Asthma

What Is Asthma?

Asthma is a disease that affects the breathing passages of the lungs (bronchioles). Asthma is caused by chronic (ongoing, long-term) inflammation of these passages. This makes the breathing passages, or airways, of the person with asthma highly sensitive to various “triggers.”

When the inflammation is “triggered” by any number of external and internal factors, the passages swell and fill with mucus.
Muscles within the breathing passages contract (bronchospasm), causing even further narrowing of the airways.
This narrowing makes it difficult for air to be breathed out (exhaled) from the lungs.
This resistance to exhaling leads to the typical symptoms of an asthma attack.

Because asthma causes resistance, or obstruction, to exhaled air, it is called an obstructive lung disease. The medical term for such lung conditions is chronic obstructive pulmonary disease or COPD. COPD is actually a group of diseases that includes not only asthma but also chronic bronchitis and emphysema.

Like any other chronic disease, asthma is a condition you live with every day of your life. You can have an attack any time you are exposed to one of your triggers. Unlike other chronic obstructive lung diseases, asthma is reversible.

Asthma cannot be cured, but it can be controlled.
You have a better chance of controlling your asthma if it is diagnosed early and treatment is begun right away.
With proper treatment, people with asthma can have fewer and less severe attacks.
Without treatment, they will have more frequent and more severe asthma attacks and can even die.

Asthma is a very common disease in the United States, where more than 20 million people are affected. In children, asthma is the most common chronic condition seen, currently affected approximately 6.1 million children under the age of 18, according to the American Lung Association. Asthma affects all races and is slightly more common in African Americans than in other races.

Common Triggers of Asthma:

ALLERGIES (molds, pollen, dust mites, cockroaches, animals–especially cats and dogs)
TOBACCO SMOKE
INFECTIONS (viral respiratory infections, colds, sinus infections)
OUTDOOR AIR POLLUTION
INDOOR AIR POLLUTION (aerosol sprays, cooking fumes, odors, smoke: cigarettes/tobacco, wood fires, wood-burning stoves)
EXERCISE

Asthma Symptoms:

When the breathing passages become irritated or infected, an attack is triggered. The attack may come on suddenly or develop slowly over several days or hours. The main symptoms that signal an attack are as follows:

wheezing,
breathlessness,
chest tightness,
coughing, and
difficulty speaking.

Symptoms may occur during the day or at night. If they happen at night, they may disturb your sleep.

Wheezing is the one of the most common symptoms of an asthma attack.

Wheezing is a musical, whistling, or hissing sound with breathing.
Wheezes are most often heard during exhalation, but they can occur during breathing in (inhaling).
Not all asthmatics wheeze, and not all people who wheeze are asthmatics.

Current guidelines for the care of people with asthma include classifying the severity of asthma symptoms, as follows:

Mild intermittent: This includes attacks no more than twice a week and nighttime attacks no more than twice a month. There should be no interference with normal activity.
Mild persistent: This includes attacks more than twice a week, but not every day, and nighttime symptoms more than twice a month. Attacks are sometimes severe enough to interrupt regular activities.
Moderate persistent: This includes daily attacks and nighttime symptoms more than once a week. Attacks require daily use of quick-relief (rescue) medication and changes in daily activities.
Severe persistent: This includes frequent severe attacks, continual daytime symptoms, and frequent nighttime symptoms. There is extreme limitation and interference with normal activity.

Just because a person has mild or moderate asthma does not mean that he or she cannot have a severe attack. The severity of asthma can change over time, either for better or for worse. Therefore, patients with asthma should be evaluated on a regular basis to ensure they are achieving good control of their symptoms. In some cases, patients may require a step-up in therapy to achieve better control; in other cases, patients may be good candidates to consider stepping down medical management if asthma has been well controlled for at least 3 months.

Outlook:

It is important to develop a personalized Asthma Action Plan with your provider so that you as a patient (or a parent) can identify symptoms of worsening asthma and learn how to address them, as well as be aware of when to seek additional medical care.

The good news for people with asthma is that you can live your life to the fullest. Current treatments for asthma, if followed closely, allow most people with asthma to limit the number of attacks they have. With the help of your health-care provider, you can take control of your care and your life.