Basic Concepts of Allergic Respiratory Disorders

Allergic respiratory disorders are increasing in number globally. Even though genetic predisposition is one of the factors in children for increased prevalence, other factors contributing significantly include urbanization, industrialization and air pollution. The saddest part about childhood allergic coughs is them being misunderstood. People often have a lot of misconceptions about the diagnosis & treatment modalities.  

Basic features of Allergic Cough?

Allergic coughs are recurrent and persistent, means they will come again & again whenever they get a trigger and will take much longer time to settle down as compared to infective coughs. Last, allergic cough are progressive, means they will worsen with time if not adequately controlled. Because of these features, long term medications are often required to achieve good control. The fact is that allergies, unlike infections can be controlled but cannot be cured.

Grading of Allergic Cough?

Grading is required to assess the severity of disease and this helps to guide our treatment strategies. Mostly allergic coughs are graded into mild, moderate or severe forms. Mild form means 1-2 episodes of cough in a year, moderate form means 3-6 episodes in a year which persist beyond 5-7 days and severe form means 1-2 episodes of cough in a month along with fast and heavy breathing. More severe the form of cough, more prolonged is the treatment. Longer the symptoms are kept under control, more are the chances that allergic cough will settle with time. 

What are the treatment modalities available to treat Allergic Coughs?

A mainstay of treatment in Allergic coughs is anti-allergic drugs, which are available in different forms – syrups, nebulizations, inhalers. The general concept among people is that nebulizations & inhalers are much stronger medications and habit forming. It’s worth mentioning here that all these forms are just methods to put the drug in the body and it’s the drug which helps to control the symptoms. 

It’s important to understand this concept because it helps in better patient compliance with treatment. Inhaled medications always have a better effect because the medication reaches the site of action directly. Secondly, the absorption of the drugs into the circulation is minimal, so the doses required are minimal and side effects negligible. The oral medications are always given in a much higher dose to achieve the same effect as compared to the inhaled medications. So the fact is that oral medications are much stronger than inhaled medications. Comparing nebulizations v/s inhalers, the dose of medications in inhalers is further reduced. Thirdly, none of the medications used for allergic coughs is addictive or habit-forming. 

Can certain foods trigger Allergic Cough?

Certain foods tend to trigger allergic cough which may vary from child to child. Most common foods triggering allergy are nuts, eggs and kinds of seafood. However, the mother needs to look at which food triggers allergy so that it can be avoided in the diet until adequate control of the symptoms is achieved. Broadly speaking, food items with preservatives & colouring agents should be avoided.

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