Many individuals think of asthma only in terms of episodes or attacks, but asthma is always present with or without symptoms. An asthmatic’s lungs have chronic low grade inflammation and with irritation the airway becomes narrowed. During an attack, the air passages narrow more and glands in the walls secrete excess mucus that traps air in the bronchial tubes, wheezing then becomes apparent. In severe cases, asthma can be deadly.
A majority of children with asthma have identifiable allergy triggers. Approximately half of adults with asthma will have allergic problems. Allergy tests should be done to identify avoidable symptom triggers. Chest x-rays, CT scans, and evaluation for gastro esophageal reflux disease may also be necessary to further evaluate some patients with asthma.
If asthma attacks are occurring more than twice a week or are unpredictable or if symptoms occur on a daily basis, treatment with long-term controller medication is recommended. Taken daily these medications help an asthmatic achieve and maintain a symptom free lifestyle.
Since inflammation or swelling plays such a critical role in asthma, daily inhaled corticosteroids have become a mainstay of asthma treatment. Taken early and as directed, these medications can control and normalize lung function in many individuals. Taken as directed inhaled steroids are safe, well tolerated and are very effective in controlling asthma. It is important however, that a patient be monitored when on inhalable steroids for any possible side effects. Other anti-inflammatory medications that may be used include cromolyn and nedocromil.
Other medications for the long term control of asthma are leukotriene receptor antagonists, long acting bronchodilators(beta agonists), long acting theophylline and oral steroids. Combination therapy of inhaled corticosteroids plus long acting beta 2 agonist may be indicated for asthma when inhaled steroids alone do not control the disease.
A short acting bronchodilator (beta 2 agonist) should always be on hand for any patient with asthma. It can be life saving, and deaths have been attributed to lack of availability.
Immunotherapy may also be helpful for those individuals with allergic asthma. Immunotherapy increases a patient’s tolerance to the allergies, which cause the allergic asthma symptoms. A recent treatment option called omalizumab (anti IgE) helps prevent asthma attacks by binding to the allergen antibody (IgE) that causes the reaction. This treatment is approved for patients 12 and older who have moderate to severe allergic asthma.
The Texas Allergy, Asthma and Immunology Society (TAAIS) is a group of more than 220 board-certified Allergists/Immunologists in Texas.
An Allergist/Immunologist is a physician, usually an Internist or Pediatrician, who has had special training and experience in the field of Allergy and Immunology and who is considered to be an expert in the diagnosis and management of immune system disorders such as asthma, allergic rhinitis (hay fever), eczema, urticaria (hives), drug reactions, food allergies, immune deficiencies, and all general aspects of anaphylaxis.
A Board Certified Allergist/Immunologist is a physician who has passed the certifying examination of the American Board of Allergy and Immunology. A list of Board Certified Allergists can be found here. Those with “ABAI” under Board Certification are Board Certified Allergists/Immunologist.