Asthma

Asthma is a disease of reversible obstruction of the lung airways that is associated with chronic airway inflammation. Common symptoms include chest tightness, shortness of breath, wheezing and cough. In most patients with asthma, allergic causes or triggers of asthma symptoms can be identified. Pollens, for example, can trigger during tree, grass or ragweed pollinating seasons. House dust mites and cats are very common causes of allergic asthma. Typically allergic asthma begins in childhood and then recurs in adulthood. Asthma beginning in adulthood is less often allergic in nature and can be associated with chronic sinus disease and nasal polyps.

Allergy Shots

Basic Evaluation of Asthma
Asthma is diagnosed by doing lung function testing (or spirometry) and showing blockage of the airways that improves after treatment with inhaled bronchodilator medication. Another newer procedure (exhaled nitric oxide) can be performed at Advanced Allergy for early detection of chronic bronchial inflammation (with eosinophils) characteristic of chronic asthma. All patients with asthma should be evaluated for allergic causes by skin testing or blood tests that measure allergic IgE antibody. This is essential for selecting subsequent treatment options. In addition to allergy to airborne substances, asthma can be caused or triggered by the work environment (occupational asthma), medications (aspirin like drugs) and chronic sinus disease. In about 25% of cases, allergy or other causes cannot be identified.

Management and Treatment of Asthma
Treatment decisions are based upon whether causes can be identified as well as the overall disease severity. Where a cause can be identified such as allergy to indoor pets, avoidance is the best solution. In most cases, this is not enough, and patients will require daily controller medications in the form of inhalers to control daily symptoms and prevent flareups of asthma. Prevention of “flareups” or asthma exacerbations is essential to reduce risk of asthma emergency room visits and hospitalization. Allergists at Advanced Allergy are experts in managing patients with severe persistent asthma with multiple flareups. In severe uncontrolled asthma patients, inhaler therapy may not be adequate and biologic therapy with monoclonal antibodies may be required to prevent asthma flareups and manage day to day bronchial symptoms. Allergy injections can be very helpful in many patients with less severe allergic asthma.