Asthma

When you breathe in, air passes from your nose and mouth to your lungs through a system of tubes referred to as airways or bronchial tubes. This is much like a tree trunk and branches. The trunk is the windpipe which branches off to smaller airways called bronchi. Asthma is an “airway transportation” problem. The lungs function normally in their job of extracting oxygen from air taken in with inspiration. However, the bronchial tubes become swollen, irritated, narrowed, and full of mucous. This congestion causes the work of breathing to increase. Therefore, asthmatics will experience symptoms of shortness of breath, wheezing, cough and chest tightness as a result of extensive narrowing and swelling of the airways throughout both lungs. Sometimes, a chronic cough is the only symptom (cough variant asthma).

Asthma symptoms can occur daily, weekly or intermittently and range from mild to severe. This can be very frightening to people with asthma as well as their families. There are an estimated 20 million people living in the United States with self-reported asthma. It is extremely important to seek medical attention for this illness. It is the most common chronic illness among children and if left untreated or under-treated, asthma may result in a significant reduction in quality of life, with potential loss of lung function, exercise limitation, difficulty sleeping, school or work absenteeism, costly emergency room visits and in a few cases, death.

There is no cure for asthma but the symptoms can be well controlled with medications and other proper treatment. Asthma triggers (see below) are noted on the initial office visit. Since more than 60% of asthmatics have an allergic trigger, skin testing should be done with the results evaluated by a certified allergist.

Asthma Triggers

Asthma inflammation occurs for reasons that are still not well understood but there seem to be specific triggers which worsen asthma. Sometimes two or more triggers are necessary before asthma symptoms worsen.

Allergies (mold, dust mites)

Upper respiratory infections

Irritants- fumes, odors, smoke

Weather changes/ barometric pressure changes

Cold Air

Exercise

Emotion ( laughter)

Medications ( beta blockers)

Asthma diagnosis

Diagnosis of asthma is made by history of symptoms, physical examination, and lung function studies.

Occasionally a transient asthma-like condition presenting with a hacking cough may occur following certain viral upper respiratory infections. This post-viral cough may last for many months following the initial infection.

Types of Asthma Medications

Bronchodilators- inhaled medication to relax swollen muscles and open airways.

Inhaled Steroids- safe, inhaled, medications used daily for a block of time (or year round) for prevention of symptoms.

Combination Inhalers- contain both steroids and bronchodilators for more effective control of symptoms

Montelukast- tablets that prevent asthma symptoms but not as reliably as inhaled steroids.

Xolair- a biological injectable medication which reduces IGE and thereby reduces asthma symptoms and exacerbations. This medication is prescribed with combination inhalers and even with allergy injections. It is reserved for the most severe allergic asthmatics.

Please read our allergy posts for research updates on asthma and other allergic conditions.