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Five Conditions to Consider With Uncontrolled Asthma

Treating These Conditions May Improve Your Uncontrolled Asthma


Updated March 11, 2009

If your asthma is not well controlled despite your best efforts, you may want to consider asking your asthma provider about these five problems that may contribute to uncontrolled asthma. Treating any of these problems may lead to noticeable improvements.

1. Heartburn or Acid Reflux

Gastroesophageal reflux disease or GERD is one of the most common conditions that may lead to uncontrolled asthma. GERD occurs when acid from your stomach leaks back into your esophagus and causes symptoms due to irritation. While the link between GERD and asthma is not totally clear, treating GERD may improve your asthma.

2. Obesity

Asthma is not only more common among overweight and obese people, but obese people with asthma tend to have more severe asthma symptoms, inflammation, and increased risk for a new asthma diagnosis. This risk is greatest among teens and older women. Obesity may worsen asthma, even among people who are physically active.

The good news? Studies show that losing weight can help by improving lung function, decrease exacerbations, improve quality of life, and reduce dependence on corticosteroids (asthma medications). Overall, losing weight may improve your asthma symptoms, and will be good for your health in general.

3. Obstructive Sleep Apnea

You asthma provider may also want to consider obstructive sleep apnea (OSA) if you have uncontrolled asthma. Typically OSA patients or their partners may complain of:

  • Loud snoring
  • Excessive daytime sleepiness
  • Breath holding spells noted by sleeping partner

A diagnosis of OSA is made by undergoing a polysomnogram or sleep study.

OSA is treated with a continuous positive airway pressure or CPAP. Patients with uncontrolled asthma and OSA who use a CPAP tend to have improvements in peak expiratory flow. Obtaining a correct diagnosis is essential, though, because if used incorrectly a CPAP can worsen symptoms.

4. Rhinitis

You may not realize it, but that runny, itchy nose may be partly responsible for your uncontrolled asthma symptoms. When there is inflammation and irritation of the upper airways, as during rhinitis, there is a good chance the lower airways are irritated as well. Treating this condition may lead to improvements in your asthma.

Typical symptoms of rhinitis include:

  • Runny nose
  • Sneezing
  • Scratchy throat
  • Itchy eyes
  • Congestion

Using intra nasal steroids can decrease visits to the emergency department for asthma.

5. Sinusitis

Patients can have serious sinusitis but may not have any symptoms. If they do, they're usually:
  • Cold-like symptoms that persist more than 2 weeks
  • Nasal congestion with thick, colored discharge
  • Pain in teeth
  • Pain over the sinuses
  • Fever
  • Antihistamines or decongestants don't seem to help

Your doctor may just order a cat scan of your sinuses if your symptoms are significant and he/she cannot otherwise explain them. In fact, there is a direct relationship between how abnormal the cat scan of your sinuses is and inflammation in your lungs. Treating sinusitis with antibiotics, when appropriate, and nasal steroids can improve asthma symptoms.

6. Sources


National Heart, Lung, and Blood Institute. Clinical practice Guideline. Accessed March 8, 2009. SECTION 3, COMPONENT 3: CONTROL OF ENVIRONMENTAL FACTORS AND COMORBID CONDITIONS THAT AFFECT ASTHMA

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