Asthma Health Article

Diagnosis

The first stage of asthma diagnosis is from a history of asthmatic symptoms. These symptoms include periods of coughing, wheezing, shortness of breath, or chest tightness that come on suddenly in response to specific stimulants or time periods. A history of head colds that evolve into chest congestion or take more than 10 days to recover from is pertinent. Family history of asthma or allergies may also be part of the diagnosis.

A physical exam may reveal wheezing in the chest that can be heard with a stethoscope. A device called a spirometer may be used to check the function of the airways in children over five years of age and in adults. The test measures the volume of air and the speed with which air can be blown out of the lungs after a deep breath. If the airways are narrowed from inflammation and the muscles around the airways tightening up from asthma, the results will be lower than normal. If spirometry results are normal but asthma symptoms are present, other tests are performed. A bronchial challenge test involves inhalation of a substance such as methacholine, which causes narrowing of the airways in asthma. The effect is measured by spirometry to determine is asthma is present. Children under five years of age usually cannot use a spirometer successfully. In such cases, asthma medications are often attempted as part of the diagnosis to determine if they are able to alleviate the symptoms.

Allergy testing may be performed to determine if there are specific allergens that the individual is reactive to. A device called a peak flow meter may be used every day for several weeks to measure breathing efficiency. Tests may be performed to determine the reaction of the airways to exercise. In some cases, a chest x ray or an electrocardiogram may be used to determine if a foreign object, other lung disease, or heart disease could be causing asthma-like symptoms. The results of the medical history, physical exam, and lung function tests are used to diagnose the severity of asthma and determine treatment.

Treatment and management

Asthma is treated by avoiding stimulating factors and by medication. There are two main types of asthma medication. Acute medications give rapid, short-term treatment, and are only used when asthma symptoms require immediate relief. Acute medications are bronchodilators that may be inhaled and take effect within minutes to dilate the airways and allow normal breathing. Bronchodilators may be used at the beginning of an asthma attack to provide relief. Bronchodilators may also be used before exercise to prevent exercise-induced asthma symptoms. Long-term control medications are taken daily over long periods of time to control chronic symptoms and prevent asthma attacks. The full effect of these medications requires several weeks of use. Individuals with persistent asthma require long-term control medications.

The most effective, long-term control medication for asthma is an inhaled corticosteroid. Corticosteroids reduce the swelling of airways and help to prevent asthma attacks from occurring. Inhaled corticosteroids are preferred for treatment of all levels of persistent asthma. In some cases, steroid tablets or liquid medications are used temporarily to control asthma. Other types of asthma medications inhibit the inflammatory mediators released in the asthma response. Some of these long-term control medications may be used in combination with inhaled corticosteroids to treat moderate persistent and severe persistent asthma. Long-term control medications are used in a preventative manner and will not stop a currently occurring asthma attack. Many asthmatics require both a short-acting bronchodilator to use when symptoms worsen and a long-term daily asthma control medication to treat ongoing inflammation.

Uncontrolled asthma during pregnancy can be very dangerous. Lowered oxygen levels to the fetus may cause damage. Many asthma treatments are considered safe to use during pregnancy. Older adults may need adjustments in asthma treatment because of other present diseases or conditions. Some medications, such as beta-blockers used for hypertension, aspirin, and nonsteroidal anti-inflammatory drugs such as ibuprofen, can interfere with some asthma medications or cause asthma attacks. The use of corticosteroids may also adversely affect bone density in adults.

Asthmatics can monitor the function of their respiratory system with the aid of peak flow meters and spiro-meters. These devices measure the amount of air exhaled with each breath. They are used to regularly monitor the severity of asthma symptoms and to evaluate and manage treatment procedures for individual patients. Maintaining control over asthma symptoms, combined with a healthy lifestyle, are key components of asthma treatment.

Emergency care may become necessary during a severe asthma attack. Emergency care takes place in a hospital setting and may include treatment with high levels of bronchodilators and corticosteroids, additional medications, and oxygen administration in an attempt to restore normal respiratory activity. Delayed access to emergency treatment can lead to complete respiratory failure where the patient simply stops breathing and cannot be revived.

In cases of allergic asthma, allergy shots may also assist in reducing symptoms. Allergy shots, also known as allergen immunotherapy, are recommended for individuals who suffer from allergic asthma when it is not possible to avoid contact with the allergens that stimulate asthma. A series of shots with controlled and gradually increasing amounts of allergen may be given over a number of months or years. The shots are vaccines containing various allergens, such as pollen or dust mites. The increased exposure to the allergen desensitizes the immune system to allergen triggers. Allergy shots can diminish the severity of asthma symptoms and lower the dosage of required asthma medications.