Asthma is a lung disease in which normal airflow into and out of lungs is impaired. Smoke, exercise, cold air, infection, mold, dust, and mites, for example, make lung airway cells produce more mucus. The mucus becomes thicker and more sticky, and breathing tubes (airways) clog up and become very small. Wheezing and shortness of breath result.
Early-onset asthma (extrinsic, or allergic, asthma) has both genetic and environmental causes. Late-onset asthma (intrinsic asthma) in adults older than 35 can be triggered by infections and exercise.
Emotional stress may also cause an asthma attack and result in a visit to the emergency room and use of oxygen and drugs.
Asthma is diagnosed by reviewing symptoms; doing a physical checkup; and testing lung function. The health care provider may order blood and skin sensitivity tests to exclude other disorders that present with similar symptoms. Lung (pulmonary) function tests can tell if breathing is normal and how sensitive airways are. These tests use a peak flow meter to measure air breathed in and out.
Asthma can be mild irregular (intermittent—i.e., symptoms less than two times per week). Or it can be mild long-lasting (persistent—symptoms more than two times per week but less than once daily), moderate persistent (daily symptoms), or severe persistent (constant symptoms). The health care provider will base the treatment on asthma’s severity.
Drugs, often given by an inhaler, may control asthma. Some work almost immediately and are used during an asthma attack. Others help stop future attacks. Some medications to reduce inflammation, known as leukotriene receptor antagonists (such as montekast), can also be given in pill form.
The three types of common treatments are symptomatic, long-term, and immune therapy. For symptomatic treatment, short-acting drugs in inhalers are used as needed, usually by patients with mild intermittent asthma. Long-acting drugs in inhalers are used every 12 hours.
Long-term treatment involves corticosteroids given in inhalers to reduce lung swelling and redness (inflammation). They are for mild, moderate, and severe persistent asthma.
Immune therapy, often called allergy shots, is for patients who have asthma caused by uncontrolled allergies. Asthma is treatable, and most flare-ups and deaths caused by asthma can be prevented.
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