Asthma is a chronic lung disease characterized by chest tightness, shortness of breath, coughing and wheezing.  With asthma, a blockage of airflow in and out of the lungs occurs from muscle squeezing, swelling and excess mucous.  Between 12-15 million people in the United States have asthma, including up to 5 million children.

Physicians who are not specialists in this disease may mistake its symptoms for an infection, unaware that the underlying problem is asthma.  Asthma is characterized by three airway problems:  obstruction, inflammation and hyper responsiveness.  Asthma patients respond to environmental factors differently than non-asthmatics.  In response to a trigger, the asthmatic's airways become narrowed and inflamed, which results in wheezing, coughing and tightness in the chest.  If you have asthma, you can minimize symptoms by avoiding these triggers, and by working with your doctor to develop an effective plan for treatment.

Triggers for Asthma

Asthmatic symptoms can be triggered by several factors, including:

• Allergens or irritants
• Exercise
• Medications or foods
• Viral or sinus infections
• Reflux disease
• Emotional anxiety

?Hay fever? (allergic rhinitis) is considered a risk factor for developing asthma, as up to 80% of asthmatics also have hay fever.  Both can be triggered by year-round allergens, including pollens, molds, animal dander, and house mites and other insect droppings.

Other substances can aggravate asthma, including air pollutants (cigarette smoke, chemicals in the air, wood smoke), occupational exposure to allergens (gases, vapors, dust, and fumes), strong odors (perfumes, household cleaners, paints and varnishes), airborne particles (chalk dust, talcum powder), and changing weather conditions (humidity, temperature, winds). 

Viral infections can also trigger and/or aggravate asthma, especially in children.  These infections irritate the nose, lungs, sinuses and throat, which may trigger asthma flare-ups.  Sinusitis (an inflammation in the cavities around the eyes and nose) can also trigger asthma.

Managing Asthma

Because asthma is a chronic disease, it requires careful monitoring and effective treatment.  The treatment of asthma has four main components

• The use of objective measures of lung functions to assess the severity of asthma and to monitor treatment (peak flow meters and spirometers)
• Environmental control measure to avoid or eliminate factors that trigger asthma symptoms or flare-ups
• Medication therapy for long-term management to reverse and prevent airway inflammation as well as therapy to manage asthma flare-ups
• Patient education to foster a partnership between the patient, his family and the physician

According to the Guidelines, there are six goals for the effective management of asthma:

• Prevent chronic and troublesome symptoms
• Maintain (near) ?normal? breathing
• Maintain normal activity levels, including exercise
• Prevent recurrent asthma flare-ups, and minimize the need for emergency room visits or hospitalizations
• Provide optimal medication therapy with no or minimal adverse effects
• Meet patients' and families' expectations of satisfactory asthma care

By working with their doctor to manage their asthma, asthmatics should be able to participate in normal daily activities.

Asthma Medications

The purpose of asthma medications is to reduce the inflammation in the patients' airways that cause the wheezing, coughing, tightness in chest and other symptoms.  The following medications are commonly used in asthma treatment:

• Anti-Inflammatory Drugs ? cromolyn or nedoromil, which stop and prevent the inflammation in the lungs
• Corticosteroids ? used in inhaled or oral form, depending on the severity of the asthma
• Bronchodilators ? used in emergencies to open up the bronchial tubes to allow more airflow. 
• Anti-leukotrienes ? fights potent chemicals called leukotrienes, responsible for airway inflammation

Asthma in Children

Asthma is the most common and serious disease in childhood.  Asthma affects nearly 5 million children in the United States, and is the cause of nearly 3 million doctors visits and 200,000 hospitalizations each year.   In infants and young children, asthma may appear as rapid or noisy breathing, cough, and/or chest congestion.

Asthma symptoms can interfere with many school activities for children, as asthmatic children may have less stamina than other children.  Many asthmatic children may try to avoid or limit their involvement in physical activities to prevent the coughing and wheezing that may occur. 

Children with asthma do not often identify chest tightness, because they are often so used to the feeling that they are unaware that it is a warning sign.  For parents, often the only observable symptom of chest tightness is recurring coughing spells.  Up to 80% of children with asthma develop symptoms before the age of five.  For this reason, the proper diagnosis of childhood asthma relies heavily on parents' observations about their child's symptoms.

Once asthma is diagnosed, proper treatment and management can occur.  Often the child must use a peak flow meter to measure the flow of air from the lungs.  Often medications are also used to prevent and improve symptoms.  Once the child has been diagnosed and is receiving asthma treatment, the child should be encouraged to participate in normal physical activities as much as possible. While many parents feel the need to prevent their asthmatic children from engaging in physical activity, aerobic exercise is very important to the asthmatic child to improve airway function.

With proper diagnosis, monitoring and treatment, individuals with asthma can engage in regular physical activity and can live normal healthy lives.

For more information

Contact the American Academy of Allergy, Asthma and Immunology

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