Questions about Asthma

WHAT IS ASTHMA?

Asthma is an inflammatory lung disease with the following characteristics:

• The lining of the bronchial airways become swollen or inflamed, therefore the mucus glands make more mucus;
• The muscle that surrounds the airways contract or tightens in response to the exposure to the triggers; and
• The airway becomes “twitchy” or hyper responsive when exposed to triggers

These changes produce airway obstruction, shortness of breath, cough and/or wheezes.

WHAT CAUSES ASTHMA?

The cause is unknown. In many cases, there is a genetic predisposition for the Allergic (Atopic) Diseases. A close family member may have allergic rhinitis (hay fever), eczema or asthma. About 75% of children with asthma have allergies.

HOW DO YOU TEST FOR ASTHMA?

Scientists have not found a specific blood test to diagnose asthma. Older children and adolescents may have a test called Pulmonary Function Test (PFT) that measures the amount of forced air exhaled in one second which is decreased in asthma and improves with bronchodilators. A similar but less sophisticated test can be performed with a peak flow meter.

In younger children and toddlers, asthma is suggested by the recurrent episodes of persistent cough that happen more at night, make the child gag or vomit, and improve with bronchodilators. The episodes may happen after a regular cold, or with seasonal changes (fall and spring). These children may get diagnosed as having recurrent “pneumonias” or recurrent “bronchitis”. Many asthmatics make a high pitched sound called “wheezing” but not all of them do, making the diagnosis more difficult.

WHAT TRIGGERS ASTHMA?

Common triggers are:

• Infections
• Exercise
• Allergy (molds, pollens, animals, dust mites, some foods)
• Weather changes
• Irritants (paints, cleaners, sprays); and
• Air pollution (ozone, cigarette smoke, auto exhaust, sulfur dioxide).

HOW IS ASTHMA TREATED?

Avoiding the triggers is the first step in preventing asthma. There are two types of medications to treat asthma--the “quick-relief” and the “long-term” medications.

The quick-relief medicines are bronchodilators. They relax the contracted muscle around the air tubes providing prompt relief of symptoms. Do not expect them to provide long-term asthma control. Medications in this category include Albuterol and Xopenex.

The long-term medications prevent symptoms by reducing inflammation. They must be taken daily to be effective. Do not expect them to provide quick relief during an asthma exacerbation. Medications in this category include inhaled steroids, leukotriene modifiers, cromolyn, nadocromil and theophylline.

WHAT IS THE GOAL OF ASTHMA TREATMENT?

The goal of the treatment is to achieve asthma control:

• Less chest tightness, shortness of breath, cough or wheezing
• No nighttime awakening
• No restrictions in physical activity
• No missing school or work
• No unscheduled visits to the doctor
• No ER visits
• No hospitalizations
• Normal or near normal lung functions

WHAT IS THE ASTHMA ACTION PLAN?

It is a written plan that guides the asthmatic on how to treat asthma exacerbations early at home. It includes how to watch for worsening symptoms, what medications to take and how often, and when to seek medical attention. The children who are old enough to use a peak flow meter may monitor their asthma and follow the recommendations for the asthma “zones”. Green is the safe zone, yellow means caution, and red is a medical alert.

It is very important that all the caregivers understand and follow the asthma action plan so the above goals become a reality in your child’s life. Ask questions about anything that is not clear. Learn more about asthma. There are many resources available that will help you understand the disease better and therefore become a partner with your child’s physician.

ASTHMA EDUCATION RESOURCES:

Allergy & Asthma Network Mothers of Asthmatics
American College of Allergy, Asthma, and Immunology
American Lung Association
Asthma and Allergy Foundation of America
Food Allergy & Anaphylaxis Network
National Jewish Medical and Research Center