Asthma in children and young adults is associated with various accompanying diseases also called as co-morbid conditions. The most frequently associated diseases with asthma are nasal allergy or allergic rhinitis, eye allergy or allergic conjunctivitis, overweight or obesity and obstructive sleep apnea (OSA). This is related to the common lining of the nose, sinuses and lungs, leading to common susceptibility to inhaled allergens. This is called as unified airway disease.

This articles details the various co-morbid conditions associated with asthma in children and young adults. Timely recognition and treatment of co-morbid conditions is important.

Nasal Allergy or Allergic Rhinitis
Allergic rhinitis is a very common chronic health problem and affects up to almost 40% of the population. Research and clinical experience suggests that almost 80% of patients with asthma have associated allergic rhinitis. Untreated allergic rhinitis leads to a significant impact on the quality of life including sleep, school and work performance. Treatment of allergic rhinitis requires intranasal steroids, anti-histamines and montelukast. Treatment of allergic rhinitis has been shown to improve asthma symptoms as well.

Eye Allergy or allergic conjunctivitis
Eye allergy or allergic conjunctivitis is inflammation of the lining of the eye also called conjunctiva. Symptoms of allergic conjunctivitis include red, itchy and watery eyes. On eye examination small bumps called papille can be seen on the conjunctiva. Some children with an advanced form of allergic conjunctivitis called vernal kerato-conjunctivitis get changes on the cornea which can affect a child's vision. Treatment includes antihistamine and mast cell stabilizer drops (such as olopatadine, bepotastine) and eye lubricants.

Obesity
Obesity and asthma seem closely related. Obesity is a risk factor for the development of asthma, and asthma may increase the risk of developing obesity. Fat tissue produces inflammatory substances that affect the lungs. Research suggests that obese children with asthma often use more medications, suffer worse symptoms, have more asthma attacks and are less able to control their asthma than patients in a healthy weight range.

Obstructive Sleep Apnea (OSA)
Childhood asthma and obstructive sleep apnea (OSA) have a bidirectional relationship where each disorder adversely influences the other one. Obstructive sleep apnea (OSA) causes increased inflammation in the airways, leading to worsening asthma. Children and adults with asthma have twice the risk of having obstructive sleep apnea (OSA) compared to children without asthma. It is hence important to screen children with asthma for sleep disorders including obstructive sleep apnea (OSA).

In case your child is having asthma or recurrent wheezing you need to get in touch with a pediatric allergist or pulmonologist for a proper evaluation and treatment of the co-morbid problems.