Is There a Cure for Asthma?

Though it has long been treatable, a cure for asthma remains elusive. Preventive treatment, however, may minimize the difficulty an individual experiences with asthma. Scientists throughout the world are searching for specific cures.

Is Asthma Life-Threatening?

Not usually, but in severe cases asthma can be life-threatening. Deaths occur more frequently in adults. More than 80 percent of the 3,880 deaths related to asthma in 1985 occurred in asthmatics over age 45. Usually, however, the airways can be opened and the attack controlled with medications. In a severe attack, the airways may become completely blocked leading to respiratory failure. This condition is a medical emergency and requires immediate attention. It is important for asthmatics to learn to recognize severe episodes and how to prevent them. Some physicians blame the dramatic increase in asthma related deaths to an over-reliance on drugs designed to open obstructed airways. It appears more likely, however, that deaths are due to the delay in administering therapy to relieve the episode.

Tips for Patients and Parents of Asthmatic Children

* Above all else, learn everything you can about asthma;
* Learn what triggers your (your child's) symptoms and avoid them as best you can;
* Recognize the signs of an oncoming episode and learn to judge its severity;
* Provide preventive care so that you or your child have the least amount of difficulty with symptoms;
* Learn self management skills for yourself, and teach your child these skills in an age-appropriate way.

Summary

What Is Asthma?

Asthma is a respiratory condition characterized by episodes of airflow obstruction in the bronchial tubes. Symptoms caused by this obstruction include coughing, chest tightness, wheezing and shortness of breath. Although problems are often separated by symptom-free periods, asthma is a chronic disorder.

Who Gets Asthma?

Asthma tends to occur within families. The role of inheritance plays a less clear role in adult-onset asthma. People of any age may have asthma, but more than half the cases are found in children between the ages of 2 and 17. In young children, boys are nearly twice as likely to develop asthma as girls, but this gender difference tends to disappear in older age groups.

What Causes an Asthma Episode?

A wide variety of "triggers" may initiate an episode of asthma. The most common triggers are allergens, exercise, viral respiratory infections, respiratory irritants and aspirin.

Allergens are substances to which susceptible individuals may become allergic. They are a major source of problems in children and adults. Common allergens include plant pollen (tree, grass and weed), animal dander, house dust mites, cockroaches, fungi and certain foods. When an allergic individual comes in contact with one of these allergens, a complicated series of events causes the body to release certain chemicals (mediators). These mediators then trigger asthma.

Exercise is a very common trigger of asthma. In fact exercise-asthma can limit physical activity in some individuals, although it need not do so. Very often, respiratory symptoms do not occur until exercise is completed.

Viral respiratory infections are a leading cause of acute asthma episodes, particularly in the winter months. Surprisingly, bacterial infections (except sinusitis) do not usually provoke acute asthma attacks.

Cold air, smoke, industrial chemicals, perfume, paint and gasoline fumes are all examples of irritants that can provoke asthma. These irritants probably trigger asthma by stimulating irritant receptors in the respiratory tract. These receptors, in turn, cause the muscles surrounding the airway to constrict, resulting in asthma symptoms.

Aspirin and aspirin-containing products can trigger asthma attacks in susceptible individuals. The exact cause of the reaction is unclear, but it is not an allergic reaction in the vast majority of affected people. Ten to twenty percent of adult patients with asthma experience a significant decrease in their lung function after taking aspirin. Other "nonsteroidal anti-inflammatory agents" not chemically related to aspirin can cause similar reactions. As a general rule, asthmatics should avoid these products.

Less commonly, food additives can trigger asthma, but this is rare. Of these, the most frequently implicated trigger is sulfites, which are used to preserve certain foods and medications. In some cases, the mechanism appears to be respiratory irritation. The food color tartrazine (yellow food dye #5) has also occasionally been implicated as an asthma trigger.

What Happens During an Asthma Episode?

An asthma patient's breathing tubes are "twitchy." That is, the bronchial tubes (or, bronchi) narrow in response to certain triggers. Because individuals without asthma do not react to these stimuli, the bronchi are described as hyperactive. During an episode, muscles surrounding the bronchial tubes contract, narrowing the air passages. Inflammation also occurs along the lining of the airways, producing swelling and further reduction of airway size. In addition, mucus glands along the inside of the air passages produce excess mucus that accumulates in the already narrowed air passages. The end result is that breathing, especially exhaling, becomes extremely difficult. Air becomes trapped behind the narrowed bronchial passages and there is a decrease in the oxygen available to the body.

How Long Does an Asthma Episode Last?

The duration varies according to the severity of the attack. Mild episodes may only last a few minutes or hours. Severe episodes, however, may go on for days or even weeks. Mild symptoms can resolve spontaneously or may require medication. More severe episodes can also be treated with medications but may require hospitalization.

What Should Be Done During an Episode?

Always follow the instructions of your allergist. Ask for a written plan for both day-to-day management and specific instructions on what to do during an episode. In general, it is important to stay calm and take your prescribed medications. Bronchodilators are the most commonly prescribed drugs to treat an asthma episode. They relax the muscles surrounding the airways, resulting in dilation of the bronchial tubes. Bronchodilators may be inhaled, taken orally or injected.

Why Does Physical Exertion Trigger Asthma?

During aerobic exercise, rapid breathing occurs through the mouth. As a result, the air that reaches the bronchial tubes has not been warmed and humidified by passing through the nose. This cold, dry air can trigger asthma. Asthma symptoms are generally at their worst after six to eight minutes of aerobic exercise. More than 70 percent of all asthmatics experience some degree of exercise-induced asthma.

Should Patients With Asthma Avoid Sports and Exercise?

By taking preventive measures, asthmatics should be able to compete in any sport, even at an elite level. Not all sports, however, are equally tolerated. In general, exercise and sports that involve prolonged periods of running are more likely to provoke asthma symptoms than nonaerobic ones. Swimming is one of the best-tolerated sports. In most instances, exercise induced asthma can be controlled to allow participation in any sport. Many Olympic athletes, including several gold medal winners, have had asthma.

What Is the Difference Between Allergies and Asthma?