ASTHMA DEFINITION:

Asthma is an inflammatory disease of the airways of the lungs that causes wheezing and/or difficulty breathing.

SYMPTOMS:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest pain
  • Abdominal pain
  • Vomiting

CAUSES:

Asthma tends to run in families where there is a history of asthma or allergies. Many people who have asthma will have a trigger that will bring on an asthma attack. These triggers include:

  • Viral infections such as colds
  • Allergies
  • Exercise
  • Exposure to cigarette smoke
  • Changes in weather & humidity
  • Emotional stress
  • Hormonal changes such as menses

Sometimes the illness simply appears without an apparent trigger.

CONTAGION:

This is not a contagious illness.

DIAGNOSIS:

The diagnosis is usually made clinically which means by history and physical. If a person has recurrent wheezing, one can safely say they have asthma. Pulmonary function testing can be done to help confirm the diagnosis. This is where a person blows as hard as they can into a machine that takes measurements of air flow. These measurements help to confirm the diagnosis. A less technical measurement of airflow can be taken with a small hand-held peak flow meter. The pulmonary function testing and peak flow meter can also be used to show response to treatment. An x-ray can be taken to rule out any other illness or a foreign body such as a toy in the lungs.

OUTCOMES:

Asthma is a chronic disease. The disease course tends to follow family history. If a father had asthma as a child but stopped wheezing at age 12, the same is likely for his son. However, not all asthma follows a family history and for some this is a lifelong illness. Although treatments are improving, the overall incidence of asthma and deaths from asthma are increasing. This may be due to environmental factors such as smoking or pollution, misunderstanding and misuse of the medications, misdiagnosis of asthma as chronic bronchitis, allergic bronchitis, or allergic cough allowing under-treatment of this condition.

TREATMENT:

Asthma is a chronic disease of varying severity. Treatment will depend on the severity of the illness and the response to each treatment mode. The goal of treatment is to have a normal lifestyle, to prevent asthma exacerbations as much as possible, and to avoid the side effects of medications as much as possible.

In order to treat asthma properly, the severity of asthma has been categorized as:

  • Mild Intermittent
  • Mild Persistent
  • Moderate Persistent
  • Severe Persistent

The National Heart, Lung, and Blood Institute, National Institutes of Health Expert Report 2: Guidelines for the Diagnosis and Management of Asthma has an excellent method for the diagnosis and treatment of asthma for children under 5 years of age and for older children or adults.

GOALS FOR ASTHMA TREATMENT:

  • Prevent chronic and troublesome symptoms (e.g., coughing or breathlessness at night, in the morning, or after exertion).
  • Maintain (near) “normal” pulmonary function.
  • Maintain normal activity levels (including exercise and other physical activity).
  • Prevent recurrent exacerbations of asthma and minimize the emergency room visits or hospitalizations.
  • Provide optimal pharmacological therapy with minimal or no adverse effects.
  • Meet patients’ and families’ expectations of asthma care.

Written by Dr. Michael Bornstein, who has over 28 years of experience as a pediatrician. 

Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.