ASTHMA

General Information

DEFINITION--A chronic disorder with recurrent attacks of wheezing and shortness of breath.

BODY PARTS INVOLVED--Lungs; bronchi; bronchioles.

SEX OR AGE MOST AFFECTED--It affects all ages but 50% of the cases are in children under age 10 (boys with asthma outnumber girls). In adult onset asthma, women are more often affected than men.

> Breathing difficulty--

neck muscles tighten. Severe symptoms of acute attack:

• Bluish skin.
• Exhaustion.
• Grunting respiration.
• Inability to speak.
• Mental changes, including restlessness or confusion.

CAUSES--

Overactivity and spasm of air passages (bronchi and bronchioles), followed by swelling of the passages and thickening of lung secretions (sputum). This decreases or closes off air to the lungs. These changes are caused by:

• Allergens, such as pollen, dust, animal dander, molds and some foods.
• Lung infections such as bronchitis.
• Air irritants, such as smoke and odors.
• Exposure to occupational chemicals or other materials.
• Stresses (viral infection, exercise, emotional upset, noxious odors, tobacco smoke).

RISK INCREASES WITH

• Other allergic conditions, such as eczema or hay fever.
• Family history of asthma or allergies.
• Exposure to air pollutants.
• Smoking.
• Use of some drugs such as aspirin.

> Take prescribed preventive medicines regularly--

don't omit them when you feel well.

• Investigate and avoid triggering factors.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor, chest x-rays.
• Laboratory blood studies and pulmonary-function test.
• Allergy testing, usually with skin tests.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Emergency-room care and hospitalization for severe attacks.
• Psychotherapy or counseling for the whole family to help cope with a chronic condition.

POSSIBLE COMPLICATIONS

• Respiratory failure.
• Pneumothorax.
• Lung infection and chronic lung problems from recurrent attacks.

PROBABLE OUTCOME--Symptoms can be controlled with treatment and strict adherence to prevention measures. Half of the affected children will outgrow asthma.

How To Treat

GENERAL MEASURES--

• Eliminate allergens and irritants at home and at work, if possible. Get treatment for desensitizing to specific allergens.
• Keep regular medications with you at all times.
• Sit upright during attacks.
• Stay indoors as much as possible during high allergen times.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Expectorants to loosen sputum.
• Bronchodilators to open air passages.
• Intravenous cortisone drugs (emergencies only) to decrease the body's allergic response.
• Cortisone drugs by nebulizer, which have fewer adverse reactions than oral forms.
• Antihistamines by nebulizer. These are preventive drugs.

ACTIVITY--Stay active, but avoid sudden bursts of exercise. If an attack follows heavy exercise, sit and rest. Sip warm water. Treatment with bronchodilators often prevents exercise-caused asthma.

DIET--No special diet, but avoid foods to which you are sensitive. Drink plenty of fluids daily to keep secretions loose.

Call Your Doctor If

• You have symptoms of asthma.
• You have an asthma attack that doesn't respond to treatment. This is an emergency!
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.