Asthma is a significant health condition impacting more than 300 million people worldwide. It can be very serious and even deadly, but can be well-controlled in almost every case with minimal to no symptoms, allowing for the ability to exercise vigorously and have a normal quality of life with little to no attacks. Asthma is a chronic condition which means that it often requires treatment even if you are not having any symptoms. It involves airway inflammation and constriction. A variety of triggers such as viral infections, allergens, irritants like smoke and dust, cold air, and even exercise can make asthma flare. Many people with asthma have allergies to things in the environment such as animals and pollen (e.g. trees, grass, weeds). Dust mites and dust mite allergy are less common in southern Idaho because of the dry climate.
Symptoms/diagnosis
The symptoms of asthma include wheezing (a high-pitched sound with breathing out), chest tightness, coughing, and shortness of breath.
In order to diagnose asthma, your allergist will take an extensive history, examine you, and then do a lung function test (this may be repeated after a dose of albuterol, a bronchodilator), an exhaled nitric oxide test, and skin tests. Occasionally, other tests such as a chest x-ray or blood tests such as a CB, and total IgE level may be needed. Your asthma will be further classified based on the presence of allergies, elevated FeNO, elevated total IgE, previous exacerbations, symptoms, lung function, level of eosinophils, exhaled nitric oxide, etc. in order to allow for more comprehensive and individualized therapy. There are a number of subtypes of asthma including allergic and nonallergic asthma, aspirin exacerbated respiratory disease (AERD), asthma in pregnancy, exercise-induced asthma, and type II asthma (characterized by the presence of allergies, elevated eosinophils in blood, and an increased exhaled nitric oxide levels). Severe type II asthma may be responsive to some of the biologic medicines for severe asthma including Xolair, Nucala, Fasenra, Dupixent, Tezspire, and Exdensur.
Management
Your BVAAC board-certified allergist will formulate an individualized treatment plan based on a stepwise care approach which will include extensive education and attention to trigger factors as well as other conditions such as allergies or sinusitis that may make your condition worse. Asthma treatment involves maintenance medications and in some cases allergy shots or biologics.
There are two types of medications for asthma: quick-relief medications and long-term control medications. Quick-relief medications, such as albuterol, relieve symptoms but do not have any effect on the inflammation in your airways long-term. In contrast, long-term controller medications need to be used on a regular basis to treat and prevent airway inflammation. One of the most effective medications are inhaled corticosteroids, the preferred long-term control medication according to all asthma guidelines. There are several other medications available including some of the newer biologic medicines for severe asthma.
Scientific research has shown that people with asthma who see a board-certified allergist have fewer asthma hospitalizations, ER visits, doctor visits, days absent from work or school, and financial costs.