Treating rhinitis can cut asthma risk

Expert points to 50% cut in A&E visits for children with asthma if allergic rhinitis is well managed.

Asthma: preventable deaths (Photograph: istock)

GPs can halve emergency admissions for children with asthma by ensuring allergic rhinitis is properly managed, according to a paediatric allergy specialist.

Consultant paediatrician Dr Dalbir Sohi pointed out that allergic rhinitis was easy to treat and that GPs would gain confidence through experience.

Dr Sohi, lead for paediatric allergy and ambulatory care at North Middlesex University Hospital NHS Trust, spoke at the MIMS Paediatrics in Primary Care conference in London last month.

She said research had shown that around 80% of deaths in people with asthma were preventable if appropriate allergy testing was available.

Dr Sohi added that allergic rhinitis can exacerbate lower airway disease. 'All of you who have worked in A&E will know that, when the weather changes, all the asthmatics and all the people with breathing conditions will come in,' she said.

She added: 'If a child has asthma and concomitant allergic rhinitis, if you were to treat the rhinitis you can decrease asthma attendances to A&E by 50%.

'That is quite a significant chunk if you want to reduce some of your patients coming to secondary care.'

Dr Sohi said GPs should ask patients with asthma whether they have rhinitis symptoms, look up their noses and treat the condition.

'You will gain experience and confidence,' she said. 'It is easy to treat. Use daily, non-sedating antihistamines, and if that doesn't work you can add in some inhaled nasal corticosteroid, mometasone or fluticasone.'

Treatment could be stepped up further if that was not successful, she added.

Dr Sohi said patients could also be tested for sensitivity to specific allergens.

Patients could then have treatment optimised to help them cope with environmental conditions that raised exposure to specific antigens, she added.

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