Alternative Asthma Treatments
The word “asthma” has its roots in Greek, meaning “to breathe hard” or “panting”, and has been described by physicians as notable as Hippocrates and Maimonides. Among the chronic ailments of childhood, Asthma ranks as one of the top chronic diseases affecting our children,[i] and the combined costs for medical treatment and lost productivity due to asthma is approximated to be over 16 billion dollars.[ii] This is no small issue, and it is crucial for the medical community to entertain the possibility that there are options and adjunctive therapies that may be added to the conventional approach to asthma treatment. Rates of prevalence and office visits for asthma have more than doubled since 1980 and remain at the highest rates we have ever seen.[iii] Emergency department visits have also increased since 1992, and mortality rates have declined since a recent increase in the 1980’s and 1990’s.[iv] This may be due to better asthma management and/or more effective and easily administered medications. An extraordinary amount of drug company funding to support the research and development of new medications has resulted in many more choices for these patients. These medications do provide symptomatic relief and save lives. However, despite the rapid influx of new medications, asthma prevalence rates remain high. The statistics beg the question: Are we treating the root of the cause or just its manifestations? Conventional diagnosis is largely based on symptoms, so conventional treatment has followed suit to address just that—the symptoms. Concerns of the possible long term effects of these medications have driven parents to seek alternative medicine for their children’s asthma. For example, corticosteroid use in asthma patients is common, and is known to cause decreases in bone density. Considering that teens gain approximately half of their skeletal mass during puberty, some of these patients may be predisposing themselves to an increased risk of osteoporosis later in life, especially at post-menopausal age. A salient point is that those who are currently being treated with corticosteroids may also have had previous chronic exposure to steroid treatment. Asthmatics often have a past history of other atopic conditions such as eczema and allergic rhinitis. Treatments for these conditions include other delivery routes of corticosteroids (nasal, topical, oral), possibly compounding long-term effects. Prevalence of interest in CAM for asthma exists internationally and across race and income lines. [v][vi][vii][viii] Some of the most popular treatments include breathing techniques, botanical medicine, homeopathy and acupuncture.[ix]
The concern of infection due to microbes has led to a strong emphasis on sterile environments. Consumers are constantly bombarded with advertising for antimicrobial soaps and other cleaning supplies, sending the message that sterility is the path to optimal health. It is clear that the rate of allergic diseases have risen in societies with the advent of technology and industrialization. It is possible that our children are receiving less exposure to nature or a farm-like environment, which may contribute to rising rates of the allergic conditions? In fact, those who are exposed to such environments do show less atopy,[x][xi] possibly due to immunomodulatory properties of the dust or other allergens in those settings.[xii] Another factor in the benefit of farm-like settings may include a diet richer in beneficial microbes such as those found in raw dairy products. Industrialized societies are also seeing that the rise of asthma rates and hospitalizations due to asthma are directly related to air pollution, [xiii] which is understandable.
[i] Adams PF, Hendershot GE, Marano MA; Centers for Disease Control and Prevention/National Center for Health Statistics. Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10. 1999 Oct;(200):1-203.
[ii] National Heart, Lung and Blood Institute Chartbook, U.S. Department of Health and Human Services, National Institute of Health, 2004.
[iii] Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics. 2002 Aug;110(2 Pt 1):315-22.
[iv] Akinbami L; Centers for Disease Control and Prevention National Center for Health Statistics. The state of childhood asthma, United States, 1980-2005. Adv Data. 2006 Dec 12;(381):1-24.
[v] Andrews L, Lokuge S, Sawyer M, Lillywhite L, Kennedy D, Martin J. The use of alternative therapies by children with asthma: a brief report. J Paediatr Child Health. 1998 Apr;34(2):131-4.
[vi] George M, Birck K, Hufford DJ, Jemmott LS, Weaver TE. Beliefs About Asthma and Complementary and Alternative Medicine in Low-Income Inner-City African-American Adults. J Gen Intern Med. 2006 Sep 25 (Epublication)
[vii] Tokem Y. The use of complementary and alternative treatment in patients with asthma. Tuberk Toraks. 2006;54(2):189-96.
[viii] Slader CA, Reddel HK, Jenkins CR, Armour CL, Bosnic-Anticevich SZ. Complementary and alternative medicine use in asthma: who is using what? Respirology. 2006 Jul;11(4):373-87.
[ix] Slader CA, Reddel HK, Jenkins CR, Armour CL, Bosnic-Anticevich SZ. Complementary and alternative medicine use in asthma: who is using what? Respirology. 2006 Jul;11(4):373-87.
[x] Riedler J, Eder W, Oberfeld G, Schreuer M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000 Feb;30(2):194-200.
[xi] Riedler J, Braun-Fahrlander C, Eder W, Schreuer M, Waser M, Maisch S, Carr D, Schierl R, Nowak D, von Mutius E; ALEX Study Team. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet. 2001 Oct 6;358(9288):1129-33.
[xii] Peters M, Kauth M, Schwarze J, Korner-Rettberg C, Riedler J, Nowak D, Braun-Fahrlander C, von Mutius E, Bufe A, Holst O. Inhalation of stable dust extract prevents allergen induced airway inflammation and hyperresponsiveness. Thorax. 2006 Feb;61(2):134-9.
[xiii] Lee SL, Wong WH, Lau YL. Association between air pollution and asthma admission among children in Hong Kong. Clin Exp Allergy. 2006 Sep;36(9):1138-46.
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