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Bronchial Asthma

By Mahmoud K. Effat, M.D., Pediatric Allergist and Immunologist
The Chester County Hospital

Published: May 19, 2008

Asthma is a significant health problem in the United States affecting more than 20 million individuals, including five million children. Asthma is a condition that makes the bronchial tubes of the lung overly sensitive and easily inflamed. As a result, these tubes become narrow. A person with asthma may experience varying symptoms that can include coughing, wheezing, chest tightness or difficulty breathing. At times these symptoms can be very severe, even life threatening.

Exposure to allergens in the air - pollen, dust mites, animal dander or mold - can trigger asthma. Respiratory irritants - viral infections, cigarette smoke, strong odors and fumes and indoor suspended particulate matters (dust) - can also prompt asthma symptoms. Exercise can also set off asthma. The changes in hormonal levels that accompany puberty or pregnancy can also play a role in asthma. Exposure to certain substances in the work place can also cause asthma symptoms.

The tendency to develop asthma is hereditary and can often be traced to other family members. A few of the risk factors for developing asthma have been identified; they include having parents with asthma, having a personal history of nasal allergy, having eczema or food allergy, exposure to dust mites in the house, or growing up with parents who smoke.

The number of people developing asthma has been increasing. The reasons for this trend are unclear. However, a few factors have been implicated. One of which is pollution. Another factor is improved hygienic measures in a developed country might have left the immune system not needed for fighting infections, so it engages in struggles with harmless elements, like allergens.

Approach to asthma begins with proper evaluation, to determine its severity and possible causes. Asthma intervention must start with limiting the exposure to the triggers, whether it is allergens - dust mites, animals, mold or pollen - or irritants - smoke, fumes or odors.

Medications for asthma are used in a stepped manner, according to its severity. There are two types. One is the dilators, which are medications that open the tubes of the lung. The other is the controllers that reduce the inflammation in the lung that causes the narrowing of the bronchial tubes. These medications are usually in inhalers form, and an inhaler can contain a combination of both bronchodilators and controller medications. During severe exacerbations, nebulizer and oral medications may be required.

Individuals who have allergies can greatly benefit from allergy desensitization with immunotherapy, such as allergy injections.

Most importantly, asthma has to be closely monitored. Individuals who have asthma should not ignore their symptoms, as it can flare up unexpectedly and can lead to long-term loss of lung function due to lung injury.

This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.

Last Updated: 7/27/2009