May 2nd, 2017

World Asthma Day

 

By Deborah Gentile, MD & Sergei Belenky, MD, Pediatric Alliance — Allergy, Asthma, and Immunology.

 

 

 

 

Asthma — An Overview

Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs.

If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath, and/or chest tightness.

For many asthma sufferers, timing of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma symptoms only when exercising. This is called exercise-induced bronchoconstriction (EIB), or exercise-induced asthma (EIA). Staying active is an important way to stay healthy, so asthma shouldn’t keep you on the sidelines. Your physician can develop a management plan to keep your symptoms under control before, during and after physical activity.

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma. 

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

According to Dr. Deborah Gentile, an allergist/asthma specialist with Pediatric Alliance, “Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.”

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve. With the help of your health care provider, you can take control of your condition and participate in normal activities.

 

Asthma — Symptoms & Diagnosis

Asthma Symptoms
:  According to the leading experts in asthma, the symptoms of asthma and best treatment for you or your child may be quite different than for someone else with asthma.

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe. Other symptoms include:

•    Shortness of breath

•    Chest tightness or pain

•    Chronic coughing

•    Trouble sleeping due to coughing or wheezing

 

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen, or mold. Non-allergic triggers include tobacco smoke, air pollution, cold air, or changes in weather.

Asthma symptoms may be worse during exercise, when you have a cold, or during times of high stress.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing, and shortness of breath. In some children chronic cough may be the only symptom.

 

If your child has one or more of these common symptoms, make an appointment with your health care provider:

•    Coughing that is constant or that is made worse by viral infections, happens while your child is asleep, or is triggered by exercise and cold air

•    Wheezing or whistling sound when your child exhales

•    Shortness of breath or rapid breathing, which may be associated with exercise

•    Chest tightness (a young child may say that his chest “hurts” or “feels funny”)

•    Fatigue (your child may slow down or stop playing)

•    Problems feeding or grunting during feeding (infants)

•    Avoiding sports or social activities

•    Problems sleeping due to coughing or difficulty breathing

 

Patterns in asthma symptoms are important and can help your doctor make a diagnosis. Pay attention to when symptoms occur:

•    At night or early morning

•    During or after exercise

•    During certain seasons

•    After laughing or crying

•    When exposed to common asthma triggers

 

Asthma Diagnosis
:  Asthma is diagnosed by taking a thorough medical history and performing breathing tests to measure how well your lungs work.

One of these tests is called spirometry. You will take a deep breath and blow into a sensor to measure the amount of air your lungs can hold and the speed of the air you inhale or exhale. This test diagnoses asthma severity and measures how well treatment is working.

 

Many people with asthma also have allergies, so your doctor may order allergy testing. Treating the underlying allergic triggers for your asthma will help you avoid asthma symptoms.

 

Asthma Treatment & Management

According to Dr. Sergei Belenky, an allery/asthma specialist at Pediatric Alliance, “There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management”. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your health care provider will prescribe the best medications for your condition and provide you with specific instructions for using them.

Controller medications are taken daily and include inhaled corticosteroids.

Combination inhalers contain an inhaled corticosteroid plus a long-acting beta-agonist (LABA). LABAs are symptom-controllers that are helpful in opening your airways. However, in certain people they may carry some risks. LABAs should never be prescribed as the sole therapy for asthma. Current recommendations are for them to be used only along with inhaled corticosteroids.

Leukotriene modifiers are oral medications that may be prescribed as single controller therapy for mild or exercise induced asthma or as an add-on therapy for moderate or severe asthma.

Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. Quick-relief medications do not take the place of controller medications. If you rely on rescue relief more than twice a week, it is time to see your allergist.

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. They can cause serious side effects if used on a long term basis.

Visit the American Academy of Allergy, Asthma and Immunology Drug Guide for a complete list of medications commonly used to treat asthma.

If you are pregnant, you may be hesitant about taking medications, including those for asthma. This can be a mistake for your health and that of your baby-to-be. Continue taking your prescribed asthma medications and make an appointment with your allergist to discuss treatments that will help you have a healthy pregnancy. Additionally, you may want to enroll in a study designed to monitor medications and pregnancy.
People with asthma are at risk of developing complications from respiratory infections such as influenza and pneumonia. That is why it is important for asthma sufferers, children and adults, to get vaccinated against influenza annually.

With proper treatment and an asthma management plan, you can minimize your symptoms and enjoy a better quality of life.

 

*** Dr. Belenky and Dr. Gentile are available to help diagnose and manage your child’s asthma and allergies in concert with you and your primary care physician. Appointments can be scheduled by calling their office at 412-348-6868.

 

 

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  • MEET THE EDITOR

    Ned Ketyer, M.D.

    Ned Ketyer, M.D.

    Dr. Ketyer has special interests in developmental pediatrics and preventative medicine, specifically how nutrition and the environment affect health. He earned his bachelor’s degree from the University of Vermont and his medical degree from Northwestern University Medical School. He completed his residency at Children’s Hospital of Pittsburgh.

    As one of the founding physicians of Pediatric Alliance, PC, Dr. Ketyer served as its president from 1997-2004. He has been practicing general pediatrics at Pediatric Alliance since 1990. Dr. Ketyer and his wife have three boys and live in Pittsburgh's South Hills. 



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