Understanding Asthma

4/10/98

Charles Booras M.D.

by Charles H. Booras, MD

Between 12 and 15 million people, including close to five million children, in the United States have asthma. Asthma is a chronic disease in which airflow in and out of the lungs may be blocked by muscle squeezing, swelling and excess mucus. Patients with asthma may respond to factors in the environment, called triggers, which do not affect non-asthmatics. In response to a trigger, an asthmatic's airways become narrowed and inflamed, resulting in wheezing and/or coughing symptoms.

What is asthma?

Asthma is a chronic lung disease that makes breathing difficult. During an episode of asthma, the lining of the airways, or bronchial tubes, becomes inflamed and swollen. Surrounding muscles become tighter so that the airways are even narrower A thick mucus is also produced, which further blocks breathing. Although asthma cannot be cured, its symptoms can be controlled with the help of your doctor and a manageable treatment plan.

What are the symptoms of asthma?

Typical symptoms include shortness of breath, tightness in the chest, wheezing, and coughing.

How is asthma diagnosed and treated?

Asthma is best diagnosed with a visit to your doctor, who will evaluate your medical and family history A physical exam will also be necessary, during which your doctor will listen to your breathing. Certain lab tests are also helpful in diagnosing asthma. These tests determine pulmonary function, blood counts, and allergies.

While there is no cure for asthma, there are a number of ways to control asthma symptoms. Your doctor will prescribe asthma medications to meet your needs. You should work closely with your doctor and report on the effectiveness of the medicine and any side effects you may experience. You should also try to discover what triggers an asthma attack. Together, you and your doctor can develop a medication plan and treatment.

What causes asthma?

The exact cause of asthma is not known, but it does seem to run in families

Patients with asthma may be supersensitive to various substances and environmental conditions that are normally harmless. Some common triggers may include allergens such as pollen, animal dander, dust, and dust mites as well as irritants such as smoke, fumes, and strong odors. Other triggers can be changes in the weather or temperature, certain drugs, and food additives.

Nocturnal asthma, or asthma symptoms that occur at night, can be related to a number of factors including allergens in the bedroom, late responses to triggers exposed to during the day, heartburn, and even the drop in body temperature that occurs during sleep.

Exercise-induced asthma involves asthma symptoms that occur during or immediately following activity.

Take an active role in your own therapy. What you can do -

Managing your asthma correctly is the most important effort you can make to ensure that you lead a normal and healthy life. Your best start is forming a strong partnership with your doctor. Together you can develop a personalized treatment plan to help control your symptoms.

Eat right, exercise, and get enough rest. Know your asthma triggers and ways to avoid contact with them. Watch for warning signs of an episode so that you can begin treatment quickly and effectively with the proper dose of prescribed medicine. Stay calm when symptoms do arise and ask for help from family, friends, or your doctor when you need it.

If your medication does not seem to alleviate your symptoms, seek the medical care you need immediately. Be sure those around you are aware of your condition and teach them ways they can assist you when urgent help is needed. Keep emergency information and important phone numbers handy.


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Home Environment

For patients with asthma, the ideal atmosphere is as free as possible of asthma triggers. While it may be impossible to remove every trigger from your home, you can alter some things to provide cleaner and healthier air.

Air-conditioning may offer relief from some airborne triggers. If air-conditioning every room is not an option, then a window unit for your bedroom is a smart alternative. And, in houses with forced-air heat, a filter or damp cheesecloth over vents can trap airborne particles.

The simpler your decor, the better. Remove as many dust-trapping items as possible. Ornate and upholstered furniture, knickknacks. draperies, and floor coverings are notorious collectors of dust. Opt for furnishings that are easily cleaned, such as vinyl-covered couches, washable shades, and wood or linoleum flooring. And, when cleaning your home, a dampened dust cloth will attract particles and keep them from becoming airborne.

In your bedroom, choose Dacron or other synthetic pillows. Cover mattress and box spring with allergen-proof covers for additional protection. Use washable cotton or synthetic bedding.

Prevent situations that encourage mold to form. Keep bathrooms clean and dry. Install a dehumidifier. Check foods for spoilage. Dry your freshly laundered clothes promptly. And, don't cultivate a lot of houseplants since moist potting soil can be a haven for mold.

Avoid exposure to pets, particularly cats. Animal dander and animal saliva are known allergens. Do not smoke, and initiate a no-smoking policy in the home. If these efforts are not possible, designate pets and smokers to areas outdoors or at least to rooms in the house that are far removed from your bedroom. This will ensure that you have a healthy retreat when needed.

Work Environment

Air-conditioning may be effective in the workplace for reducing the number of airborne allergens. Air filtration systems are an additional help, provided they are used properly and maintained.

When you identify triggers that may provoke an asthma episode, minimize your exposure to them. Heavy scents, smoke, and fumes may aggravate asthma symptoms. Investigate the possibility of relocating your work area or, at the very least, modifying working conditions. For example, you might ask your supervisor to initiate a no-smoking policy or to limit smoking to designated areas of the building.

Stress can also be a contributor to asthma episodes Tension and anxiety cause your airway muscles to tighten, making breathing more difficult. Try stress reduction techniques to help you relax and to put you more in control of your asthma. 

Foods and Drugs

An asthma episode can also be triggered by things you eat or medicine you take. 

Processed foods contain chemicals, called sulfiting agents, which are added as preservatives. Foods that may contain these chemicals include dried fruits, fruit juices, vegetables, and wines. Many patients may need to avoid sulfiting agents because these chemicals may initiate an asthma episode. Other foods can cause you to experience an allergic reaction that may trigger an asthma episode. The most common culprits are cheese and dairy products, citrus fruits, tomatoes, seafood, and corn. 

Certain drugs have been identified as asthma triggers. Aspirin and aspirin-like medicines are likely to instigate the occurrence of symptoms in those who encounter recurring sinusitis and have nasal polyps. Beta-adrenergic blocking agents (Inderal, Tenormin, and others) which are used to treat migraines, rapid heart rate, congestive heart failure, tremor, and glaucoma, are also known to provoke asthma episodes.

Thanks to:
Principal Health Care of Florida, Inc.,
Glaxo Inc
.,
The American Academy of Allergy and Immunology.


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