Asthma

In this Article

• Myths, facts, and statistics about asthma
• What is asthma?
• From the past to the present
• The scope of the problem
• Normal bronchial tubes
• How does asthma affect breathing?
• The importance of inflammation
• Which triggers cause an asthma attack?
• The many faces of asthma
• Types: allergic (extrinsic) and nonallergic (intrinsic) asthma
• Typical symptoms and signs of asthma
• Acute asthma attack
• What medications are used in the treatment of asthma?
• Asthma At A Glance
• Patient Discussions: Asthma - Effective Treatments

The importance of inflammation

Inflammation, or swelling, is a normal response of the body to injury or infection. The blood flow increases to the affected site and cells rush in and ward off the offending problem. The healing process has begun. Usually, when the healing is complete, the inflammation subsides. Sometimes, the healing process causes scarring. The central issue in asthma, however, is that the inflammation does not resolve completely on its own. In the short term, this results in recurrent "attacks" of asthma. In the long term, it may lead to permanent thickening of the bronchial walls, called airway "remodeling." If this occurs, the narrowing of the bronchial tubes may become irreversible and poorly responsive to medications. Therefore, the goals of asthma treatment are: (1) in the short term, to control airway inflammation in order to reduce the reactivity of the airways; and (2) in the long term, to prevent airway remodeling.

Allergy assist

The hallmark of managing asthma is the prevention and treatment of airway inflammation. It is also likely that control of the inflammation will prevent airway remodeling and thereby prevent permanent loss of lung function.

Various triggers in susceptible individuals result in airway inflammation. Prolonged inflammation induces a state of airway hyperreactivity, which might progress to airway remodeling unless treated effectively.

Which triggers cause an asthma attack?

Asthma symptoms may be activated or aggravated by many agents. Not all asthmatics react to the same triggers. Additionally, the effect that each trigger has on the lungs varies from one individual to another. In general, the severity of your asthma depends on how many agents activate your symptoms and how sensitive your lungs are to them. Most of these triggers can also worsen nasal or eye symptoms.

Triggers fall into two categories:

• allergens ("specific") and



• nonallergens -- mostly irritants (nonspecific).

Once your bronchial tubes (nose and eyes) become inflamed from an allergic exposure, a re-exposure to the offending allergens will often activate symptoms. These "reactive" bronchial tubes might also respond to other triggers, such as exercise, infections, and other irritants. The following is a simple checklist.

Common Asthma Triggers:

Allergens

• "seasonal" pollens



• year-round dust mites, molds, pets, and insect parts



• foods, such as fish, egg, peanuts, nuts, cow's milk, and soy



• additives, such as sulfites



• work-related agents, such as latex

Allergy fact

About 80% of children and 50% of adults with asthma also have allergies.

Irritants

• respiratory infections, such as those caused by viral "colds," bronchitis, and sinusitis



• drugs, such as aspirin, other NSAIDs (nonsteroidal antiinflammatory drugs), and beta blockers (used to treat blood pressure and other heart conditions)



• tobacco smoke



• outdoor factors, such as smog, weather changes, and diesel fumes



• indoor factors, such as paint, detergents, deodorants, chemicals, and perfumes



• nighttime



• GERD (gastroesophageal reflux disorder)



• exercise, especially under cold dry conditions



• work-related factors, such as chemicals, dusts, gases, and metals



• emotional factors, such as laughing, crying, yelling, and distress



• hormonal factors, such as in premenstrual syndrome

Asthma - Effective Treatments

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What kinds of treatments have been effective for your asthma?

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