Asthma is a chronic disease involving the inflammation and constriction of the bronchial tubes. The bronchial tubes are the airways that allow air to come in and out of the lungs. In the case of asthma, these airways are always inflamed and can tighten when asthma symptoms are triggered, causing wheezing, coughing, shortness of breath, or tightness in the chest. There are many different types of asthma with many distinct triggers, often requiring a personalized treatment plan to manage.
Asthma symptoms can be worsened by pre-existing allergies to allergens such as pollen, mold, and dust. This is known as allergic asthma.
Asthma affects millions of children and their families. Most children who develop asthma do so before the age of five, and about one in five children grow out of their asthma by age 19.
Exercise-induced asthma, also called exercise-induced bronchio-constriction is triggered by strenuous exercise.
Exposure to irritants like dust, chemicals, gases, and other harmful substances at work may lead to occupational asthma. Some workers are at a higher risk of developing occupational asthma, including farmers, laboratory personnel, and those who handle plastics, metal, and wood.
Asthma that presents predominantly as a dry cough and without symptoms of wheezing, shortness of breath, or chest tightness is called cough-variant or cough-dominant asthma.
Eosinophilic asthma (EA) is a rare but severe type of asthma that is marked by elevated levels of eosinophils in the airways and the respiratory system. Eosinophilic asthma can cause excessive inflammation that can impact other systems in the body as well, commonly causing inner ear infections, nasal polyps, chronic sinus infections, aspirin-exacerbated respiratory disease, and even gastrointestinal issues.
Neutrophilic asthma is a severe refractory type of asthma that’s associated with high neutrophil levels in sputum, fixed airway obstruction, and poor response to standard treatment.
Asthma-COPD Overlap Syndrome
Asthma-COPD Overlap Syndrome (ACOS) describes the medical situation in which a patient has both asthma and chronic obstructive pulmonary disease (COPD) simultaneously. Like asthma, COPD causes breathing problems and obstructs airflow, sometimes making it difficult for doctors to diagnose both conditions when both are present.
Asthma symptoms can vary drastically from person to person. The following symptoms are most common:
- Shortness of breath
- Chest tightness
- Chest pain
- Chronic coughing
- Trouble sleeping due to coughing or wheezing
Asthma symptoms can worsen when you have a cold, during times of high stress, or during exercise. Asthma attacks, also called asthma exacerbations, occur when the airways become swollen and inflamed, making breathing especially difficult. Asthma attacks can be triggered by common allergens like pollen, mold, pet dander, or dust mites. They can also be triggered by smoke, pollution, changes in weather, or cold air.
Children often have trouble describing their asthma symptoms, but may exhibit certain behaviors that can be telling. We recommend that parents look for the following symptoms if they suspect that their child has asthma:
- Constant coughing, which is often worse at night
- Coughing that is made worse by viral infections
- Coughing that occurs while your child is asleep
- Coughing that 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
Symptom patterns can be very telling in the case of an asthma diagnosis, so it’s important to pay attention to when and why symptoms occur. In addition to your medical history, Dr. Cajigal will use asthma and allergy testing methods to understand your condition.
Spirometry is a breathing test that measures the amount of air your lungs can hold and the speed of the air you inhale or exhale. Dr. Cajigal will use a spirometry test to diagnose asthma severity and measure how well different treatments are working.
Managing any underlying allergy triggers can drastically improve asthma symptoms and help to prevent asthma attacks. For this reason, Dr. Cajigal will also run allergy tests to ensure that you’re receiving comprehensive care for your asthma. Allergy testing can involve skin tests for pollen, mold, and dust allergens as well as confirmatory blood tests.
Asthma cannot be cured, but it can be well managed with therapies that control symptoms. The goal of asthma management is to decrease the intensity and frequency of asthma symptoms and minimize the adverse side effects of your asthma regimen. The asthma management plan that works for one person can look much different than what works for another, and your asthma may change over time, so it’s important that you continue to work with your allergist to track your symptoms and adjust your treatment plan as needed.
Controller medications are taken regularly to minimize asthma symptoms and prevent asthma attacks. Examples of controller medications include inhaled inhaled corticosteroids, leukotriene modifiers, anticholinergics, long-acting beta agonists (LABAs), theophylline, or combination inhalers that contain both a corticosteroid and a LABA.
Rescue medications provide rapid relief when symptoms develop. They are used to relax and open the airways during an asthma attack. Rescue medications include short-acting beta-agonists like albuterol, levalbuterol, and pirbuterol. Oral and intravenous corticosteroids may also be prescribed for use during serious asthma attacks. Asthma rescue medications do not take the place of controller medications, and should only be used in the prescribed circumstances. If you rely on rescue relief more than twice a week, it’s time to see Dr. Cajigal for a new treatment plan.
Immunotherapy: Biologic Injections & Allergy Shots
Biologic injections can help control symptoms and prevent asthma attacks. Biologic therapies include omalizumab, benralizumab, mepolizumab, and reslizumab. If you have allergy-induced asthma, allergy shots may also be prescribed to reduce your body’s sensitivity to a particular allergen.
Viral respiratory infections can create complications for individuals with asthma. Individuals with asthma, especially a should have all of their vaccinations up to date to reduce their risk of developing complications from respiratory infections. We hope you’ve found this information helpful. Get in touch with us at St. Louis Family Allergy to learn more about asthma and how to most effectively manage it! We’re looking forward to your visit.
 American College of Allergy, Asthma & Immunology: https://acaai.org/  Asthma and Allergy Foundation of America: https://www.aafa.org/