Asthma
Overview and Symptoms:
Asthma is a condition caused by inflammation in your small airways that can narrow, swell and produce extra mucus.
Asthma symptoms may be different for each person. Your symptoms may not even be the same each time you have a flare-up. Common symptoms may include wheezing, shortness of breath, difficulty breathing, tightness in your chest or coughing.
Causes and triggers:
Asthma can be caused by several factors including genetics and environmental triggers.
There are many things that trigger Asthma and vary from person to person.
- Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
- Respiratory infections, such as the common cold
- Physical activity (exercise-induced asthma)
- Cold air
- Air pollutants and irritants, such as smoke
- Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
- Strong emotions and stress
- Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
- Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
Diagnosis:
Diagnosis of Asthma requires a complete review of your respiratory history and physical exam.
It is also important to measure your lung function when diagnosing or staging asthma.
A Spirometry (Pulmonary Function Test) will help measure lung function. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
To help determine specific triggers, allergy testing is also helpful.
Types of allergy test:
Skin test – Food, Environmental, Drug
Blood Test – Food, Environmental, Drug
Like most allergists, we opt to perform skin testing as it is safe, reliable and yields prompt results that we can use to tailor your individual treatment plan.
Treatment:
Avoidance of your specific triggers is the best way to manage asthma and reduce your need for medications.
Medications may also be needed to help reduce inflammation in your airways and control you symptoms.
There are multiple types of asthma medicines:
Controllers medicines (also called “preventers” or “controllers”). You should take these medicines every day to control your asthma and prevent asthma symptoms and flare-ups.
- Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta).
- Leukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo).
- Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways.
- Combination inhalers. These medications — such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera) and Fluticasone-vilanterol (Breo) – contain a long-acting beta agonist along with a corticosteroid.
“Rescue” medicines (“relievers”). These medicines to relieve asthma symptoms quickly but do not prevent flare-ups. This is important before physical activity or if you know you may be exposed to any of your triggers. Rescue medications do not reduce inflammation in your airways. Examples include, Albuterol, Atrovent.
Biologics are a new type of medications that help to modify your immune response and reduce inflammation and control symptoms. Examples include Xolair, Nucala, and Fasenra.
Allergy Shots (Allergy Immunotherapy) helps to shift your immune system away from its allergic tendency and can lead to reduce symptoms and need for medications over time.
Your doctor can help determine which type of therapy is best for you.
