Asthma is a Greek word meaning panting. It is a chronic (condition that has a long duration) lung disease, characterized by recurrent episodes of breathlessness, wheezing, coughing, and chest tightness, termed exacerbations. The severity of exacerbations can range from mild to life threatening. Exacerbations can be triggered by exposures and conditions such as: respiratory infections, house dust mites, cockroaches, animal dander, mold, pollen, cold air, exercise, stress, tobacco smoke and indoor and outdoor air pollutants. Both the frequency and severity of asthma symptoms can be reduced by using medications and reducing exposure to environmental triggers.
It causes bronchoconstriction (narrowing of the airways) due to inflammation (swelling) and tightening of the muscles around the airways. The inflammation also causes an increase in mucus production, which causes coughing that may continue for extended periods.
Asthma currently affects more than 15 million Americans, approximately half of whom have mild, but persistent asthma (symptoms more than twice a week). It is currently estimated to cost the U.S. economy $11.3 billion in health costs and lost productivity. The additional cost of treating all patients with mild persistent asthma with daily medication is estimated at $2 billion.
For the past 15 years, an epidemic of asthma has been underway in the United States. The steady rise in the prevalence of asthma constitutes an epidemic, which by all indications is continuing. Even if rates were to stabilize, asthma would continue to be a profound public health problem. It is a potentially fatal, chronic disease responsible for over 1.8 million emergency room visits per year, over 460 thousand hospitalizations per year and over five thousand deaths per year. Although the burden asthma affects Americans of all ages, races and ethnic groups, recent data indicate that children, low-income and minority populations have been most severely affected.
It is only within the past 20 years that scientists have learned that asthma is due to an inflammatory process in the bronchial air passages of the lungs that causes chronic irritation and narrowing of the airways, resulting in loss of lung function. In 1991, the NHLBI's "Guidelines for the Diagnosis and Management of Asthma" emphasized for the first time the role of inflammation in asthma and called for the use of anti-inflammatory agents to reduce inflammation over the long term, in addition to medications to provide symptom relief.
In 1997, the updated Guidelines recommended that patients with mild persistent asthma take daily medication, such as inhaled corticosteroids or anti-leukotrienes, to prevent or reverse airway inflammation. Since anti-leukotrienes were a relatively new class of medication, the guidelines also called for additional research on them.
Asthma is difficult to diagnose because it has varying degrees of severity and its symptoms are similar to other lung conditions. Working closely with your physician to set up a comprehensive management plan can help reduce the risk of severe attacks and increase your quality of life. By identifying and eliminating triggers, routinely monitoring your breathing and properly using medications, you can help control symptoms and maintain your usual lifestyle. Patients must learn to identify these triggers and practice avoidance techniques. Patients should be aware of any circumstances or substances that worsen their asthma.
In most people younger than age 30, asthma is triggered by allergies. About 40 to 50 percent of adults with asthma are allergic to airborne particles. Skin testing is the best way to determine to what substances you may be allergic. Allergens include house dust mites, cockroaches, tobacco smoke, pollen, molds and dander from animals, especially cats.
In some people, aspirin and other (Voltaren, Ibuprofen/Advil, Motrin/Nuprin/Aleve, Ketoprofen / Orudis, Indomethacin, Indocin, Keterolac/Toradal) nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen symptoms, causing sudden, severe attacks. Sulfites are preservatives added to some perishable foods which can cause hives and shortness of breath in a few people with asthma. The Food and Drug Administration (FDA) now prohibits sulfites in fresh fruits and vegetables, except potatoes, and requires warning labels on foods containing the preservatives.
Nutritional supplements that may be helpful include Vitamin B6, of which a deficiency is common in asthmatics, Magnesium, Selenium, Vitamin C and Vitamin E.