Asthma is a chronic disease that involves inflammation of the lungs. Airways swell and restrict airflow in and out of the lungs, making it hard to breathe. The word asthma comes from the Greek word for "panting." People with asthma pant and wheeze because they cannot get enough air into their lungs.
Normally, when you breathe in something irritating, or you do something that causes you to need more air, like exercise, your airways relax and open. But with asthma, muscles in the airways tighten, and the lining of the air passages swells.
Asthma is the most common chronic childhood illness. About half of all cases develop before the age of 10, and many children with asthma also have allergies.
Asthma can either be allergic or non-allergic. With allergic asthma, an allergic reaction to an inhaled irritant, such as pet dander, pollen, or dust mites, triggers an attack. The immune system springs into action, but instead of helping, it causes inflammation. This is the most common form of asthma.
Non-allergic asthma does not involve the immune system. Attacks can be triggered by stress, anxiety, cold air, smoke, or a virus. Some people have symptoms only when they exercise, a condition known as exercise-induced asthma.
While there is no cure for asthma, it can be controlled. People with moderate-to-severe asthma should use conventional medications to help control symptoms. Complementary and alternative therapies, used under your doctor's supervision, may help, but should not replace conventional treatment.
Most people with asthma go for periods of time without any symptoms, then have an asthma attack. Some people have chronic shortness of breath that gets worse during an attack. Asthma attacks can last minutes to days, and can become dangerous if airflow to the lungs becomes severely restricted.
Primary symptoms include:
If you have any of these symptoms, seek emergency treatment:
Asthma is most likely caused by several factors. Genes play a part. You are more likely to develop asthma if others in your family have it. Among those who are susceptible, being exposed to environmental factors, such as allergens, substances that cause an allergic reaction, or infections, may increase the chance of developing asthma.
The following factors may increase the risk of developing asthma:
Childhood asthma, in particular, can be triggered by almost all of the same things that trigger allergies, such as:
Other triggers include:
Asthma symptoms can mimic several other conditions, and your doctor will take a thorough history to rule out other diseases. You may also have lung function tests to measure how much air your lungs can hold and how much air you breathe out. Your doctor may use a spirometer to measure how much air you exhale and how quickly you get air out of your lungs. Other tests may include chest and sinus x-rays, blood tests, or allergy tests.
Asthma is classified as:
Although you cannot prevent asthma, you can take steps to reduce the number and frequency of attacks.
Avoiding asthma attacks, reducing inflammation, and preventing lung damage are the primary goals of treatment. The more you know about your condition, the more closely you can work with your doctor to develop an asthma action plan. To control asthma, you need to prevent exposure to allergic triggers and take medication as prescribed. Monitoring your breathing and taking your medications every day will help you control asthma over the long term. You may still need emergency medications during an asthma attack.
In a severe attack, you may need to be hospitalized for oxygen and medications that are given intravenously (IV).
Medications for asthma are prescribed for two different purposes: to stop an immediate attack, and to control inflammation and reduce lung damage over the long-term.
Quick relief medications: These drugs are called bronchodilators and help open the airways when you have an attack.
Short-acting beta-adrenergic agonists start working immediately. These drugs include:
Beta-adrenergic agonists may be used in combination with anticholinergic medications to treat severe asthma. Ipratropium bromide is the most commonly used anticholinergic drug for asthma treatment. Sometimes, steroids are needed for an acute asthma attack. They can take longer to work (from a couple of hours to a few days) and include:
Long-term control: These drugs are usually taken every day.
Inhaled corticosteroids reduce inflammation and have fewer side effects than oral corticosteroids. They include:
A class of drugs called leukotriene modifiers help reduce the production of inflammatory chemicals called leukotrienes that cause your airways to swell. They include:
Cromolyn (Intal), nedocromil (Tilade): These medications, which are inhaled, can help prevent mild-to-moderate attacks and are used to treat exercise-induced asthma.
Theophylline (TheoDur): This medication helps open airways and prevents asthma symptoms, especially at night. Too much can cause serious side effects. So your doctor will monitor levels in your blood.
Omalizumab (Xolair): Used to treat allergic asthma when other medications have not worked.
A typical step-wise approach for long-term management of asthma might include low-dose inhaled corticosteroids, medium-dose inhaled corticosteroids, or low-dose inhaled corticosteroids plus long-acting beta-agonists, medium-dose inhaled corticosteroids plus long-acting beta-agonists, high-dose inhaled corticosteroids plus long-acting beta-agonists, and oral prednisone.
Although there is no diet for asthma, people who have allergic asthma may also have food allergies that can make their asthma worse. If you think you may have food allergies, talk to your doctor about trying an elimination diet.
Eating plenty of fruits and vegetables that are high in antioxidants may also help control asthma. One study found that people with asthma who followed the Mediterranean diet had better control of asthma symptoms. Some studies suggest that people with asthma tend to have low levels of certain nutrients. But there is no evidence that taking supplements helps reduce asthma attacks. An overall healthy diet will help you get the nutrients you need, and help your body deal with a long-term condition like asthma.
The use of herbs is a time-honored approach to strengthening the body and treating disease. However, herbs can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a knowledgeable health care practitioner.
Preliminary studies indicate that acupuncture may help reduce symptoms for some people with asthma, but not all studies agree. Acupuncture should be used in addition to, not as a replacement for, conventional medicine when treating asthma.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of asthma based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
Some people may find their symptoms get worse for a short time when starting on a homeopathic remedy. Because this may be dangerous for some people, be sure to work with a knowledgeable homeopath.
Because stress and anxiety can make asthma worse, including stress management techniques in your daily life may help reduce symptoms. However, these techniques do not directly treat asthma.
Clinical severity of asthma during pregnancy seems to follow severity before pregnancy. Exacerbations may occur in up to 36% of pregnancies, most frequently between 14 to 24 weeks.
Long-term treatment with theophylline for asthma may reduce blood levels of vitamin B6.
People with asthma can live normal, active lives. Because asthma is a chronic illness, it requires self care and monitoring over the long term, as well as continual communication with your doctor. Having asthma does increase the risk of developing other chronic conditions, including kidney disease, sleep apnea, and depression. Preliminary studies also suggest that asthma may accelerate the aging process.
Most people with asthma have occasional attacks separated by symptom-free periods. Paying attention to your mood, lowering the stress in your life, and having a good emotional support system will help you take good care of yourself. Routine follow up visits are encouraged, at a frequency of every 1 to 6 months, depending on severity.
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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