WASHINGTON, May 15, 2017 (GLOBE NEWSWIRE) -- Asthma is a chronic medical condition that affects over 20 million Americans, including 6 million children. It is a lung disorder in which the bronchioles, the inner lining of the small breathing tubes of the lungs, become inflamed and swollen. The muscles in the walls of the bronchioles may spasm, or narrow, causing symptoms of asthma which include chest tightness, wheezing, shortness of breath, or coughing. Individuals with mild asthma may not even be aware they have it, as wheezing may only be audible with a stethoscope if present at all.
Rather than being a distinct clinical entity, asthma is now considered to represent overlapping syndromes with similar clinical features. Asthma may develop at any age, but most commonly occurs in early childhood, or mid-adulthood. Asthma that presents in childhood typically responds well to appropriate treatment and is often outgrown with time. Many cases that occur in adulthood respond well to treatment, but remain chronic. There is a strong genetic component to asthma, as approximately 40% of children who have asthmatic parents will develop asthma. Asthma also varies by ethnicity; for example, in 2006, asthma prevalence was found to be 20.1% higher in African Americans than in whites. Most patients with asthma, approximately 70%, have allergic disease. Most children with asthma have allergies that cause or significantly aggravate their asthma.
Triggers
As with many medical conditions, a combination of genetic susceptibility and environmental exposure plays a role in the development of asthma. Identification and avoidance of specific asthma triggers is imperative to help achieve optimal control of asthma. The most common environmental asthma triggers are allergens (inhalants such as house dust mites, pollens, molds, and animal dander), viral respiratory infections, exercise, and cigarette smoke. Other triggers may include cold air, humidity, occupational exposures, menses, emotional stress, pollutants, sulfite sensitivity, and ingestion of non-steroidal anti-inflammatory agents.
Asthma-like Conditions
There are a variety of medical conditions that can mimic asthma. These conditions must be considered in a patient who continues to experience symptoms despite being on optimal medical treatment for asthma. They include acid reflux or GERD, habit cough, vocal cord dysfunction (or paradoxical vocal cord movement), upper airway obstruction, foreign body aspiration, Churg-Strauss Vasculitis, Chronic Eosinophilic Pneumonia, Hyper-eosinophilic Syndrome, ACE-inhibitor-induced cough, COPD, pulmonary embolism, congestive heart failure, cystic fibrosis, sarcoidosis, post-viral tussive syndrome and bronchiectasis.
Comorbid Conditions
Optimal asthma control is often difficult to achieve until co-morbid (or co-existing) medical conditions have been properly addressed and managed. Co-morbid conditions to consider in the asthmatic patient include environmental allergic disease, chronic sinusitis, obstructive sleep apnea, GERD, tobacco abuse, Allergic Bronchopulmonary Aspergillosis, corticosteroid resistance, occupational exposures, obesity, and Type II diabetes mellitus.
Evaluation and Diagnosis
Asthma is usually suspected when the characteristic symptoms occur, especially at nighttime, with exercise, with colds or with allergy flare-ups. Definitive diagnosis and optimal treatment of each individual case requires not only periodic exams, but also measurements of lung function, starting by five or six years of age. This is done by using spirometry which is a type of lung test that measures the amount and rate of air flow from the lungs. Correlation of the results of a patient’s spirometry test with their clinical symptoms helps the physician decide whether or not a patient’s asthma is under optimal control and whether or not a patient’s medications should be increased, decreased or left unchanged.
Allergy testing is typically performed as part of the initial evaluation of an individual with asthma since allergies are a trigger in up to 85% of individuals with asthma. Chest x-rays, blood work, and other tests are rarely needed for the diagnosis and management of asthma, unless other medical problems are suspected.
Optimal management of asthma begins with utilizing the evidence-based NHLBI (National Heart, Lung and Blood Institute) asthma guidelines to stage the patient’s asthma based on impairment and severity. Treatment is then arranged with medications as appropriate to the level of disease.
Treatment
The goal of treatment is to develop a personalized, comprehensive treatment plan for the patient’s asthma that includes appropriate medical therapy, minimizes exposure to environmental triggers, treats underlying co-morbid conditions as discussed above, and patient education about their condition. The most common reason that patients experience suboptimal control of their asthma is that they do not take their medications as prescribed. This may occur for a variety of reasons, including non-compliance, poor device technique, lack of understanding of their disease condition, and/or socio-economic factors.
There are three basic categories of asthma medications- the first is bronchodilators, which temporarily relieve symptoms by relaxing constricted bronchial tubes. These are typically used only when needed. The second is anti-inflammatory medications, which prevent or heal the inflammation inside the bronchial tubes. These are generally used every day, even when the patient feels well. The final category includes medicines that modify the immune system to try to prevent asthma symptoms.
Depending on the patient’s history and the results of any allergy testing, specific measures may be recommended to help the patient minimize exposure to their asthma triggers, allergic or otherwise. This will help reduce the amount of medication needed to control the patient’s asthma. Also, allergy immunotherapy injections are the most effective long-term preventative strategy for allergy treatment. For patients with allergy-induced asthma desensitization with immunotherapy injections (allergy shots) can dramatically reduce allergy-induced symptoms and decrease the amount of medications necessary to control asthma.
How Your Local Allergy Partners Physician Can Help
Your Allergy Partners physician can help determine the cause of your asthma by combining a thorough medical history and physical examination with appropriate diagnostic testing. Allergy Partners’ physicians can help with administration of allergy immunotherapy when appropriate. They are also experts in the administration of Xolair. Allergy Partners’ physicians, nurses and asthma educators are dedicated to teaching patients about their asthma and asthma medications (including device technique), which greatly decreases the rate of medical non-compliance and inappropriate medication usage. Allergy Partners’ ongoing dedication to patient education is demonstrated by multiple useful tools on the Allergy Partners website, including a medical conditions library, instructional videos on proper medication device technique, pollen counts and blog.
PR: NOVA MedMarket