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What is Asthma?

by Samuel Snyder, D. O.


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Brazil, Brasil


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Dr. Samuel Snyder is Associate Professor and Chair of Internal Medicine at Nova Southeastern University College of Osteopathic Medicine. He is a Fellow of the American College of Physicians, the American Society of Nephrology, and the American College of Osteopathic Internists. He is board certified in both Internal Medicine and Nephrology. He writes scientific and popular articles and lectures widely on a wide range of medical subjects.
hat uncomfortable, gripping sensation in the chest, pulling at the breath, making each gasp a wheeze, creating the fear that each breath might be the last—that is asthma. This condition is becoming more common, and more serious, both among kids and adults. It causes missed days of work and school, emergency room visits, hospital admissions, and can even kill.
What is asthma?
Asthma is defined as reversible inflammation of the airways, causing constriction of the smooth muscles in the small airways, the bronchioles (bronk-ee-ole). This results in shortness of breath and the characteristic wheeze. But not all people with asthma wheeze. Some simply have shortness of breath with a reduction of air movement through the airways. Others have coughing instead of wheezing, so called “cough equivalent” asthma. Either way, the symptoms may progress, and shortness of breath may become extremely severe.
Why does asthma occur?

Often, the cause of asthma is allergic. Many foods have been implicated to cause asthma, as have inhalants, such as dust, molds, fibers, animal danders, fumes, smoke, and even perfumes. Infections such as colds, flu or bronchitis can trigger attacks of asthma. Occasionally, a person suffering from heart failure might wheeze in such a way as to mimic asthma. But often the cause of acute asthma attacks cannot be determined. It is possible these individuals might simply be more sensitive to the allergic stimuli that trigger asthma in others.
How can asthma be treated?

The main aims of treatment in asthma are to reduce inflammation, to dilate the constricted bronchioles, and if infection is present, to treat the infection. The most potent anti-inflammatory drugs used are corticosteroids (also called steroids). These are usually delivered by inhalation, but in serious
acute cases, can be given orally or even intravenously. Inhaled medicines are given either by metered dose inhalers (MDI’s), or nebulizers. MDI’s are hand held canisters that deliver measured puffs of medication as a person inhales. Nebulizers are machines that deliver medications as microdroplets in saline, pushed into the airways under pressure.

Beta agonists are a class of medicine that relax the bronchiole muscles by opposing the nerve impulses responsible for constriction. These are delivered by inhalation, and are a mainstay of therapy. But they are not without risk, and should be used on an “as needed” basis for most people, rather than daily.

Several allergy medications have beneficial effects on asthma by reducing the stimuli to inflammation. These include antihistamines and leucotrienes.

When necessary, antibiotics or antiviral medications are appropriate.

And when an attack is so severe that a visit to the emergency room becomes necessary, oxygen is usually given.
Can asthma be prevented?

The most important part of prevention in asthma is avoiding known triggers. Allergens, the stimulants of allergic attacks, should be tracked down and avoided, if possible.

Sensitive individuals may benefit from air purifiers in the home. There are several types of these from which to choose. The HEPA filter is widely recommended by lung doctors. Some people have to wear masks to reduce the risk of inhalant allergens.

We do not know why asthma has become more common over the last decade or so. It might be related to higher levels of pollution in the air, or even to higher levels of UV light related to atmospheric changes. Significant research continues to fight this common disease.
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