Do you struggle with shortness of breath? Does it get worse when exercising or with a change in the weather? If so, you may be suffering from asthma.
“Asthma is defined as an acute or chronic inflammatory disease of the lung airways,” David Monjot, MD, a pulmonary care provider with Mercy Health – Springfield Pulmonology, says. “It causes inflammation of the airway, which leads to excessive bronchial secretions as well as twitching or spasming of the smooth muscle in the airway. Chronic inflammation can eventually lead to narrowing of the bronchial airway.”
In recent years, asthma has become much more common. More than 26 million people in the United States are affected by asthma, including around 7 million children, making it a leading chronic disease for children. Although the exact cause of asthma is unknown, genetic variants play a large role in the development of the disease.
“The clinical diagnosis of asthma is made by a combination of clinical history and physical testing,” Dr. Monjot explains. “The clinical history usually involves various symptoms, such as persistent cough and shortness of breath. The physical exam reveals various signs and symptoms that aren’t available through the clinical history, such as rapid pulse and wheezing on auscultation of the lungs with a stethoscope. Cyanosis, which is seen as discoloration of the lips and other mucous membranes, is another one.”
Asthma can be triggered by a variety of factors, such as exercise, cold air, viruses, bacterial infections and cigarette smoke. In some cases, it can be allergen-induced with animal dander, pollens and environmental irritants being some of the more common causes.
As with any disease, there are several different types of asthma. It can range from stage I to stage IV. After the initial diagnosis, most patients go through a staging process to judge which specific stage they have. This helps to determine which selection of treatments the patient will benefit most from.
“The stages of asthma vary between mild intermittent, mild persistent, moderate persistent and severe persistent,” Dr. Monjot shares. “Asthmatic symptoms become more persistent with each stage, and they ultimately get worse. For example, stage I, which is known as mild intermittent asthma, is both cold air and exercise-induced. Someone who has mild symptoms and very few asthmatic attacks would be classified as having stage I asthma. However, someone who suffers from ongoing symptoms, both day and night, or someone who has to severely limit their activity levels due to such symptoms and a significant loss of lung function would be classified as having stage IV asthma.”
Each stage is different, so the recommended treatment changes based on the stage the patient is diagnosed with. The most common form of treatment is a rescue, or short acting (SABA) inhaled medication. For the more difficult stages, a patient is often treated with multiple inhaled medications. This sometimes even includes the addition of oral corticosteroids and theophylline medications.
“With proper diagnosis and treatment, most asthma can be controlled with symptom reduction and improved quality of life,” Dr. Monjot says. “However, it’s important to understand that not every person with asthma has the same symptoms and each person needs to be evaluated independently. Asthma attack prevention is paramount – and each individual should have an action plan ready to go as well as have frequent communication with their primary care provider or pulmonary specialist.”
Learn more about pulmonary and respiratory care services we offer at Mercy Health.