Know the facts about asthma and how it can be managed

Many of us have heard of asthma before and know a little bit about what it is. Asthma Awareness Month is coming up in May, so let’s take a closer look at this disease.

Dr. Krishna Rangarajan, a pulmonologist with Lawrence Pulmonary Specialists, said the National Asthma Education and Prevention Program defines asthma as a “common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness and an underlying inflammation.”

“So, to break it down, asthma is a lung disease that can cause shortness of breath, coughing and wheezing due to a variety of causes,” he said. “Patients with asthma have lungs that react strongly to stimuli that other people may not notice. The reaction results in shortness of breath, coughing and/or wheezing due to the inflammation.”

Rangarajan said there is no single cause of asthma. Rather, there are multiple risk factors.

“Some risk factors can include environmental exposures, genetics, family history, nutrition and also secondhand smoke exposure,” he said. “Though there is no real cause, if you have asthma there are ways it can be monitored and treated.”

Rangarajan said the simplest way to monitor asthma is to see how you are able to go about your daily life, how often you have to use a rescue inhaler, what your peak flow numbers are and how often you have more intense difficulty that requires oral steroids.

“Knowing what your triggers are can help you to avoid an asthma flare,” he said. “Understanding those triggers is important because they vary from person to person. For some, it can be seasonal with certain allergens, or a response to certain smells, perfumes, mold and cigarette smoke. One of the most important things you can do is quit smoking if you do smoke.”

One big misconception about asthma is that there is one test to diagnose it. It often takes some testing and a lot of information from the patient about what is going on to help build a story.

“Asthma is often combined with COPD, but they are different diseases. We also see that there can be overlap between the two diseases,” Rangarajan said. “For some people, asthma can get better over time. Some children will ‘grow out of it’ and never have a problem as an adult. Sometimes it will not be a problem in high school and through your 20s and 30s but will show up again later. But with asthma therapy, our goal is to get it under good control so people can continue doing what they need and want to do.”

Rangarajan said asthma therapies are types of treatment used to control the inflammation in a patient’s lungs. The treatments are different for each person, based on their severity of their asthma.

“The mainstay of treatment is an inhaled corticosteroid to help control the inflammation,” he said. “There is also medication (that helps) dilate the airway and is used as a rescue medication when someone is having more symptoms. If someone is still having significant symptoms despite inhalers, then we have newer injectable medications available as well. This area has been growing quite a bit over the last several years and, for the right patient, can make a huge difference in their therapy and livelihood.”

Rangarajan said that though asthma is not fun to deal with, there are ways to control it. He said the goal for his patients is for them to have the right amount of medication to control their symptoms while working to reduce the levels of medications to decrease any side effects.

“It is much safer to have good asthma control on medications than poor control without,” Rangarajan said. “The recommended doses are adjusted based on symptoms, the frequency of exacerbations, peak flows, how much someone is needing their rescue inhaler and sometimes lung function testing. Do not hesitate to seek medical attention when it is needed and reach out to your pulmonologist.”

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