Ask the allergist is a regular feature in our newsletters where Canadian allergists answer your questions!
Dr. Julia Upton is on staff at the Hospital for Sick Children in the Immunology and Allergy Department; and an Associate Professor in the Department of Paediatrics at the University of Toronto. She is the past Section Chair of the Anaphylaxis and Food Allergy Section of the Canadian Society of Allergy and Clinical Immunology. Dr. Upton is also a member of our Healthcare Advisory Board.
Please note: Dr. Upton is answering as an individual allergist and her answers do not constitute an official position of her affiliated organizations. Her responses are for informational purposes only and do not constitute specific medical advice, recommendations, diagnosis, or treatment. Please talk to your doctor about any concerns or questions you may have regarding your own health or the health of your child.
This month she answers a question about having asthma and what it means for one’s food allergy.
If I have asthma, what does it mean for my food allergy?
Asthma is a lung condition where the airways can tighten, swell and have extra mucous leading to difficulty moving air in and out when breathing. We can think of lungs in uncontrolled asthma as being tight/narrow and they close even more when exposed to an allergen. The symptoms of asthma include shortness of breath, wheezing, coughing, and a tight feeling in the chest.
When a person with asthma and food allergy has breathing symptoms it can be difficult to know if these symptoms are from asthma or from an allergic or anaphylactic reaction. Both asthma and anaphylaxis cause tightening of the airways. An anaphylaxis action plan can take into account the diagnosis of asthma and recommend carrying and using both an epinephrine auto-injector and a reliever inhaler treatment if a person experiences asthma symptoms.
For people who also have food allergy, asthma recognition and control is essential because an accidental exposure to their food allergen (or deliberate eating of their food allergen in food oral immunotherapy) can affect the lungs. The better controlled their asthma is, meaning the more open and healthy their airways are, the less severe the added airway tightening will be during an allergic reaction to food.
Asthma is controlled with efforts to avoid environmental allergens and by medications, such as inhaled steroids or other controller treatments. Asthma education teaches a person with asthma and their family to recognize the signs and symptoms of asthma and which actions to take. People with asthma need to be educated about asthma symptoms and recognize when they need to use extra medication and when they need to seek medical attention.
Overall in someone with asthma and food allergy, we want to minimize having tight and narrow airways which then become even more compromised in a reaction to food. We want to see that both conditions are well managed, and that epinephrine auto-injectors and asthma medications are carried when age appropriate. In addition we want to use the epinephrine auto-injector first if there is any possibility that breathing symptoms could be food allergy-related; asthma medications can be given after epinephrine.
To learn more
Watch: Food allergy and asthma webinarWatch our webinar for an in-depth discussion on food allergy and asthma.
Do you have a food allergy-related question you’d like to ask an allergist in the months to come? If so, send it along to us at info@foodallergycanada.ca. Please note: The allergists in this series answer questions on general topics, please talk to your doctor if you have questions about your own health or the health of your child.
Tags: ask the allergist, asthma, dr upton