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Monday, February 8, 2010

The many faces of asthma

Bronchial asthma, usually simply referred to as asthma, is a common condition, affecting well over 20 million Americans, increasing every year. The disease affects both children and adults, and its severity can vary from very mild to deadly. It account for more than 400,000 hospital admissions and more than 4,000 deaths every year.

While most people think of asthma as a disease of the lungs, in reality it’s a chronic condition of the bronchi, the airways that carry air in and out of your lungs. In asthma, the bronchial linings (mucosa) become inflamed, and become sensitive to a variety of irritants. The tiny muscles that surround the bronchi tighten and the mucus glands that are imbedded in the bronchial mucosa produce extra mucus.

Some people think of asthma as occasional wheezing. But in reality, asthma has many faces. It can indeed present as wheezing, mild and short lived, or as a chronic persistent condition, but it can also present in other forms such as a chronic or intermittent cough, excess mucus production, or shortness of breath at rest or associated with exercise.

The frequency and severity of asthma symptoms vary widely. Some people have infrequent “attacks,” or flare-ups, and are otherwise symptom-free, while others have severe, chronic symptoms. But no matter what your symptoms are, you must think of asthma as a chronic condition.

What triggers asthma or an asthma attack depends on how susceptible you are. Common triggers include allergens such as dust, molds, animal dander and cockroaches; tobacco smoke; viral respiratory infections; strenuous exercise; exposure to very cold temperatures; certain foods and food additives, and certain drugs such as the beta blockers used in the treatment of heart disease. Sometimes, psychological factors play a role. Hyperventilation, or excessive breathing, seen in some patients with anxiety, can lead to an asthma flare-up.

Asthma is usually easy to diagnose, but its severity should be thoroughly evaluated by a qualified physician. Occasionally, the diagnosis is elusive, and it has to be distinguished from other diseases that can masquerade as asthma.

Asthma is treatable. New research and an ever-increasing understanding of asthma have lead to better treatment. It is now clear that the overwhelming majority of flare-ups, hospitalizations and deaths can be prevented. But the success of treatment depends on the skill of the treating physician, and the patient’s compliance. Too frequently, especially in milder cases, there is a reluctance to treat or be treated, which may lead to disastrous outcomes.

Treatment depends on severity and triggers, and must be individualized. It ranges from the occasional use of bronchodilators (puffers), to long-term use of inhalers and oral plays a significant role, immunotherapy (allergy shots), or the use of a relatively new anti-allergy injectable medication (Xolair, omalizumab) may be appropriate. Relaxation methods, regular exercise and a thorough understanding of your condition are very helpful.

So if you have asthma, see to it that your needs are properly addressed, and take your treatment seriously; your mind and body will thank you for it. Need help? Contact us.

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