Asthma is a chronic disease of the airways in the lung due to inflammation or swelling. This inflammation of the air tubes makes it more difficult to get air through the tubes. In addition to inflammation, lungs with asthma often make excess mucous and the muscles around each air tube are more likely to constrict (bronchoconstriction) and cause the airways to become even smaller. So there are three different causes of asthma inside the lungs that lead to the symptoms of asthma such as coughing, wheezing and shortness of breath.
For many Colorado patients with asthma the symptoms are not present every day, but may increase if triggered by a viral illness, exercise, tobacco exposure or allergen exposure (pet dander or pollens). Research has shown that inflammation of the lungs is still present even if you feel well in between episodes of breathing problems.
How is Asthma Diagnosed?
The diagnosis of asthma can be difficult but many things can help your doctor determine if you have asthma:
• Lung function testing: such as a peak flow meter or a spirometry.
• A peak flow meter which can be used at home to help you and the doctor determine how the asthma affects the your lungs from day to day.
• Spirometry is a blowing test that can be done in the doctor’s office, helps the doctor understand how your lungs function.
• Symptoms will also help the doctor determine if your breathing problems are asthma. The doctor will need to know which respiratory symptoms you experience: Coughing? Wheezing? Shortness of breath? The doctor will also want to know when these symptoms occur and how often.
• Whether or not medications have helped your breathing problems in the past is also good information for the doctor.
• Finally the doctor will want to know if you smoke tobacco currently or have ever smoked tobacco in your life or lived with a smoker. The doctor may also have questions about any inhalation exposures you may have had at a current or previous job.
Who Develops Asthma?
At this time we do not know exactly why some people develop asthma and others do not. We do know that asthma is often related to being allergic or atopic, and people with allergies and/or atopic dermatitis (eczema) are more likely to develop asthma. We also know that being allergic is inherited from one’s parents, and having a parent with asthma increases the chance of developing asthma.
How is Asthma Treated?
How your doctor treats asthma will depend on several factors including the severity of the asthma in each patient. There are two different groups of asthma medications, rescue medications and controller medications.
- Rescue medications are used when you have symptoms of cough, wheeze or shortness of breath. These medications (such as albuterol and Xopenex) work by relaxing the muscles around the air tubes so that air can move in and out more easily. These medicines are inhaled into the lung either by a handheld metered dose inhaler (MDI) or by nebulizer.
- Controller medications are used to control the asthma symptoms by decreasing the inflammation, decreasing mucous production, and relieving bronchoconstriction. The most common type of controller medication used is an inhaled steroid. There are also controller medications called leukotriene receptor antagonists that work by a different pathway to decrease inflammation. Long acting bronchodilators, which work to keep the muscles around the air tubes from constricting. Controller medications are used every day, whether you are breathing well or poorly, because controller medications do not work fast. Instead, when given over time, controller medications work to decrease the inflammation, mucous production, and bronchoconstriction in your lungs, which means you will be able to breathe better.
Each patient with asthma may respond to different medications in different ways than other patients. For that reason, your doctor will pick the medication that they thinks is the best to control your asthma symptoms.
What Triggers Asthma?
Common triggers of asthma symptoms include viral upper respiratory illnesses or colds. For many patients, vigorous activity and exercise can make asthma symptoms worse. Tobacco smoke exposure, pet dander, and environmental allergen exposure (dust mites and pollens of trees, grasses and or weeds) can also make asthma symptoms worse. For some patients changes in the weather and food allergies can also make asthma symptoms worse.
How can I improve my Asthma?
• Avoiding triggers such as tobacco smoke, pet dander and environmental allergens can help maintain good control of your asthma symptoms. If you have questions about the best ways to avoid your environmental triggers, speak with your doctor or nurse.
• If exercise is a trigger for your asthma symptoms, your doctor may recommend pre-treatment with a rescue medication 10-15 minutes before the activity.
• If viral upper respiratory illnesses trigger for your asthma, your doctor may recommend that you monitor yourself closely and she may give you a plan to change medications if necessary. Also treating nasal symptoms with saline nasal rinses is often helpful during a viral illness.
• Some patients with asthma also have GE reflux disease. For these patients, treatment of the GE reflux disease will often result in better control of asthma symptoms.
• The most important thing that you can do to make your asthma symptoms better is to make sure that you are getting your asthma medications regularly.