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Treatment: What is the impact of co-morbidities on asthma?
The patient has the same respiratory mucosa in the upper and lower airways.17, 18 Thus it makes sense that upper-airway diseases can influence lower-airway function in many patients with asthma. Inflammation plays a critical role in the pathogenesis of rhinitis, sinusitis and nasal polyps, just as in asthma. Asthma and rhinitis often co-exist in the same patient and sinusitis is a complication of upper-respiratory infections, allergic rhinitis, nasal polyps and other forms of nasal obstruction. Nasal polyps are often associated with asthma and rhinitis and often with aspirin sensitivity.1
Several other co-morbidities are of potential importance and their joint management in primary care is worthy of research as they have all been poorly researched to date. These include the combinations of asthma with COPD, gastro-oesophageal disease and obesity.
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