Asthma

What is asthma?

Asthma is chronic inflammation of the airways in the lungs.  The characteristics of asthma include airway:

• Obstruction
• Inflammation
• Hyper-responsiveness

What are the symptoms of asthma?

Common symptoms of asthma are listed below.  However each individual may experience symptoms differently.

• Intermittent or chronic cough, especially at night or with exertion
• Chest tightness
• Noisy breathing or wheezing
• Shortness of breath
• Symptoms of recurrent bronchitis

Asthma may resemble other respiratory problems, such as emphysema, bronchitis, croup and lower respiratory infections.  Consult your healthcare professional for a diagnosis.

What causes asthma?

The basic cause of the lung abnormality in asthma is not yet known, although it has been established that it involves a special type of inflammation of the airways that lead to the following:

• Contraction of airway muscles
• Mucus production
• Swelling in the airways
• Allergic rhinitis, gastroesophageal reflux, and upper respiratory infections can trigger asthma

What happens during an asthma attack?

People with asthma have acute symptoms when the air passages in their lungs get narrower because of inflammation.

• Breathing becomes harder and may hurt
• There may be coughing
• There may be a wheezing or whistling sound, which is typical of asthma.
  Wheezing occurs because:
  • Muscles that surround the airways tighten, and the inner lining of the airway swell and push inward.
  • Membranes that line the airways secrete extra mucus.
  • The mucus can form plugs that further block the air passages.
  • The rush of air through the narrowed airways produces the wheezing sound.

What are the risk factors for an asthma attack?

Although anyone can have an asthma attack, it most commonly occurs in:

• Children and adolescents between age 5 and 17
• Females
• People living in urban communities
• Exposure to tobacco smoke
• Other factors include:
• Family history of asthma
• Uncontrolled allergic rhinitis
• Uncontrolled gastroesophageal reflux disease (GERD)

How is asthma diagnosed?

To diagnose asthma and distinguish it from other lung disorders, doctors rely on a combination of medical history, physical examination, and specialized breathing tests, which include:

Spirometry
A spirometer is a device used by your health care professional that assesses lung function.  The test is performed by blowing as hard as possible into a tube connected to a small machine (a spirometer) that measures the amount of air and speed that is breathed in and out.

This can help:

• Determine how well the lungs receive, hold, and utilize air
• Monitor lung disease
• Monitor the effectiveness of treatment
• Determine the severity of lung disease
• Determine whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)

Peak flow meter
A device is used to measure the fastest speed in which a person can blow air out of the lungs.  To use a peak flow meter a person takes a deep breath in and out and then blows as hard and fast as possible into a mouthpiece.  During an asthma attack or other respiratory flare-up, the large airways in the lungs slowly begin to narrow.  This will slow the speed of air leaving the lungs and can be measured by a PFM.  This measurement can help evaluate how well or how poorly the disease is being controlled.

Chest x-ray
This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

Blood tests
Blood tests are used to analyze the amount of carbon dioxide and oxygen in the blood.

Allergy tests
This can be done by skin prick test or blood to determine if there is an allergic trigger.

What is the treatment for asthma?

Specific treatment for asthma will be determined by your doctor based on:

• Your age, overall health, and medical history
• Your symptoms
• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Treatment of potential triggers such as allergic rhinitis, gastroesophageal reflux, and infection
• Expectations for the course of the disease
• Your opinion or preference

As of yet, there is no cure for asthma.  However, it can be controlled with prescription medications that may help prevent or relieve symptoms, avoidance and treatment of potential triggers, and by learning ways to manage episodes.

How is asthma managed?

The goal of asthma management is ASTHMA CONTROL.  People with asthma can learn to identify and avoid triggers.  They can also educate themselves about medications and other asthma management strategies.

Asthma is a chronic disease.  It has to be cared for all the time, not just when symptoms are present.

The four parts of Asthma Control are:

• Identify and minimize contact with asthma triggers
• Understand and take medications as prescribed
• Monitor asthma to recognize signs when it is worsening
• Know what treatment to start to prevent worsening of symptoms

Working with a health care professional is the best way to take care of asthma.  The more information a person with asthma has, the better asthma can be controlled. 

What to expect at UCLA

• Board certified allergists that care for adults and children.
• A thorough evaluation to determine severity of asthma and control by history, physical exam and specialized objective measures of lung function via breathing tests outlined above.
• Determination of triggers and measures to avoid or eliminate factors that can induce or trigger asthma flare-ups (exacerbations). 
• Access to new therapies designed to reverse and prevent airway inflammation including injections that can be given in our fully staffed clinic such as Omalizumab (Xolair) and Mepolizumab (Nucala).
• Well trained nurses that can effectively administer allergy shots (immunotherapy) to decrease sensitivity to potential allergy triggers
• Patient education that includes a partnership between the patient, family members, and the doctors.