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Aspirin induced asthma was first described over one hundred years ago. There is a large body of clinical evidence to support the association between aspirin use and the development of asthmatic symptoms. However, contrary to common wisdom, this reaction is not a typical allergic reaction. The reasons and causes asthmatic symptoms are associated with aspirin use are complex.

Aspirin Exacerbated Respiratory Disease (AERD) is the medical term now being used to describe aspirin induced asthma. This term is more accurate than "aspirin induced asthma" as it is now thought that aspirin does not cause the asthma, so much as it makes a pre-existing disease worse.

There is no definitive cure for aspirin exacerbated respiratory disease. The best management approach is to simply avoid the use of aspirin and other nonsteroidal anti-inflammatory medications which can cause a flareup of the asthmatic symptoms. Most people with AERD do not show problems with exposure to aspirin until they are in their 30s or 40s. This condition is therefore quite uncommon in children.

Symptoms of AERD are similar to any presentation of asthma. Often the wheezing and shortness of breath will not become apparent until two or three hours after a person takes a dose of aspirin or other nonsteroidal anti-inflammatory medication.

The most common symptoms include coughing, wheezing, shortness of breath, and even a runny nose. It is also possible to experience some degree of chest pain.

AERD is not limited just to the use of aspirin. Any medication that inhibits the cyclo-oxygenase one (COX-1) pathway has the ability to induce an asthmatic reaction. The exact mechanism by which COX-1 and asthma are related would require a very complex explanation which is outside the scope of this article. However, the end result of the inhibition of the COX-1 pathway is the production of a series of chemicals that induce constriction of the airways in the lungs. This constriction leads directly to the symptoms seen in in exacerbation of asthma.

In addition to the use of aspirin, various types of nonsteroidal anti-inflammatory medications such as Advil or Motrin have been associated with the development of AERD.

Diagnosing a person with a AERD can often be more difficult than a seen. Because of the frequent use of NSAIDs and aspirin asthmatics during asthma exacerbations, it is often hard to establish a solid cause-and-effect relationship between asthma symptoms and aspirin or NSAID use.

Treatments for AERD are similar to any cause of asthma. In addition, limiting or tightly restricting the use of aspirin is an obvious step in the prevention of this problem. It should be noted that the only COX-2 selective inhibitor remaining on the market, Celebrex, has not been shown to increase the risk of asthmatic symptoms. Many doctors are using a category of medications known as leukotriene inhibitors to treat a AERD. Two examples of these medications include zileuton and montelukast.

If you experience wheezing, shortness of breath, or other asthmatic symptoms after taking aspirin, be sure to contact your doctor as soon as possible. This is especially important for people who have pre-existing asthma or other lung disorders.

Learn more about this author, Erich Rosenberger M.D..
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