure, you can take albuterol one-half hour prior to the exposure. If the coughing occurs on a daily basis, an anti-inflammatory preventative asthma medication would be recommended.
Member: Does Allegra make you sleepy?
Pien: The second-generation antihistamines such as Allegra are not supposed to cross to the brain, so there should be minimal sedative effects with the medication. But everyone is different and some have complained of drowsiness with it.
Member: Is there an alternative to albuterol?
Pien: Yes, there is. There are other MDI's available such as Maxair, Alupent, and also a nebulized form of a bronchodilator called Xopenex.
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