FCAAIA Notes: This is one of many studies showing the safety of inhaled steroids. Inhaled steroids have always been the first choice for persistent asthma. Their safety and negligible risk for side effects far outweighs the risks of poorly controlled asthma. In fact, this study also shows that oral steroids (the treatment of choice for significant asthma flares) are a risk factor for fracture.
The most common concern we hear about inhaled steroids is growth suppression in pre- and early adolescents. In fact, even those data are so weak that they are only a concern in those (extraordinarily rare) patients who already had significant growth suppression while on the medications. Those same studies usually fail to report that poorly controlled asthma with or without oral steroid bursts can also suppress growth rates. Continue reading “ASSOCIATION BETWEEN INHALED CORTICOSTEROID USE AND BONE FRACTURE IN CHILDREN WITH ASTHMA”
FCAAIA Notes: So here’s that “is it gluten or something else” discussion again. We have discussed that many people who label themselves gluten sensitive are in fact not. Of course, some people have Celiac Disease and I (but not everyone) believe that some patients have an actual non-celiac gluten enteropathy (abdominal symptoms with gluten, but not Celiac Disease).
This report raises the possibility that some of those patients don’t have an issue with gluten but with another component of wheat, fructan.
Fructan is a fermentable sugar and one of the foods eliminated in a FODMAP Continue reading “FRUCTAN, NOT GLUTEN, MAY BE THE REAL CULPRIT FOR MANY AN UPSET STOMACH”
FCAAIA Notes: Let me start off by saying you should not stop nursing your baby just because of these data. Breast feeding has numerous health benefits independent of whether it affects the likelihood of developing allergic air way diseases (asthma and allergies) or not.
I first heard data like these about 20 years ago in a meeting of investigators at the NIH. But, then and now the discussion centered on the numerous factors affecting asthma and allergy risk. There are some over which we have no or little control Continue reading “BREASTFEEDING DOES NOT PROTECT CHILDREN AGAINST ASTHMA AND ALLERGIES”
FCAAIA Notes: Allergies rhinitis (nasal allergies) affect 15-20% of the population. Although many people “just live with it”, many also do not recognize the impact allergies have on their quality of life. Nasal congestion is the symptom by which people are most bothered, but fatigue, lack of concentration, and poor school or work performance are all major effects of poorly controlled allergies.
Allergies are a chronic, not an episodic disease. However, allergies are still often treated only episodically. These updated guidelines confirm what we already knew. Intranasal steroid sprays are the best choice for prevention of allergy symptoms. Several are available over the counter and are designed to be used every day. They are incredibly safe, Continue reading “NEW GUIDELINES FOR ALLERGIC RHINITIS CHANGE TREATMENT”