Top Things Your Patients Need to Know About Asthma

Medscape

4 hours ago

The roughly 28 million Americans living with asthma are familiar with the challenges of inflammation and narrowing of the airways that affects how the lungs are supplied with air. That's not including the typical symptoms, such as wheezing, shortness of breath, chest tightness, and coughing.
And, while medication and lifestyle modifications usually work to help manage these symptoms, full-blown attacks can occur due to airway tightness, and these attacks can be life-threatening.
' Asthma is most often a chronic condition and needs to be thought of that way,' said Morris Nejat, MD, who specializes in adult and pediatric allergy and immunology and is owner and chief medical officer of NY Allergy and Sinus Centers in New York City. Doctors, he said, should do detailed review of a patient's health history and perform breathing and lung function testing to measure how severe the condition is.
As a physician, you should encourage patients not to ignore asthma symptoms — no matter what they are.
'Keep an eye on your cough, wheezing, shortness of breath, and chest pain,' is what Diane Cymerman, MD, who specializes in allergy, asthma, and immunology at Stony Brook Medicine in Stony Brook, New York, says patients should be told. 'It's also important that you aren't relying solely on albuterol-type inhalers. If you need an albuterol-type inhaler more than 2 times per week, it's time to see a physician to begin asthma controller medications.'
Here are five important things patients should know about asthma:
1. Watch for Early Symptoms
If a patient has never been officially diagnosed with asthma, one sign that they might be developing the condition is long-term or persistent dry coughing, particularly at night or upon waking up. Routinely experiencing shortness of breath or chest tightness may also be an early sign of asthma.
'Cough is the most common symptom of asthma and usually starts long before asthma advances to wheezing,' said Angela Duff Hogan, MD, chair of the asthma committee of the American College of Allergy, Asthma, and Immunology. 'Recognizing this early symptom can help stop a full-blown asthma attack.'
2. Learn the Triggers
While asthma triggers can sometimes depend on one's age, the long list of factors that can prompt asthma include bacterial sinus and respiratory infections — especially common viral infections. High on the list as well: Pollution, smog, strong odors or fumes, and lung irritants, including cigarette smoke or even sitting near a campfire.
'Exercise and taking aspirin or NSAIDs can also play a role in worsening asthma symptoms,' Hogan said. 'Emotional triggers, including stress, can also prompt asthma.'
Other triggers that can exacerbate asthma symptoms include al lergens such as dust mites, roaches, pet dander, pollen, and mold spores.
Allergy testing can identify what exactly a patient is allergic to, although that may require a referral to a specialist. Also, Nejat said, suggesting patients keep a diary of symptoms can be extremely helpful, especially when preparing for an appointment with an asthma specialist.
3. Fluctuating Weather
It's normal to feel a worsening of asthma symptoms during extreme weather changes. In addition, damp weather spreads pollen and mold, which is yet another asthma trigger. Climate change, including longer pollen seasons and wildfires, have also contributed to breathing issues for those with the condition.
' The weather can certainly affect asthma,' Hogan said. 'Very cold air can cause the muscles that line your lung airways to tighten, and extremely hot temperatures can cause dehydration, which worsens asthma by thickening mucus, making it harder to breathe.'
4. Age of Diagnosis
While one can develop asthma at any age, a family history of asthma and the presence of other allergy conditions could play a pivotal role.
In addition, adult-onset asthma (meaning a diagnosis in anyone older than 20 years) is currently being studied due to the increase in adults developing asthma.
The reasons for the connection aren't exactly clear but may relate to having a history of allergies (around 30% of adult asthma is triggered by allergies), acid reflux, or being exposed to certain irritants or air pollution.
5. Always Be Prepared
Treatments for asthma can vary. For patients with well-controlled asthma, treatments can include maintenance inhaler therapy (or a rescue inhaler) for symptoms like coughing or wheezing. Inhaled corticosteroids may also be beneficial.
Patients should always have their medicines handy — and never use expired medication. It's also critical that patients both know how to correctly use an inhaler and have an asthma action plan.
A patient should never wait until their wheezing to get some relief. 'Let your inhaler be your bestie,' Hogan tells patients. 'Make sure you have it available and use it when you should.'
If, however, a patient feels like their usual medications aren't effective, they shouldn't hesitate to seek out another option.
'You'll want to make sure your asthma specialist assesses the cause and offers you the best management of your symptoms,' Cymerman said.
One final note for patients: 'Just because you feel 'well' doesn't mean that your asthma is gone or that you should stop your controller medicine,' Hogan said.