The public health burden of asthma is approaching alarming levels. The Centers for Disease Control estimates that nearly 24 million people of all ages are afflicted with this chronic respiratory condition. Further, asthma is one of the most common chronic allergic and respiratory conditions impacting children.
The public health burden of asthma is approaching alarming levels.
The Centers for Disease Control estimates that nearly 24 million people of all ages are afflicted with this chronic respiratory condition. Further, asthma is one of the most common chronic allergic and respiratory conditions impacting children.
The signs of asthma can vary between individuals and can present differently in individuals at different times. Milder symptoms can begin as chronic coughing, exercise limitation, wheezing or shortness of breath. Symptoms can progress intermittently or on a chronic basis to become associated with decreased productivity, work absences or lost school days. If left untreated, asthma can impair quality of life and lead to disability and even death.
The underlying cause of the condition is inflammation or irritation of the respiratory passages, which constricts the airways, making it difficult to breathe. The causes of the disease may not always be evident.
It appears that genetic factors can lead to a predisposition to become asthmatic. Natural factors (pollen, dust mites, animals, molds, other infections) and manmade environmental factors (tobacco smoke, occupational triggers, chemicals, toxins, pollution) also appear to be playing an increasingly important role.
The correlation between passive cigarette smoke exposure and asthma is particularly strong, especially with regard to children. Research has shown that children who live in homes with smokers have a 44 percent higher chance of developing asthma than those children who do not live in homes with smokers.
One of the major challenges of treating asthma is that each patient has a unique environmental history and a different genetic makeup. For both physician and patient, the first step before any therapeutic intervention is to pursue a thorough review of potential triggers. Once this assessment is made, an asthmatic patient and the physician together can develop a customized action plan with strategies to manage the condition. These steps may include avoidance of offending triggers (removing cigarette smoke, mold, dust, or animals), medications, and in some cases, desensitization (immunotherapy) to lower the patient's degree of allergic reactivity.
Since several factors can contribute to poor control, patients who have chronic respiratory symptoms for which the cause may be unclear may want to meet with an asthma specialist for an assessment. This would include a thorough history, physical examination and some simple tests to verify triggers and assess the severity of the patient's condition. These findings will provide the basis of a customized action plan that can be revisited over time, adjusted seasonally, as a patient ages, or changes the home or work environment.
For those patients interested in obtaining a customized action plan to achieve better asthma control, an effective approach would be described simply as this: get tested, get treated and get better. For more information, visit the American Academy of Asthma, Allergy and Immunology at www.aaaai.org or the Massachusetts Medical Society at www.physicianfocus.org.
Dr. Daniel G. Steinberg is a board-certified specialist in Allergy/Immunology, director of the Allergy & Asthma Center of Massachusetts, and a past president of the Massachusetts Allergy & Asthma Society. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org.