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Asthma

Most asthma is allergic in nature, but about 1/3 of asthma is non-allergic (without evidence of any skin or blood test allergy triggers). While most asthma is diagnosed in childhood, about 20% of asthma may be diagnosed as adult-onset asthma. Shortness of breath, cough, wheezing, nighttime awakenings with respiratory symptoms, or exercise intolerance may be signs of asthma. To help determine if asthma is the cause of your symptoms, we will take a careful history and perform spirometry (see above) to check for airway obstruction. We may have you take albuterol or another bronchodilator and check if your spirometry improves which helps assess for reversible airway obstruction, a hallmark of asthma. We also may recommend skin tests to check for allergic triggers of asthma. Should you be diagnosed with asthma we will help you construct an individualized treatment plan with recommendations regarding the use of a preventative inhaler medication and/or oral medications and rescue inhalers. Often by treating allergic disease with medications and/or allergy shots, asthma control also improves.

For some patients with asthma that proves very difficult to control with typical inhalers and medications, we sometimes prescribe a medication known as xolair (omalizumab) which is an injectable recombinant molecular antibody that blocks Immunoglobulin E (allergic-type antibody). This medication is administered every 2 to 4 weeks in our office to patients who meet specific criteria to receive the medication. It can be very helpful to some patients in improving their asthma control and reducing the amount of oral or inhaled steroids that they need. It is only approved for allergic asthma and requires some blood work be sent to determine if patients qualify.