A balanced approach is advisable in the case of asthma. Firstly, medicinal drugs may be necessary to control the immediate symptoms and make life bearable for the patient. Secondly, an effort should be made to identify airborne allergens. Some careful detective work, may help to pinpoint the culprits. Skin-prick tests can also be useful here, although they are not always accurate. Once airborne antigens have been identified they can be eliminated as far as possible from the home, using the methods described on p66. If something in the workplace is responsible for the asthma, either as an allergen or an irritant, every effort should be made to change to a different working environment. The asthma may get worse as the years go by, and as the bronchi become more sensitive they react to lower and lower levels of irritant – and they may begin to react to other, milder irritants as well.
After 6-8 weeks, the effect of eliminating airborne allergens and irritants can be assessed, and if there are still serious symptoms then it may be worth trying an elimination diet. Continue with the basic measures for avoiding airborne allergens while the diet is in progress. Where foods provoke asthma, it seems that skin-prick tests are not all that useful in identifying the problem food. So a diet – such as that described in Chapter Fourteen – is the only reliable means of diagnosis. In the case of babies and young children. Remember that children should not be put on an elimination diet without medical supervision. This is particularly important for anyone who has ever had a very severe attack of asthma, because there is a risk of death if a serious reaction occurs when a food is reintroduced. If you are testing foods at home, your doctor should be able to give you a supply of suitable medicine for use in a severe asthma attack.
If foods do turn out to be instrumental in the asthmatic attacks, then avoiding those foods entirely is the simplest solution. Where this proves too difficult or dull, then the drug, sodium cromoglycate, taken by mouth, may be of benefit.
Asthma is a complex disease which may not be entirely due to allergy. For this reason, not all asthmatics will be able to track down the source of their problems using the methods described, and some will have to rely mainly on drugs to control their symptoms. For this group, and indeed for all asthmatics, avoiding exposure to irritants such as smoke and fumes will help greatly. Certain jobs carry a very high risk of asthma because they involve exposure to particular chemicals – these are described on p63- Anyone with a history of asthma, even if they have been free of symptoms for many years, should try to avoid such occupations, because of the likelihood of precipitating asthmatic attacks once more.
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