Asthma Management in a 'Clean' Environment: 2. Progress and Outcome in a Cohort of Patients

• Published in: Journal of nutritional medicine Vol. 3; no. 3-4; pp. 231 - 248
• Main Authors: Maberly, D J, Anthony, H. M.
• Format: Journal Article
• Language: English
• Published: Taylor & Francis 01.01.1992
• Subjects: asthma; avoidance; chemical sensitivity; follow-up; food intolerance; inhalant allergy; prophylaxis; therapy
• ISSN: 0955-6664
• DOI: 10.3109/13590849208997979

A cohort of 19 consecutive asthma patients, stable prior to admission, were investigated in the 'clean' atmosphere of the Airedale Allergy Centre, starting with a therapeutic fast. the peak expiratory flow rate (PEF) fell initially, whether medication had been reduced or not (withdrawal), but by about the sixth day most patients were symptom-fiee on less medication; by the last week of admission the reduction in medication was very highly significant (p < 0.0005). All patients gave positive wheals on intradermal injection of inhalant allergens (4 prick-test negative). Bronchoconstriction was provoked by open food challenge in 18 patients, and by sublingual challenge with chemicals in ten patients. The implications of the findings were discussed with the patients at each stage of the investigation. They were discharged on 'vaccines' containing their Miller endpoints [1] for prophylaxis, and an individually designed rotation diet (including most trigger foods), and advised how to reduce exposure to relevant inhalants and chemicals. At follow-up >6 months after discharge, patients had more control over their asthma: 13/19 (68%) claimed to be at least 'definitely better': 5 'well' or 'almost well'. Symptoms were significantly reduced, and medication was lower at follow-up than on admission (p < 0-01). Compliance correlated with outcome (tau=0-37, p < 0.05): outcome was not related to inhalant prick-test reactivity. the study underlines the need for a randomized trial testing this management against conventional management of asthma.