Summary for HealthiNation’s Asthma

Hosted by Dr. Holly Phillips, Internal Medicine

What Is Asthma?

Asthma occurs when the passageways to the lungs become inflamed, making it difficult to breathe. When an asthma attack happens, the small tubes that carry air through the lungs react to the asthma trigger and begin to swell. This tightens the airway and allows less air to flow through. At the same time, the muscles that surround the tubes also constrict and close the tubes even further. Inside the tubes is a mucous lining. When the tubes start to tighten, the lining produces more mucous, which collects inside the tubes, also blocking air flow.

Causes of Asthma

There is no single cause of asthma, but you're more likely to develop it if you have a family history of it. Asthma can develop at any age, especially if you have allergies or are sensitive to other irritants in the environment. In most cases though, asthma results from reactions to triggers. These can either be allergic or non-allergic.

They include:

• Allergens, like pollens, molds, pet dander, dust, or cockroaches
• Air pollution or irritants like farming chemicals, nail polish, hair spray, paint fumes and home cleaning products
• Respiratory infections, like the common cold or sinusitis. And we all know children pick up these infections more frequently because they're exposed to them at school.
• Exercise
• Exposure to cold air
• Smoking and second-hand smoke
• Certain medications
• Sulfites, which are preservatives that are added to a lot of processed foods

If you have GERD, or acid reflux, this may also worsen your asthma symptoms.

Childhood Asthma

There are certain factors that increase a child's chance of developing asthma, including:

• Having a parent with asthma
• Living in a polluted city
• Exposure to second-hand smoke, especially at home
• Being overweight

Asthma Symptoms & Asthma Attack Warning Signs

Asthma symptoms are unique to each person. The signs and symptoms can range from mild to severe and each episode may vary. Avoiding asthma attacks starts with knowing the triggers but all asthma attacks give warning signs, which can include:

• Shortness of breath, coughing or wheezing during the day or night
• Chest tightness or chest pain
• The need to use inhalers or other medications more often
• High-pitched whistle when exhaling
• Coughing spasms

If you think you or your child may be having an asthma attack, stop all activity, sit down, and take long, slow, deep breaths. You may need to call your doctor, or even visit the emergency room.

Diagnosing Asthma

Diagnosing asthma can be difficult because the signs and symptoms can range from mild to severe and a lot of times can look like other conditions.

Your doctor will ask about your medical history and then start with a full physical exam. You may also be given a series of pulmonary function tests, or PFTs. They will reveal how much air moves in and out of your lungs as you breathe, both before and after using an inhaler.

The results of your physical exam and PFTs will help your doctor classify how severe your asthma is and how it should be treated.

There are four main classifications of asthma:

• Mild intermittent – This is the mildest form of asthma. When uncontrolled, it will cause symptoms up to two days per week and up to two nights per month.
• Mild Persistent Asthma - If you have this form of asthma, you have symptoms more than two nights per month and more than twice a week but not more than once in a single day.
• Moderate Persistent – This type causes symptoms every day and more than one night per week.
• Severe Persistent - This is the most serious form of asthma. It will cause symptoms throughout the day almost every day and frequently at night.

Treating Asthma

Since asthma affects everyone differently, you should work with your doctor to decide which treatment options are best for you based on the severity of your asthma, your age, and overall health. In general there are four types of treatments.

• Long-Term Medications. These are usually taken daily. Inhaled corticosteroids are among the most common.
• Long-acting Beta Agonists. These are part of a group of medications called bronchodilators, which open up constricted airways. They are used to control moderate and severe asthma and to prevent nighttime symptoms. They can also be used before exercising or exposure to cold air.
• Leukotriene Inhibitors. These block leukotrienes, which are substances that are released in your lungs during an asthma attack. These medications are an option for managing mild asthma, and are usually used along with other treatments, like inhaled steroids.
• Cromolyn Sodium and Nedocromil. These are used less commonly, but help prevent attacks triggered by exercise.

Your doctor may also prescribe other treatments for you to use from time to time, like albuterol, which is a short-acting beta agonist.

If you know you have asthma and your medication is not working, speak with your doctor immediately to make adjustments based on his or her guidance. The bottom line is that when these medications are used properly, most asthmatics live their lives virtually symptom-free.

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.