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An Integrative Approach to Atopic Disorders in Children

Lawrence D. Rosen, M.D.

Atopic disorders, including asthma, allergic rhinitis, and eczema, are widely considered to be rising in prevalence at epidemic rates. Support for this concern comes from several multinational sources, including the recently published International Study of Asthma and Allergies in Childhood (ISAAC), which surveyed rates of atopic disease in nearly 200,000 children ages 6–7 in 37 countries and in more than 300,000 children ages 13–14 in 56 countries.

The United States Centers for Disease Control and Prevention estimated that the prevalence of asthma among U.S. children has increased from 3.6 percent in 1980 to 5.8 percent in 2003. Food allergies have also risen in prevalence in the United States, with reactions to peanuts and tree nuts reportedly doubling over a 5- year period. Eosinophilic esophagitis, a formerly rare allergic disorder leading to severe gastroesophageal reflux in newborns, has been rapidly increasing in prevalence in many Western countries, including Australia. Primary care pediatric practitioners are seeing many more infants who have early atopic signs (dermatitis, gastroesophageal reflux, chronic rhinorrhea, and recurrent wheezing).

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