Bronchial asthma is the most common lung disease in adults and children. According to government statistics, the number of cases has risen, reaching one of its highest peaks in history in the past decade. Given how frequently this disease occurs and its consequences, it is important to learn about it and about its treatment.
What is asthma?
Asthma is an exaggerated reaction to a bronchial stimulus. The bronchi are the “tubes†through which the air we inhale and exhale reaches our lungs. They divide themselves in the same way branches on a tree do. Bronchi circulate and clean the air we breathe.
Two important things occur in our body when we have asthma: 1. The width of the bronchi decreases, tightening the airways, and 2. The cells that cover the bronchi swell and produce thick mucus. As a result, there is less air circulation, causing fatigue. You can hear sharp sounds when someone breathes similar to those of a whistle, called wheezing. Other symptoms may include frequent coughing, especially at night, shortness of breath, difficulty breathing, and chest tightness.
Are there different types of asthma?
We can classify asthma according to different criteria. Some of these are:
Childhood asthma: common during childhood and often associated with other diseases and allergies as well as bronchial viral infection during the first months of an infant’s life. Fortunately, around 75% of these children grow out of their asthma as teenagers.
Late onset asthma: asthma that occurs in adults 50 to 65 years of age.
Asthma triggeredby allergens such as pollen, pet dander, dust mites, found in the environment.
Intermittent seasonal asthma:generally associated with spring and fall when pollen levels are higher.
Permanent asthma: asthma that is present all year long.
Induced asthma: asthma triggered by exercise or cold air.
Treatment
Asthma treatment has changed in the past 20 years. The doctor’s role is to ask the patient about possible asthma “triggers†present at home, school or work in order to focus treatment on controlling these “triggers†as well as prescribing medicine if necessary. Today we rely on effective interventions and medicines that minimize side effects. These include aerosol inhalers that dilate bronchi, steroid inhalers that reduce swelling, pills that inhibit an exaggerated response by our immune system, and injectable medicines
Even with these new techniques, there are situations in which asthma is difficult to control and these present challenges for both doctors and patients. When this happens, it is best to try to respond to the following questions:
Is medication being used correctly as prescribed or does the patient need to learn how to take it properly?
Have efforts been made to control environmental triggers that make asthma worse?
Is specific allergy testing needed?
Is this something that looks like asthma but isn’t?
What is most important is working with your doctor to come up with the right combinations to keep asthma in control as best you can. With the right medications and changes in the environment, a person with asthma can lead an active and healthy life.
Miguel Divo is a pulmonologist at Brigham and Woman’s Hospital, Boston, MA.
