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Alternative namesBronchial asthma; Exercise induced asthma - bronchial; Reactive airways disease (RAD)
DefinitionAsthma is an inflammatory disorder of the airways, characterized by periodic attacks of wheezing , shortness of breath, chest tightness, and coughing.
Causes, incidence, and risk factors
Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. When an asthma attack occurs, the muscles of the bronchial tree become tight and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. Mucus production is increased.
Most people with asthma have periodic wheezing attacks separated by symptom-free periods. Some asthmatics have chronic shortness of breath with episodes of increased shortness of breath. Other asthmatics may have cough as their predominant symptom. Asthma attacks can last minutes to days, and can become dangerous if the airflow becomes severely restricted.
In sensitive individuals, asthma symptoms can be triggered by inhaled allergens (allergy triggers), such as pet dander, dust mites, cockroach allergens, molds, or pollens. Asthma symptoms can also be triggered by respiratory infections, exercise, cold air, tobacco smoke and other pollutants, stress, food, or drug allergies . Aspirin and other non-steroidal anti-inflammatory medications (NSAIDS) provoke asthma in some patients.
Asthma is found in 3-5% of adults and 7-10% of children. Half of the people with asthma develop it before age 10, and most develop it before age 30. Asthma symptoms can decrease over time, especially in children.
Many people with asthma have an individual and/or family history of allergies , such as hay fever (allergic rhinitis) or eczema . Others have no history of allergies or evidence of allergic problems.
Additional symptoms that may be associated with this disease:
Signs and tests
Listening to the chest ( auscultation ) during an episode reveals wheezing . However, lung sounds are usually normal between episodes.
Tests may include:
Treatment is aimed at avoiding known allergens and respiratory irritants and controlling symptoms and airway inflammation through medication. Allergens can sometimes be identified by noting which substances cause an allergic reaction.
Allergy testing may also be helpful in identifying allergens in patients with persistent asthma. Common allergens include: pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include: tobacco smoke, pollution, and fumes from burning wood or gas.
There are two basic kinds of medication for the treatment of asthma:
People with mild asthma (infrequent attacks) may use relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms from occuring. A severe asthma attack requires a medical evaluation and may require hospitalization, oxygen, and intravenous medications.
A peak flow meter, a simple device to measure lung volume, can be used at home to help you "see an attack coming" and take the appropriate action, sometimes even before any symptoms appear. If you are not monitoring asthma on a regular basis, an attack can take you by surprise. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of an individual's personal best indicate a moderate asthma attack, while values below 50% indicate a severe attack.
The stress caused by illness can often be helped by joining a support group , where members share common experiences and problems. See asthma and allergy - support group .
There is no cure for asthma, though symptoms sometimes decrease over time. With proper self management and medical treatment, most people with asthma can lead normal lives.
Calling your health care provider
Call for an appointment with your health care provider if you or your child experience mild asthma symptoms (to discuss treatment options).
Call your health care provider (or go to the emergency room) for moderate shortness of breath (shortness of breath with talking, peak flow 50-80% of personal best), if symptoms worsen or do not improve with treatment, or an attack requires more medication than recommended in the prescription.
Go to the emergency room for severe shortness of breath (shortness of breath at rest, peak flow less than 50% of personal best), if drowsiness or confusion develops, or for severe chest pain .
Asthma symptoms can be substantially reduced by avoiding known allergens and respiratory irritants. If someone with asthma is sensitive to dust mites, exposure can be reduced by encasing mattresses and pillows in allergen-impermeable covers, removing carpets from bedrooms, and by vacuuming regularly. Exposure to dust mites and mold can be reduced by lowering indoor humidity.
If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander. Exposure to cigarette smoke, air pollution, industrial dusts, and irritating fumes should also be avoided.
Allergy desensitization may be helpful in reducing asthma symptoms and medication use, but the size of the benefit compared to other treatments is not known.
Update Date: 2/10/2003A.D.A.M. editorial (2/10/2003). Previous review: Thomas A. Owens, M.D., Departments of Internal Medicine and Pediatrics, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network (1/6/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT