Preventing aggravation of allergy-like symptoms during Ramazan


By Shahina Maqbool, 13 Oct 2006

ISLAMABAD: Unpredictable weather changes, respiratory viral infections, and unprecedented heat and humidity in August and September increased the misery of respiratory allergy and asthma patients throughout Punjab and parts of NWFP.

The management of their illness becomes a challenge in Ramazan for many allergy and asthma patients as the holy month is associated with a significant change in daily routine patterns. Many believers visit mosques more frequently during Ramazan than any other time of the year. They expose themselves to dust from carpets, and many experience difficulty in breathing during 'sajda' (kneeling).

Lack of sleep and disturbed sleep patterns are also associated with an aggravation of allergy-like symptoms including sneezing, runny nose, and an occasional feeling of tightness in the chest. Excessive dietary habits including increased consumption of greasy and heavy foods also cause bloatedness, indigestion and abdominal discomfort. This, in turn, aggravates any episodes of difficulty in breathing.

'The News' talked to allergy specialist Dr. Osman Yousuf to seek advice on measures that allergy and asthma patients should take to prevent their illness from aggravating during this month. "Avoid undue exposure to factors that may aggravate allergy (such as dust, molds), and sudden changes in temperature. Take a light diet and avoid heavy meals before bedtime. Reflux of food from the stomach into the food pipe and excessive gastric acidity may cause or aggravate breathing difficulties in a syndrome called GERD (Gastro Esophageal Reflux Disease)," Dr. Osman warned.

Respiratory allergy patients should ensure that their nose remains open as a blocked nose leads to worsening of respiratory symptoms, and may even be a cause of an asthmatic attack. Nasal decongestant sprays and drops should be used sparingly as they can cause addiction, worsening of the blocked nose and even asthmatic attacks. Steroidal nasal sprays, when used under the supervision of a qualified medical practitioner, not only help to treat the symptoms but can also improve an asthmatic episode and even reduce a nasal polyp (a growth in the nose), the allergy specialist disclosed.

Frequent washing of the nose, best done by properly performing ablution, and application of oil or a lotion inside the nostrils discourages allergens and respiratory viruses from sticking to the nasal mucosa and causing nasal symptoms. This reduces the amount of medication needed in treatment of nasal allergies.

Allergy and asthma patients should continue the medications advised by their physicians. Inhalers should be continued even when the patient is well, to prevent the onset of an attack of asthma. Inhalers are best used through a spacer device, which is a valved plastic bottle to facilitate proper benefit of the medication.

Dr. Osman recommended that in view of the imminent danger of increased viral respiratory infections, especially those expected from pilgrims during Ramazan and the forthcoming Hajj, allergy and asthma patients should get vaccinated against influenza infections. Flu vaccines should be used as advised by a physician before start of the winter season. These are usually available at chemists all over the country, but unfortunately are presently in short supply.

A study undertaken last year has indicated the efficacy of a new anti-asthma drug, Montelukast, as an effective preventative measure for viral respiratory infections. Dr. Osman said, children treated with this drug in Islamabad, Lahore and other cities of Punjab during winter 2005, did not develop the classical symptoms of flu, and had far fewer exacerbations of asthma. This drug is available as the prototype costing about Rs. 100 per day, but the locally produced Montelukast is 5 to 8 times cheaper and almost as effective. However, a doctor's prescription is paramount.

Anti-allergy medication should also be continued well after the allergy season is over. In patients with repeated episodes of allergy, sore throat, cough or asthmatic episodes, it is advisable to continue second generation, non-sedating anti-allergy medication throughout winter, and until a few months after the last symptoms of allergy have subsided. Like all other illnesses, but most importantly in allergies and asthma, prevention is always better than cure, the allergy specialist said in conclusion.