Asthma by Peter Logalbo, M.D., F.A.A.A.A.I.

Asthma is a chronic disease of the lungs. Although it is chronic, not everyone with asthma has symptoms all of the time. Some individuals with asthma have symptoms that occur intermittently, and can go several weeks or months with no symptoms at all. Others with more severe asthma may have symptoms every day.

The hallmark symptom of asthma is wheezing, a high pitched noise evident usually on expiration. This is often accompanied by a cough, and a feeling of chest tightness, or not being able to get a full breath in. These symptoms are often brought on by asthma triggers which can differ from one individual to another. Probably the most common asthma trigger is a cold or upper respiratory infection. Other common triggers are inhaling cold air, strong scents like perfume or the odor of cleaning solutions, cigarette smoke, exercise and a change in the weather. Many individuals with asthma have allergies which are a trigger for their symptoms. These could include allergies to pets, pollen, dust or molds.

The first step in treating asthma is to avoid one’s triggers. This could involve the use of a scarf in cold weather, avoiding strong odors and cigarette smoke, keeping away from pets and maintaining a dust-free environment.  These steps can help one to decrease the frequency and severity of asthma symptoms.

Once symptoms occur, the first medication to use is a short acting bronchodilator, a medication which helps to open the airways. These medications work within minutes and can relieve symptoms for up to several hours. They are used only when needed, and can be administered with an inhaler or by a nebulizer which aerosolizes the medication and is easier to use in children. The second type of medication is for individuals with more frequent symptoms. These medications often contain an inhaled steroid, and sometimes also a long-acting bronchodilator. These are used on a regular basis once or twice a day to help control symptoms over a longer period of time.  Additional medications include Singulair or Montelukast, a pill taken daily that can also help to control symptoms. Finally, there are newer medications (Xolair, Nucala) which are given by injection once every 2-4 weeks for individuals with more severe asthma symptoms.

For those individuals with allergies, allergy shots are a way to reduce their sensitivity to allergens and thereby reduce asthma symptoms.