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What Is Asthma?

Asthma is a chronic lung disease that inflames and narrows the airways, making it difficult to breathe. It is estimated that 26 million Americans have asthma and it is one of the leading causes of work and school absenteeism. It has no known cure, but by identifying triggers and developing a proper management plan, asthmatics can lead a healthy, active life. Asthma affects people of all ages, but it most often starts during childhood.

What Causes Asthma?

Asthma has a strong genetic component. If you have asthma, others in your family may have asthma as well. Allergens, irritants (such as cigarette smoke and pollution), respiratory infections, weather changes and exercise can trigger asthma symptoms. However, whatever one’s triggers are, the underlying lung problem, inflammation, remains the same.

Allergic asthma is triggered by allergic reactions to allergens such as pet dander, dust mite, mold or pollen. Sometimes asthma symptoms may only occur during the pollen seasons. Identifying your specific allergic triggers is essential to managing your asthma.

Exercise-induced asthma is triggered by exercise or physical activity.

Occupational asthma is triggered by workplace irritants such as chemical fumes, gases or dust

Nocturnal asthma can occur with any asthmatic. Asthma symptoms will often increase or worsen at night.

Symptoms

How Do I Know If I Have 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. People with asthma experience extensive narrowing of the airways throughout both lungs, resulting in symptoms that often include:

  • Shortness of breath
  • Wheezing
  • Cough
  • Chest tightness

Asthma symptoms can occur daily, weekly or infrequently, and can range from mild to severe. Many of these symptoms can be very frightening to people with asthma as well as their families. 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, even death.

The good news? Though there is no cure for asthma, when properly diagnosed and treated with medications, and when “triggers” are identified and avoided, the symptoms and permanent effects of asthma can be greatly reduced, if not eliminated.

A board-certified allergy and asthma specialist will diagnose asthma after an extensive patient interview, physical exam and a lung function test. The allergists at Atlanta Allergy & Asthma are specially trained to identify the triggers of asthma and in prescribing a management plan that allows for a healthy, active lifestyle.

Testing

How Do You Test for Asthma?

An asthma diagnosis is based on several different things, including medical history, physical exam, and results of certain tests, such as lung tests. Your doctor may ask about your medical history, including any allergies, examine your nose, throat, and upper airways and listen to your breathing. The tools physicians use to diagnose asthma can include lung function tests and chest or sinus x-rays.

Treatment

How Is Asthma Treated?

A high percentage of asthma patients suffer from allergies. Up to 80% of childhood asthma patients and 70% of adult asthmatics have some allergies. Controlling allergies is the first step to controlling asthma.

There are two types of medicines for the treatment of asthma

  1. Rescue/reliever medicines Medicines provide quick relief of sudden symptoms. Rescue medications start to alleviate the symptoms of asthma within a few minutes by relaxing the muscle spasms within the airways. The most commonly prescribed medication for rescue of asthma symptoms is albuterol, or a related medication called levalbuterol. The rescue medications can be administered via an inhaler or aerosolized with a nebulizer. Typically, these medications can be given every 4 to 6 hours as needed. Trade names for rescue medications include ProAir HFA, Proventil HFA, Ventolin HFA and Xopenex HFA.

    For children, their rescue inhaler is often used with a device called a spacer. This device helps children inhale the medication into the lungs to alleviate symptoms of asthma. Your doctor may also prescribe a nebulizer for aerosolized delivery of the medication.

    Side effects can include tremor, rapid heart rate and nervousness, all of which dissipate within a few minutes of taking the medication.

  2. Controller medicines provide long-term control of asthma and prevent future symptoms. Your doctor will determine if the frequency and severity of your or your child’s symptoms require the use of a maintenance medication. All of the controller medications work by reducing the inflammation in the airways. By reducing swelling, the lungs are stronger and a patient is much less likely to have asthma symptoms.

    The most commonly prescribed medication in maintenance control of asthma is an inhaled steroid. These can be given as an inhaler or via the nebulizer in small children. These medications treat the inflammation within the lungs, the primary problem in asthma. Trade names for inhaled steroid medications that your doctor may prescribe include: Flovent, Qvar, Asmanex, Pulmicort and Alvesco. The inhalers for these medications differ between brands and your doctor will teach you how to properly administer to ensure that the medications reach the lungs. Corticosteroid medications have developed a scary reputation, but especially when inhaled, are extremely safe and effective for controlling asthma inflammation. The steroids that athletes take are a different type of steroid and are not related to the medications we use to treat asthma.

It is very important that you or your child take all the medicines that the doctor prescribes. A common mistake is to stop taking controller asthma medications when the symptoms improve. Symptom improvement is due to the medication, it does not mean the asthma is gone. Leaving asthma untreated has much bigger risks than any risks associated with the medications. Asthma may improve or worsen with changes in seasons and exposure to asthma triggers, therefore it is important to have regular check-ups to evaluate and monitor your asthma as medication changes are necessary from time to time.

Biologics in the Treatment of Asthma

For most people with mild to moderate asthma, the controller medicines work well to prevent asthma attacks and the quick-relief/rescue medicines are effective once symptoms start. However, for 5-10 percent of people with this condition, traditional asthma therapies may not work. There is a relatively new group of prescription drugs, called biologics, that target the pathways that link inflammation to asthma, rather than just treating the symptoms.

There are two types of biologic drugs approved to treat severe asthma. One type is used for patients with allergic asthma and the other for those with eosinophilic asthma. Based on the type of asthma, your Atlanta Allergy & Asthma physician will determine the biologic therapy appropriate for you.

Useful Resources

American College of Allergy Asthma & Immunology

American Academy of Allergy Asthma & Immunology

American Lung Association

Centers for Disease Control and Prevention