What Is Asthma and How Is It Treated?
Asthma is a common lung disease with no cure, but its symptoms can usually be controlled.
Asthma is often thought of as a disease of childhood, but it can affect anyone at any age. In fact, the National Heart, Lung, and Blood Institute reports that about 25 million Americans—including 7 million children—have asthma.
It’s a condition in which the airways become inflamed and narrowed. Your airways are the tubes that carry air into and out of your lungs. Inflamed and constricted airways produce more mucus, and make breathing more difficult. Wheezing and coughing are asthma’s two most common symptoms, and they can affect your quality of life and your ability to enjoy sports and other physical activities.
Despite years of research into this common respiratory problem, it’s still unclear why some people get asthma and others don’t. Researchers believe it may be a combination of inherited and environmental factors. Asthma can be mild or quite severe. Many people with asthma have no signs of the condition until something triggers a response in their airways. And what causes you to have symptoms may be much different than what triggers those same breathing issues in someone else.
Among the more common asthma triggers are:
- Airborne substances, such as dust mites, pollen, and animal dander. Other airborne irritants, such as chemical or cleaning fumes in the workplace or home can also trigger attacks.
- Physical activity, also known as exercise-induced asthma.
- Cold air.
- Respiratory infections.
- Gastroesophageal Reflux Disease (GERD), a condition in which stomach acid backs up into the esophagus—often referred to simply as heartburn.
If you have symptoms of coughing and wheezing, and your airways are producing more mucus, see your doctor. In addition to a physical exam and a careful listening to your lungs, your doctor may order one more tests to make a diagnosis.
Two tests measure your breathing. One is a spirometry test, which uses a device to measure how much and how quickly you can exhale after taking in a big breath. The other test uses a peak flow meter to measure how hard you can breathe out. This test is also used to track changes in your asthma, as well as other respiratory diseases.
Other screening measures may include chest x-rays and allergy testing. There are other tests, which may be recommended based on what these other screenings show or fail to show.
Asthma can’t be cured. The goal of treatment, then, is to relax the airways and make breathing easier. Effective treatment controls ongoing symptoms, such as wheezing and coughing, while also reducing the severity of sudden asthma attacks. These acute episodes that make it difficult just to catch your breath are often treated with quick-relief inhaled medications.
Beta-2 agonists are widely used asthma medications that come in long-acting and quick-acting forms. Albuterol is one of the most popular short-acting beta-2 agonists. It comes in an inhaler, and is recommended when sudden symptoms develop. Beta-2 agonists work by opening the airways and relaxing the muscles involved with breathing.
While there are over-the-counter asthma medications available, many health experts agree the condition is best controlled with prescription medications and the supervised care of a doctor. “It is important for people with chronic asthma to be under the care of a physician and receive an inhaled steroid for prevention of symptoms,” says Leslie Hendeles, PharmD, a professor in the University of Florida colleges of Pharmacy and Medicine. “If their asthma is under good control, they should not need albuterol more than twice a week.”
Ideally, you want long-term control of your asthma, so that the need for quick relief is kept to a minimum. Asthma attacks can be scary and uncomfortable. For most people with moderate-to-serious asthma, inhaled corticosteroids are the preferred long-term treatments. They help reduce inflammation, which in turn makes your airways less sensitive to airborne irritants and allergens.
Prolonged use of corticosteroids to control asthma symptoms and prevent attacks can lead to a mouth infection called thrush. Adding a spacer to your inhaler can better direct how the medicine is inhaled, making sure more of it lands in the back of the throat and not in your mouth.
If you are prescribed an inhaler for your asthma, be sure to get instructions for how to use it properly. The medication will only be effective if a substantial amount of each dose reaches your airways. Following your doctor’s advice is the surest way to reduce the impact of asthma in your life.
“There is no shortcut method of treating asthma. Asthma is a chronic disease of inflammation,” says Pritish Mondal, MD, a fellow in the University of Florida’s College of Medicine’s department of pediatrics pulmonary and allergy division. “The progression of the disease should be assessed by medical personnel from time to time. Secondly, overuse of quick relief medication, whether prescription or nonprescription, has the potential to harm asthma patients because it can suppress the signs and symptoms, so that they only come to medical attention when the condition is really bad. We don’t want that.”
New Findings and Treatment Options
Asthma continues to be a topic that is studies around the world. New findings continue shed light, both on the causes of this condition as well as possible treatment options. Recent research suggests, for example, that an imbalance between two substances in the blood may also be a common cause of asthma, especially in late-onset asthma. Researchers at the University of Pittsburgh have found that an imbalance between the amino acid arginine (also known as L-arginine) and asymmetric dimethylarginine (ADMA) is a common factor in obese people who developed asthma as adults. L-arginine is involved in the production of nitric oxide (NO) in the body. NO has several important functions, including helping your blood vessels and airways relax.
“In healthy people, a balance is maintained between arginine and ADMA ensuring normal levels of airway NO,” says Fernando Holguin, MD, with the University of Pittsburgh Asthma Institute. “But in obese, adult-onset asthma, the lower arginine and higher ADMA reduces airway NO levels. This finding is promising because it suggests that increasing arginine could restore NO levels and its positive effect on airways.”
This might translate into patients having less wheezing and shortness of breath.
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Preparing Yourself for an Asthma Attack
Asthma is a chronic condition that changes over time. Your asthma can get worse as you age or new triggers may develop when you least expect them. For these reasons, it’s important to have an asthma action plan that is reviewed with your doctor periodically.
Keep in mind that avoiding exercise and physical activity should not be part of anyone’s action plan. The key, if you have asthma, is to be smart about exercise if it is a trigger for you. This may mean taking medications prior to an activity or avoiding activity in cold weather or when certain allergens are in high concentrations outdoors. Be sure to work with your doctor to understand what you can do and how to avoid triggers that give you
If you pay attention to changes in your symptoms and triggers, and share that information with your physician, you can keep ahead of this troubling condition. And always remember to have your inhaler with you, no matter how well your other treatments control your asthma.
Asthma can’t be cured. The goal of treatment, then, is to relax the airways and make breathing easier.
© Alexey Poprotskiy | Dreamstime.com