Asthma

Asthma is a lung disease in which the airways swell, narrow, and produce extra mucus. When the airways swell or narrow, less air can flow into the lungs. In addition, extra mucus produced in the lungs can further narrow the airways. This makes it difficult to breathe.

Asthma affects over 20 million people in the United States alone. It most often begins in childhood, but adults can develop the disease later in life. People with a family history of asthma and allergies are more at risk of developing asthma. Although symptoms can be managed, the disease may lead to a life-threatening attack. It’s important to know how to identify asthma so it can be treated immediately.

Asthma Symptoms

• Coughing
• Shortness of breath
• Chest tightness
• Wheezing

As many as 8 out of 10 of asthma sufferers also experience allergic rhinitis. This makes allergic rhinitis (also called “hay fever”) a significant risk factor for developing asthma. Symptoms of both diseases can be caused by anything that triggers your allergies, including pollen, pets, mold, cockroaches, and dust mites.

Some symptoms vary by the type of asthma you have. There are various types of asthma you may experience. In allergic asthma, wheezing is the most common symptom. It occurs when a patient is exposed to allergens. These symptoms can easily be managed by avoiding allergic triggers.

In cough variant asthma, coughing is the only symptom. However, severe coughing can lead to difficulty breathing and asthma attacks. This type of asthma is just as dangerous as allergic asthma.

Gastroesophageal reflux disease (GERD) occurs when stomach acid comes up from the stomach into the esophagus and affects as many as 9 out of 10 people with asthma. Symptoms include repeated heartburn, severe heartburn, night-time asthma, asthma symptoms after exercise or after meals, frequent coughing, hoarseness, and belching. Treatment of GERD may decrease asthma symptoms.

Shortness of breath may be the only symptom patients with exercise-induced asthma experience. With this condition, symptoms are brought on by intense exercising or activities. If you suffer from any type of asthma, you must avoid your triggers. Talk to your doctor about what may trigger your asthma.

Asthma Triggers

• Irritants
  • Allergens
  • Viral infections
  • Sinus infections
  • Acid Reflux from gastro-esophageal reflux disease
  • Exercise
  • Emotional Anxiety
  • Medications
  • Foods

Some triggers do not cause allergic reactions, but can still aggravate your airways and nose. These substances are called irritants and may trigger your asthma symptoms. These are not allergens and, although they can cause asthma symptoms and worsen existing asthma, do not cause an allergic reaction:

• Air pollutants like wood smoke, ozone, and other airborne chemicals
• Tobacco smoke: several studies have shown an increased occurrence of asthma in children who have mothers who smoke.  You should never smoke (or allow someone else to smoke) in the home of a person with asthma.
• Dust, vapors, fumes, or gases that you are exposed to at work
• Strong sprays or odors such as household cleaners, perfumes, cooking fumes (especially when frying), varnishes, or paints
• Airborne particles like coal dust, talcum powder, or chalk dust
• Variable weather conditions, like changes in barometric pressure, humidity, or temperature, or even strong winds
• Viral infections (like colds or certain forms of pneumonia) can aggravate or trigger asthma, especially with young children. These infections may irritate the airways (throat, nose, sinuses, and lungs) and the added irritation can trigger asthma flare-ups.  In addition, sinusitis – the inflammation of the hollow chambers found around the nose and eyes – can trigger asthma. Sinusitis symptoms include post-nasal drip, wheezing, cough, sinus pain or pressure, headaches, or enlarged lymph nodes. Since sinusitis usually causes drainage of mucus into the throat, nose, and bronchial tubes, it can aggravate or trigger asthma.

Lymph Nodes can be enlarged from sinusitis or allergies and trigger asthma attacks. Since our lymph nodes are located next to the lungs, they can also affect breathing. When a person inhales allergens, these particles migrate to the lymph nodes. Enlarged or swollen lymph nodes then cause irregular breathing and wheezing. Usually, your lymph nodes will return to their normal size after fighting off an infection.

Some asthmatic adults may experience asthma symptoms after taking specific medications. These medications include aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDS) and beta-blockers (used in the treatment of high blood pressure, heart disease, and migraines).  As many as 2 out of 10 adults with asthma experience NSAID or aspirin sensitivity. Patients with asthma should consult their doctors about any over-the-counter medications they are taking or want to start taking.

Also, eating certain foods or food additives can lead to asthma symptoms, especially in children. Triggers include eggs, milk, tree nuts, peanuts, wheat, soy, fish, and shellfish.  If you find that any food triggers asthma symptoms, it is best to try to avoid eating that food. Sometimes someone with an allergy cough may think they have a milk allergy. A more likely explanation is that they have a postnasal drip from a pollen allergy and the milk protein is simply making the mucus thicker. Allergy tests can determine if there is a milk allergy or just a pollen or dust mite allergy.

As with any other chronic health condition, proper nutrition, exercise, and rest are important to your overall well-being and can help you manage your symptoms.  Stress management can also prevent anxiety and fatigue, which can increase the likelihood of an asthma attack.

Diagnosing Asthma

If you experience wheezing, coughing, or shortness of breath, then you should contact a physician. A physician can diagnose your asthma with a pulmonary function test. This test allows them to assess how well the lungs are working. It measures lung size and air flow.

Pulmonary function tests are noninvasive. It only requires you to deeply inhale and exhale into a mouthpiece connected to a small electronic device. However, certain things such as pregnancy can make a pulmonary function test less accurate. In this case, your physician may have other ways to assess your breathing.

Asthma Management

Asthma is a chronic disease that requires regular management.  According to the National Guidelines for the Diagnosis and Management of Asthma, the treatment of asthma should have four main features:

• Assessing and monitoring lung function using objective tests (spirometry, for example)
  • Avoiding triggers by modifying your environment
  • Medication therapy, as needed, for long-term prevention of airway inflammation as well as short-term symptom management
  • Patient education

For asthma sufferers, it is important to work with your physician to develop an effective treatment plan. The allergists at NY Allergy & Sinus Centers will create an individualized treatment plan for you based on your symptoms and type of asthma. Effective asthma treatment should have six main goals:

• Prevent troublesome and chronic symptoms
• Maintain as close to  “normal” breathing as possible
• Maintain regular activity levels, even exercise
• Reduce the need for emergency treatment and prevent recurrent asthma flare-ups
• Effective medication therapy that has minimal or no adverse side effects
• Patient satisfaction with their asthma care

If you are educated about what causes your asthma symptoms and how to manage them, you can reduce the amount that your symptoms interference with your life. It is important to avoid your asthma triggers, develop and follow an asthma management plan with your physician, and use asthma medications as prescribed. Together, you and your allergist can work toward ensuring that asthma does not interfere with your quality of life.

Summary

If you think you may have asthma, the asthma specialists at NY Allergy & Sinus Centers can help.  We can also help you find relief for your nasal and sinus problems, respiratory allergies, ear, nose, & throat (ENT) symptoms, and skin conditions.  We have the newest treatments and testing, and we see both pediatric and adult patients. Call us at 212-686-4448 to book your appointment.