Asthma: Allergy and Air Tubes

Asthma is a lung disease that can be treated. It is a chronic inflammatory disease of the respiratory system that results in relapsing symptoms. In simpler terms, asthma is the narrowing of the airways in the lungs that causes wheezing, coughing, and gasping for breath. It is a very unpredictable disease and can differ greatly from one person to the next. Some people have very mild symptoms every once and a while where as for others it is a daily struggle to breath. Asthma can occur at any age but most commonly begins with in the first five years of life. Approximately 7% of Americans suffer from asthma, which is roughly 18 million people, 4.8 million of which are children. Asthma is the leading cause for hospitalization among children and is the most common long-term childhood disease. “African-Americans are four times as likely as whites to be hospitalized and three times as likely to die from asthma.” This is partially because asthma is more sever in urban inner cities. Although many cases of asthma have been identified in the United States, many cases are likely to go undiagnosed.

There are eight main signs or symptoms that help identify asthma trouble. The four most common are recurrent wheezing, shortness of breath, feelings of tightness in the chest, and a cough that lasts over a week. Two symptoms are more prominent in children than in adults. They are blue nails and lips, sudden anxiety and apprehension. The last two symptoms to watch out for are when breathing out takes longer than breathing in and when breathing is faster than normal. These symptoms usually occur in episodes and are often called asthma attacks. “When an asthma attack occurs, three major changes take place in the lungs. Cells in the air tubes make more mucus than normal. Cells in the airways get inflamed causing air tubes to swell. The muscles around the air tubes tighten. These changes cause the air tubes to narrow which makes it hard to breath.”

Asthma attacks are caused by something that bothers the lungs. These are most often called “triggers.” There are two main types of triggers, allergic and non-allergic. Allergic triggers, also known as allergens, are substances that cause no problems in some people but in others, stimulate an allergic reaction causing an asthma attack. Examples of allergens are molds, pollen, dust mites, cockroaches, and animal dander (flakes from skin, hair or feathers). They trigger asthma symptoms by entering the lungs as we breath. The other main type of triggers are non-allergic. They stimulate receptors in the respiratory tract causing muscles to tighten, resulting in an asthmatic episode. They are also called irritants. Examples of irritants are tobacco smoke, perfume, paint and hairspray, cleaning products, exercise, a chest infection, certain medications and changes in the weather.

Prevention is the best way to reduce your asthma symptoms and your need for medications. Controlling your exposure to the things that trigger your attacks is one of the best methods of prevention. First, you must know what triggers cause you to have asthmatic episodes. One of the best ways to figure this out is to keep an asthma diary. Every time you have an attack, write down where you are, what you were doing and possible triggers that could have caused the attack. Many triggers are present in the home and since the majority of people spend one-third of their day in their homes, this is a great place to start the control process. Removing as many asthma triggers as possible from your home is important in controlling your asthma. One tip for allergy proofing your home is to encase your pillows and mattresses in mite-proof covers. This will prevent dust mites from forming in your bed and reduce the chance of an asthmatic episode occurring during the night. It is a good idea to keep pets outside and out of places like the bedroom. This will prevent their dander from floating around the house and lessen the chance it will enter your lungs. When cleaning, use a bleach solution to kill mold and mildew in the bathroom. If you have outdoor allergies, it is a good idea to drive with the windows up and use the air conditioning during pollen season. If you must work outside, wear a dust mask to keep unwanted particles out of your lungs. Whether you are indoors or outdoors, it is very important for people with asthma to avoid second hand smoke. You should speak with your doctor about an Asthma Management Plan that is designed just for you. An Asthma Management Plan lays out your personal treatment goals and a schedule of your daily medications.

When prevention is not enough to keep your allergies from triggering your asthma, medications to help manage your asthmatic episodes may be necessary. There are two main types of medications used to treat asthma: relievers and preventers. Bronchodilators, referred to as relievers, fight airway constriction. They relax the muscles that surround the air tubes and allow you to breath more easily. They work so fast that you notice the effect almost immediately. “However, physicians realize that bronchodilators do only half the job.” They do little to treat the underlying inflammation. Anti-inflammatory agents, or preventers work to prevent and reverse airway inflammation and they reduce airway sensitivity. This helps keep the airway from becoming constricted. However, they work much slower than relievers and must be taken regularly if they are going to be effective. When used on a regular basis they help to control the symptoms of asthma. These medications come in one of two forms, inhalers and tablets. “The most commonly used asthma inhaler is the aerosol spray inhaler. But there are dozens of other types of inhalers available.” If you do not want the hassle of dealing with an inhaler, you can choose to take a tablet. People with very severe asthma can choose to take a steroid tablet. However, they often have powerful side effects and must be used long-term. There is a tablet called theophylline that is very helpful when taken as an add-on treatment to inhalers. Studies show that inhaled medication works more effectively than tablets. Whatever form of medications you and your doctor decide is best for you; remember that their goal is to maintain “normal” lung functions. Medications are meant to allow you to continue living your life at normal activity levels.

“Asthma is classified into a number of categories based on severity of symptoms: intermittent, mild persistent, moderate persistent, and severe persistent.” These classifications help doctors determine which treatments to prescribe. Patients with intermittent or situational asthma only have symptoms present when they are exposed to certain triggers. You can avoid an asthma attack by simply avoiding those triggers that cause your symptoms. People with intermittent asthma usually do not need long-term medication. Patients with mild persistent asthma have symptoms more than twice a week but less than every day of the week. If you have this type of asthma, you need long-term preventive medication. The third type of asthma is moderate persistent asthma. Patients who suffer from moderate persistent asthma have daily symptoms and need long-term preventive medication. However, they will need to use it more frequently than someone with mild persistent asthma. The final type of asthma is the hardest to control. It is severe persistent asthma. Symptoms occur on a continual basis and require the use of long-term controller medications multiple times a day.