Asthma
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The word asthma in Greek means “no air.” A patient with asthma has difficulty moving air in and out of the lungs.
Asthma is a chronic disease of the lungs in which the lining of the airways is inflamed, which leads to cough, chest tightness, wheezing, breathlessness, and difficulty breathing.
Ten million people in the United States have asthma.
Asthma is the number one chronic disease in children
The annual cost of asthma is estimated to be $14 billion - $9.4 billion health care cost and $4.6 billion in indirect costs such as lost productivity at work and school (14.5 million lost work days per year).
The diagnosis of asthma is made from a history of typical symptoms including persistent cough, wheezing ,or difficulty breathing. Sometimes persistent cough or wheezing with effort or activity might be the only symptoms. Waking up in the early hours of the morning with cough or wheezing can be another symptom. In addition, most people with asthma will also have have allergic rhinitis (“ hay fever”). A history of allergy or asthma in family members is very common.
The physician will examine the lungs for signs of impaired air movement with breathing (e.g., wheezing)
The diagnosis is confirmed by a breathing test (spirometry) where the patient blows into a machine which detects decreased air flow. The test is repeated after giving the patient an inhaled medication that relieves airway obstruction. If this simple test does not help in diagnosing asthma, another medication test (the methacholine challenge) is done.
Many patients with asthma also need allergy skin tests to find out if the asthma is caused by inhaled pollen, molds, house dust, or animal danders which worsen the allergic reaction and inflammation in the lungs.
Treatment of asthma
There are 3 modes of treatment
- Avoidance of known triggers of asthma. These can be specific allergic triggers such as pollen, molds, house dust, animals or non-specific (non-allergic) triggers such as smoke, dust, strong odors, extremes of weather, emotional changes, exercise and infections.
- Medications
There are two types of medications:
Controller medications - control the inflammation of the airways thus preventing
asthma symptoms.
- Inhalers - steroids
- Pills - Montelukast (Singulair®)
- Short acting inhalers are effective for 4-6 hours
- Long acting inhalers are effective for up to 12 hours
- Immunotherapy (allergy shots) if allergies are causing the asthma.
See previous section on allergy treatments for more information on allergy shots.
