Other Treatments:

Immunizations

Patients with asthma should receive the flu vaccine annually, and they should receive the vaccination against pneumococcal pneumonia at least once. [For more information, see In-Depth Report #94: Colds and influenza.]

Treating Seasonal Allergies and Sinusitis

Patients with asthma and chronic allergic rhinitis may need to take medications daily. Patients with severe seasonal allergies may need to start medications a few weeks before the pollen season, and to continue medicine until the season is over.

Immunotherapy ("allergy shots") may help reduce asthma symptoms, and the use of asthma medications, in patients with known allergies. They may also help prevent the development of asthma in children with allergies. Immunotherapy poses some risk for severe allergic reactions, however, especially for children with poorly controlled asthma.

Treatment of allergies and sinusitis can help control asthma.

[For more information, see In-Depth Reports #77: Allergic rhinitis, #5: Asthma in children and adolescents, and #62: Sinusitis.]

Preventing and Treating Respiratory Infections

Respiratory infections, including the common cold, can act with allergies to worsen asthma. People with asthma should try to minimize their risk for respiratory tract infections. Washing hands is a very simple but effective preventive measure.

Treating Gastroesophageal Reflux Disease (GERD)

Patients with obvious symptoms of reflux may consider the following lifestyle changes:

• Avoiding heavy meals and meals with fried food
• Avoiding caffeine
• Avoiding eating or drinking at least 3 hours before bedtime
• Elevating the head of the bed by 6 inches
• Taking medications treating gastroesophageal reflux. Be sure to talk to your doctor before taking these medicines.

Managing Hormonal-Related Asthma

Women who suspect that menstrual-related changes may influence asthma severity should keep a diary of their menstrual dates and times of asthma attacks. Sometimes, adjusting medications in anticipation of menstruation may help prevent attacks.

Other Treatments

Children, adolescents, and adults with asthma are widely using alternative therapies. In one study, nearly half of asthma or allergy sufferers resorted to alternative treatments. To date, however, evidence does not support any value from most alternative therapies, including high-dose vitamins, urine injections, homeopathic remedies, and most herbal remedies.

Relaxation and Stress-Reduction Techniques. Some patients report benefits from many stress reduction techniques, such as acupuncture, hypnosis, breathing relaxation techniques, massage therapy, and meditation practices. There have been very few well-conducted studies supporting their use, however.

Acupuncture, hypnosis and biofeedback are all alternative ways to control pain. Acupuncture involves the insertion of tiny sterile needles, slightly thicker than a human hair, at specific points on the body.

Breathing Exercises. Breathing exercises may help improve patientsâ ' quality of life even if they do not have a major impact on medication reduction.

Probiotics. Probiotics are beneficial microbes that some believe may help protect against allergies and asthma. Probiotics can be obtained in active yogurt cultures and supplements, which are being studied for protection. However, evidence to date does not support efficacy in preventing or treating asthma.

Herbal Remedies. Few rigorous studies have evaluated herbal remedies for asthma. Manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Always check with your doctor before using any herbal remedies or dietary supplements.