Asthma and comorbidities

Abstract

This article summarizes the more common comorbidities which, in the opinion of the authors and supported by the medical literature, frequently affect asthma management. Optimal asthma control requires accurate diagnosis, implementation of effective therapy, and evaluation of coexisting conditions. Comorbidities refer to either coexisting conditions or interacting conditions, with the latter having a more significant influence on the management of asthma. This review provides the authors' clinical perspective of the more common comorbidities and relevant literature reviewed primarily from the past 4-5 years. Optimizing rhinitis and rhinosinusitis management and addressing allergic sensitivity and allergen exposure are achievable measures for the most common asthma comorbidity. Psychological dysfunction and paradoxical vocal cord dysfunction are frequently associated with poor asthma control. The effects of obesity are inconsistent in the literature but obesity likely affects asthma symptoms and possibly its pathogenesis. Treatment of asymptomatic gastroesophageal reflux does not improve asthma. Asthma is a common disease and other conditions frequently occur concomitantly in individuals with asthma. Asthma is usually very treatable and comorbidities should be considered and addressed or the asthma diagnosis questioned if treatment effects are not optimal. Evidence-based medicine is lacking as most asthma studies exclude comorbidities; additional studies are needed.