Why do I have wheezing and phlegm despite treatment?

Question

Hi doctor,

I have been experiencing recurrent wheezing and excessive phlegm for the past two years. My IgE level is 300, which is quite high. Currently, I am taking Montair LC once daily, Wysolone 20 mg twice daily for seven days, Theo-Asthalin tablets twice daily, and using a Foracort inhaler. However, I have not noticed any improvement in my symptoms.

Please guide

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concerns.

Since your IgE (immunoglobulin E) level is elevated at 300 IU/mL, your symptoms are likely related to an allergic airway disease, such as allergic asthma or allergic bronchitis.

The persistent wheezing and excessive phlegm despite current treatment suggest that we need to evaluate the underlying cause more thoroughly. I recommend starting with a chest X-ray; if your symptoms persist or if the X-ray results are inconclusive, a CT (computed tomography) scan of the chest may be necessary to rule out other conditions.

Additionally, undergo a food allergy test or an allergy panel to help identify possible triggers contributing to your high IgE levels and recurrent symptoms.

For treatment, continue using the Foracort (Budesonide and Formoterol Fumarate) inhaler regularly as prescribed, as it is the most important long-term controller.

Avoid prolonged or repeated use of oral steroids like Wysolone (Prednisolone) unless necessary, as these should only be taken if your symptoms are severe and under medical guidance.

Other medications can be adjusted once we have the results of the investigations. Once the imaging and allergy test results are available, please schedule a review to discuss them so we can optimize your inhaler therapy and plan a targeted treatment strategy that minimizes reliance on repeated oral steroids.

If you have any more questions, feel free to ask. I would be happy to guide you. Please keep your valuable feedback for better patient care.

Thank you so much.