Asthma - Learn What Is Asthma and It's Treatment

What Is Asthma?

Asthma (Az-muh) is a chronic disease that affects your airways. The airways are the tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways are inflamed (swollen). The inflammation (IN-fla-MAY-shun) makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue. This causes symptoms like wheezing (a whistling sound when you breathe), coughing, chest tightness, and trouble breathing, especially at night and in the early morning.

The Next Step

Up to this point the physician has used his interview techniques to obtain an accurate history and his physical diagnostic skills to form a working diagnosis of bronchial asthma. In order to confirm that impression, laboratory testing and especially pulmonary function testing will be required.

The Asthma Medications

Asthma medication may be roughly divided into two groups. The first group includes medications that reverse the tightness or constriction in the bronchial tubes. These medications are called bronchodilators. The second group of medications is aimed at preventing future attacks. These medications are often called anti-inflammatory since they reverse the red, swollen appearance of the inside of the bronchial tubes. The anti-inflammatory medications are not used to treat a sudden asthmatic attack.

Cyclosporin A

Other agents that suppress the immune response have also been tried in severe asthma. One of these is cyclosporin A, which has been used to a great extent in preventing rejection of transplanted organs. This agent is active against lymphocytes, white blood cells that are active in asthma.

Like methotrexate, studies to date do not show a great beneficial effect of cyclosporin A on asthma that would outweigh the risk of side effects on the immune system.

How Should Asthma Drugs Be Used?

As their number and effectiveness increase, confusion has also increased as to how these medications should be taken. Patients are often given several different medications and may find it difficult to use them all. Many patients complain they are "overmedicated" and stop medications on their own.

Exercise Testing

The above tests are performed with the patient at rest. Since exercise may create narrowing of the airways an exercise test may be extremely helpful in demonstrating that a patient develops asthma with exercise or that a patient with mild disease has worse airflow parameters after exercise. Such a test may be performed with a treadmill or a stationary bicycle. The patient is asked to slowly increase the level of exercise until either a certain heart rate is achieved or shortness of breath develops. At this point the patient is asked to perform spirometry and the airflows are compared to those obtained prior to exercise. If the exercise produces significant narrowing of the air tubes, the flow rates will be lower, confirming an asthmatic response. This procedure usually requires less than ten minutes of exercise and is performed under close observation.

How Do Doctors Diagnose Asthma?

Many people with asthma are diagnosed with the condition when they're kids, but some don't find out that they have it until their teen years or even later. In diagnosing asthma, a doctor will ask about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history.

After The Diagnosis Is Made

After using these laboratory methods to confirm the diagnosis of bronchial asthma, the physician will begin to work closely with the patient to prevent asthmatic attacks. In order for this "working partnership" of physician and patient to be successful, it is necessary to understand the nature of the attack.

Asthma (Az-muh) is a chronic disease that affects your airways. The airways are the tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways are inflamed (swollen). The inflammation (IN-fla-MAY-shun) makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue.

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