What exactly is Asthma

Statistics and Causes:
An important reason to see a health care provider is if you suspect you or your child has asthma. This is a serious condition that it's incidence has risen and so has the death rate from the disease (more than 5000 deaths annually due to asthma related conditions) And unfortunately, currently there is no cure for asthma.    

Sadly, statistics taken between 1980 and 1994 indicate the number of asthma cases in children under 5 increased by more than 160 percent and rose by 74 percent among children ages 5 through 14.  Asthma is the most common chronic childhood illness, in 1998 (the latest year for which statistics are available - and even worse now in 2007) it affected an estimated 8.65 million American children - more than 12 percent of the entire under-18 population.  Allergic rhinitis (a.k.a. hay fever) is even more prevalent, affecting an estimated 20 to 40 percent of children.  The figures aren't any better for adults either.  While accurate statistics are hard to come by, professional estimates maintain that allergies and asthma together affect roughly 50 million adults, making them the most common chronic health problems in the United States (high blood pressure is number two).

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A big mystery is why this boom in allergies and asthma.  No one really knows why it's happening.  There are a lot of theories being passed around.  Some blame it on genetics, but while genetics certainly play a role in asthma and allergies, our genetic traits change far too slowly to account for such a sudden increase.  Other theories  are:  1.  We're spending more time indoors and exposed to high levels of indoor allergens.  2. Complications during pregnancies that come to full term could be resulting in a higher risk of allergies and asthma for children born of those pregnancies. 3. Airborne waste materials from fossil fuel combustion (exhaust from cars and power plants, etc) could be affecting the mucous membranes in the lungs and nose, boosting allergic responses. 4.  An epidemic increase in obesity rates, coupled with a dramatic drop in fruit and vegetable consumption is playing havoc with our immune systems.  5.  Immune system defects resulting in allergies and asthma are set early in life, probably in the fetal stage and are locked into one's 'immunological memory'.                                                                       

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Defining Asthma:
Allergies and asthma tend to go hand in hand, and identifying your allergy triggers can help you to take sensible treatment steps to avoid them. Simply put, asthma is a disease in which the airways of the lungs become hypersensitive to one or many irritants. The American Academy of Allergy Asthma and Immunology defines asthma as:  Asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed.  The muscles of the bronchial walls tighten and extra mucous is produced, causing the airways to narrow.  The result could range from a frequent tendency for a cough, wheezing or severe difficulty in breathing.  In some cases, breathing may be so labored, that an asthma attack becomes life-threatening.  Although asthma is defined more as a respiratory condition than an immune system disorder, it has its roots in the immune system. Repeated asthma attacks can also cause permanent damage and compromise lung function over time.                                                                                                                              

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Types of Asthma:
Asthma is divided into four main types.  Each can behave somewhat differently, are triggered differently and can respond to different treatments.  That is why asthma is such an difficult disease to treat. The book Allergy and Asthma Relief defines these four types as:  1.  Allergic asthma is the most common form and if you have allergies you probably have allergic asthma.  Attacks are triggered by allergens such as seasonal pollens or perennial inhalant allergens such as dust mites and animal dander. 2.  Nonallergic asthma is a form of asthma resulting from something inside your body, such as a sinus infection or heartburn.  It generally develops later in life and very little is known about its causes.  3.  Mixed asthma is a kind characterized by triggers from both allergies and nonallergic factors.  Your allergy to grass and ragweed triggers your asthma, but you have symptoms even during the winter, when there is no pollen.  4. This last type is Acute severe asthma or potentially fatal asthma.  With this form, you often have so much trouble breathing that you become exhausted and collapse.  You're also in significant danger of death. People with acute severe asthma can go down-hill very fast and even die within the first 24 hours of an attack.    

Asthma Triggers:   

• The American Academy of Allergy Asthma and Immunology has also listed possible triggers of Asthma as:

•  *  Allergens (Pollens, Molds, Animal dander, House dust mites,   Cockroach droppings and foods) *  Irritants such as tobacco smoke, strong odors.    AND -                                                                

• Weather changes.                                                                                                            

• Viral  or sinus infections.                                                                                                  

• Exercise.                                                                                                                          

• Reflux disease (Stomach acid flowing back up the esophagus, or food pipe)                         

• Medications                                                                                                                      

• Foods                                                                                                                              

• Emotional anxiety.

So, you can see that asthmatic conditions can be triggered by just about anything. That's why controlling the onslaught of asthma is so critical but also very difficult.                                 

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General Asthma management:

Since asthma is a chronic disease, it requires continuous management and appropriate treatment. According to the national Guidelines for the Diagnosis and Management of Asthma, asthma treatment has four main components: 

•  * The use of objective measurement of lung function (such as peak flow meters and spirometers) to assess the severity of asthma and to monitor the course of treatment.                                       

•  *  Environmental control measures 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 patients, his or her family, and the physician and other health care providers.

According to the Guidelines, there are six general 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.

Important medications are bronchodilators that open (and keep open) the large and small airways in your lungs. They come in two forms: short-acting (also known as rescue medications), which are used when your asthma symptoms are worsening or you're having an attack, and long-acting - used on a daily basis to prevent your asthma from getting worse. These medications have very little effect on inflammation though, so they won't provide the kind of long-term relief you need for this chronic condition.  Check the Treatment section of this site for more asthma recommendations.

You and your physician can work together on these goals to ensure that your asthma is well-managed.  The better informed you are about your asthma triggers and management, the less asthma symptoms will interfere with your activities. The Allergy Triggers checklist in the Investigation Forms area - can help you and your health provider with this. It is important to avoid your triggers, work with your physician on a management plan and take appropriate medications as prescribed.  Together, you and your allergist/immunologist can work to ensure that asthma does not interfere with your optimal quality of life.  

Asthma in children:
The American Academy of Allergy Asthma and Immunology states that:  50% to 80% of children with asthma develop the symptoms of asthma before the age of 5.  It further states that children suffering from asthma also miss more than 10 million school days each year due to complications of the disease.  Asthmatic symptoms can result in poor academic performance, anxiety and further isolation from peers if not properly taken care of by an allergist/immunologist.

Watch for the key symptoms for asthma (wheezing, coughing, shortness of breath or rapid breathing, and chest tightness) plus some other childhood indicators.  Those are:

• Fatigue:  Your child may slow down, stop playing or become easily irritated.

• Infants may have problems feeding and may grunt during suckling.

• Older children may avoid activities such as sports or sleepovers.

• A child may have problems sleeping because of nighttime coughing or difficulty breathing.

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So, you can see that asthmatic conditions can be triggered by just about anything. That's why controlling the onslaught of asthma is so critical but also very difficult.  Patterns of asthma symptoms are also important.  You should pay attention to when the asthma occurs.  Does it occur either 1. at night or early morning, 2. during or after exercise, 3. seasonally,  4. after laughing or crying or 5. when exposed to possible asthma triggers at home, school or daycare.

No two children have exactly the same asthma symptoms or outcomes.  It is a very individualized disease.  The best way to determine if your child does have asthma, is to look and listen for triggers or symptoms.  If you suspect your child might have asthma, take your child to an allergist/immunologist for proper diagnosis.  Allergists/immunologists are specialists who are specifically trained to manage the prevention, diagnosis and treatment of allergies and asthma.

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Asthma management for children:
Currently there is no cure for asthma.  But for most children, asthma can be controlled with appropriate management and treatment.  While asthma is a chronic illness, it should not be a progressively debilitating disease.  When appropriate treatments and careful avoidance measures are practiced, children with asthma can participate in regular activities.

Concluding:
Allergies and asthma are pretty good at masquerading as other ailments, and vice versa. So, self-medicating for your suspected allergic conditions could mask more serious health problems - better treated by a health provider. Additionally, serious allergies and allergic asthma may best be treated with prescription medications, available only through physicians. Allergies and asthma are very complex diseases and makes identifying a cause or causes very difficult.  However, pharmaceutical companies continue to research and bring better and better drugs to help us cope with allergies and asthma. That is another reason why you should see a health-provider and possibly get newer prescription medications that might work better for your situation.      

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