Suffering From Allergic Bronchitis. Becomes Severe During Weather Change. What To Do?
Welcome to Healthcare Magic and thank you for writing to us.
You seem to be suffering from allergic rhinitis with asthma and dust triggers some or most of the symptoms.
You will need a full allergy testing to aeroallergens (extended aeroallergy panel with fungal pollens) including a full blood count (complete hemogram), IgE level, Thyroid functions, 25OH D3 levels. The last two results if abnormal explains why allergy may be worsening.
Lung function tests if not already done need to be done after 3 days of stopping Formoterol if possible.
Dust mite allergy is very common and if proven on blood or skin tests, you will need to start taking avoidance measures and antihistamines with nasal sprays.
Antihistamines generally include the long acting non-sedating Fexofenadine 180mg with Azeflo nasal spray 2 sprays/nostril twice daily.
As Montelukast and Formoterol is already part of the medication, we need to know if that is adequate with the lung function tests.
Optimal medical management is tried for at least 2 seasons, before consideration of immunotherapy. This treatment will be guided by the allergy test results.
Immunotherapy is usually a long treatment course anywhere between 3-5 years.
I hope that was useful.
Best Wishes.
Thank you for posting the follow-up query.
Weather change is associated with change of environmental pollens, and if you are allergic to say Birch pollen symptoms will begin in March and go until May. Severe coughing can itself cause chest pain, but if these symptoms are UN-RELATED to the allergy symptoms, then you must get the appropriate investigations such as Chest X XXXXXXX ECG and 2D-ECHO done.
Sudden change in room temperature also triggers cough in some people, and these are mostly patients with asthma where the airways are hyperreactive anyway. So strong perfumes, scents, cold air triggers the protective cough reflex and with it the chest pain if coughing for long.
I hope that was clear.
Best Wishes.
Fexofenadine 180mg once daily
Azeflo nasal spray 2 sprays per nostril twice daily
and/if required
Monlevo-LC one tablet at night
You can try only with Fexofenadine before using the nasal spray and see whether it is working for you.