Asthma Diagnosed and Treated by Lung Doctors in Baltimore

Asthma is a chronic disease that affects breathing. Airways, the tubes allowing air to come in and out of the lungs, become narrow, inflamed and swell and produce excess mucus. These sensitive airways react when confronted with certain allergens such as pollen, animal dander, mold, dust mites and irritants. The narrow airways cause wheezing, coughing and labored breathing.

Asthma can be treated with preventive medicines that provide long-term control, as well as quick-relief medicines that provide immediate relief of symptoms.

Risk factors for developing asthma may include:

• Family history (parent or sibling)
• Allergic conditions such as hay fever and skin conditions that create rashes
• Obesity
• Smoking
• Contact with second hand smoke
• Mother who smoked at pregnancy
• Babies born with low birth weight
• Being exposed to exhaust fumes or other pollutants
• Work-related environments that use chemicals

Asthma symptoms can vary in severity and differ from individual to individual. Asthma symptoms may include:

• Shortness of breath
• Chest tightness, pain or pressure
• Wheezing (common sign in children) or whistling
• Difficulty sleeping at night
• Tired or weak after exercising
• Mood changes such as tired, easily upset, irritable
• Decline in lung function capacity when measured with peak flow meter
• Cold or allergy symptoms (sore throat, nasal congestion, sneezing, running nose and headache)

If common asthma symptoms go untreated, more complex asthma symptoms can occur and cause an asthma attack, which can be life-threatening. An asthma attack occurs when several muscles surrounding the airways are affected and begin to tighten. As the asthma attack takes place, airways become inflamed and the lining of the airways become filled with thick mucus making it difficult to breath.

Complex asthma symptoms include:

• Extreme wheezing when breathing in and out
• Continuous coughing
• Trouble speaking
• Pale and wet face
• Excessive breathing
• Lips or fingernails turn blue in color
• Behavior of anxiety and panic

Conditions that can trigger asthma symptoms:

• Exercise induced asthma – takes place when the air is chilly and dry
• Job-related asthma - caused by job irritants like chemical vapors, gases or dust
• Allergy-induced asthma - caused by mold, dust mites, pet dander, cockroaches or pollen from flowering plants
• Air contaminants like smoke
• Drug interactions including beta blockers, aspirin, ibuprofen and naproxen

Testing for asthma requires a physical examination. If asthma symptoms are severe, it may require a visit to a lung doctor, also known as a pulmonologist. The exam will include a thorough patient medical history to exclude other serious lung diseases, such as COPD (Chronic Obstructive Pulmonary Disease), bronchitis and emphysema.

A lung function test may be included in the exam to determine how much air moves in and out while breathing. Lung tests may include:

• Spirometry
• Peak flow
• Methacholine challenge
• Nitric oxide test
• Imaging tests
• Sputum eosinophils

Tests results will help the doctor determine the severity of the asthma and how to categorize it. Asthma categorization includes:

• Mild intermittent
• Mild persistent
• Moderate persistent
• Severe persistent

Asthma can be treated with preventive medicines that provide long-term control, as well as quick-relief medicines that provide immediate relief of symptoms. Other asthma treatment options also include:

• Recognizing asthma triggers and how to prevent them
• Taking daily asthma medications
• Keeping symptoms under control

If asthma is brought on by allergies, treatment options may include allergy shots and allergy medications.