Healthy Lung Month: How to Treat Asthma

Asthma is one of the most common chronic diseases in the world. Millions of people suffer from this disease in which the bronchial tubes (airways) become inflamed, narrow, and swell. Although there are many shared symptoms among patients, not all cases of asthma are alike or have similar causes. Treating asthma is a matter of determining what triggers asthma attacks or episodes and adjusting your lifestyle to prevent exposing yourself to these triggers.

The Facts About Asthma

• 26 million Americans, or 1 in 13 people in the U.S., have asthma.
• Rates of asthma have increased in all age, sex, and racial groups since the early 1980s.
• Over 11.5 million people, 3 million of them children, report having asthma episodes or attacks in a calendar year.
• Asthma causes 11 million doctor's office visits and 1.7 million emergency department visits yearly.
• Asthma is the number one chronic disease for children.
• Nearly 14 million missed school days are caused yearly by asthma, making it the number one reason for children to miss school.
• The economic cost of asthma in a five-year period is almost $82 billion, between medical costs and lost work and school days.

Asthma Symptoms

Our common image of an asthma sufferer is someone carrying an inhaler and having episodes of wheezing and difficult breathing. These are visible symptoms, but their severity can differ between people with the disease. Many people may not even be aware they have asthma, especially if these symptoms are less severe.

Symptoms can include:

• Coughing: especially at night, during exercise, or when laughing.
• Difficulty breathing.
• Shortness of breath.
• Wheezing: a whistling sound in your chest while breathing, especially exhaling.
• Chest tightness.

Asthma symptoms in children often show up before age 5, but this can be difficult for even doctors to recognize due to the small bronchial tubes infants and very young children possess. Asthma symptoms may be mistaken for the effects of head or chest colds, or other illnesses.

Pediatric asthma symptoms can include:

• Coughing: especially at night. Watch for nagging coughs that linger for days or weeks.
• Wheezing or whistling sounds while breathing, especially exhaling.
• Frequent colds that settle in the chest.
• Difficulty breathing: watch for fast breathing or breathing that causes the skin around the ribs or neck to pull in tightly.

Asthma Risk Factors and Causes

The prevalence of asthma has increased for decades, and although there's no single answer why, there are some relevant risk factors:

• Family History: a parent with asthma increases your risk of developing it 3 to 6 times above someone whose parents don't have it.
• Obesity: risk of asthma increases in both children and adults who are overweight, due to increased bodily inflammation, and obesity rates have risen.
• Allergies: allergic conditions increase the risk factor for asthma, and allergy rates are also rising.
• Viral Respiratory Infections: children who have issues with respiratory infection are at increased risk of developing asthma.
• Air Pollution: exposure to ozone raises the risk for asthma. People who grew up or currently live in urban areas are at increased asthma risk.
• Occupational Exposure: exposure to certain elements in the workplace, as well as industrial or wood dusts, chemical fumes and vapors, and molds, can cause the development of asthma even in adults with no history of it.
• Smoking: although smoking rates have decreased, smokers and people exposed to secondhand smoke are still at increased risk of asthma.

Racial factors come into play in asthma rates in the U.S. Puerto Ricans have the highest prevalence of asthma, while African-Americans have the highest prevalence of childhood asthma. African-Americans with asthma also have higher mortality rates and hospital admission rates. These statistics are attributed to poverty, urban air quality, and lack of patient education and quality health care.

Asthma Triggers

Asthma is not just obstruction of the airway, but also inflammation. The muscles surrounding the bronchial tubes constrict, limiting the ability to breathe. Asthma attacks have a variety of triggers, some of which wouldn't be immediately obvious:

• Illness: including influenza, sinusitis, and upper respiratory infections.
• Exposure to allergens: especially airborne ones like animal dander, dust mites, or pollen.
• Extreme weather conditions or changes in weather.
• Exposure to smoke or cigarette smoke.
• Exposure to strong smells: perfumes and other odors.
• Strenuous exercise.
• Strong emotional reactions: severe stress, crying, laughing.

Managing and Living with Asthma

Managing asthma is about knowing what type of asthma you have. Asthma isn't just one condition, but defined both by the pathways of inflammation and by the sources and triggers of asthmatic episodes. Some of these include:

• Allergic asthma
• Aspirin-induced asthma
• Cough-variant asthma
• Exercise-induced asthma
• Nighttime asthma
• Occupational asthma
• Steroid-resistant asthma

Knowing your type of asthma, especially as defined by your triggers, is key to managing it. Adapting your lifestyle to ensure your environment and habits prevent triggering attacks or episodes is vital to living comfortably with the disease. Steps may include:

• Tracking your symptoms for ideal medication intake.
• Removing triggers such as allergens from your environment.
• Consulting with your doctor on an exercise plan that helps strengthen your lungs without triggering an episode.

Treating Asthma

Asthma treatment options can include a number of devices and machines to deliver medication or clear airways.

Inhalers: These are typically rescue devices that deliver puffs of medication to inhale. The medications are often corticosteroids, which reduce inflammation that closes the airway, or brochodilators, which relax the bronchial muscles in order to open the airway.

Nebulizer Machines: Nebulizers are machines that convert liquid medication into a mist, allowing you to inhale it through a mask or mouthpiece and absorb it into your lungs. They typically deliver brochodilators, allowing your airway to relax and open.

PEP Therapy Devices: Many asthma patients deal with excessive levels of secretions that block the airways. PEP therapy devices utilize a technique called vibratory PEP (positive expiratory pressure) to loosen and mobilize secretions, allowing the patient to expel them by coughing.

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