Common Asthma Types
There are several different ways of categorizing asthma. There is no rigid rule about it; these common asthma types are often ad-hoc classifications that developed over the course of years. Some classifications are based on the age at first onset; others depend on the factor that triggers symptoms and still others on where the patient is when the symptoms appear.
Let’s look at a few key asthma types. The first two are based on the age at which asthma symptoms appear initially.
In a majority of cases, asthma begins during childhood or adolescence so this is the most common asthma type. Asthma makes an appearance in a child when the child is hypersensitive to specific allergens in the environment. This excess sensitivity is generally due to genetic factors. Substances that trigger allergic responses include pet dander, cockroach parts, dust mites, pollen, etc. Other factors like breathing in cold air can also cause allergic reactions.
The allergic response involves production of antibodies to trap the foreign substance, which in turn makes the cells in the airway extra-sensitive to allergens. When the child continues to be exposed to the substance/s, asthma symptoms develop and he may have a mild or severe asthma attack.
As with most other asthma types, having a family history of asthma or allergies or both can predispose a child to becoming asthmatic.
Asthma may start during adulthood as well, although this is less common than child-onset asthma. In fact, asthma can start off at any age, even well into adulthood. Asthma starting during adulthood seems to affect women more than men. This is unlike child-onset asthma which affects more boys than girls.
Some adults do not have allergic responses, but still have asthma symptoms. This can happen when they have conditions like nasal polyps or sinusitis. There are also cases of asthma triggered off by drugs like aspirin.
Adults may also develop asthma as a result of exposure to plastics, metals, wood dust and other environmental / work related substances.
Exercise induced asthma
This is a common asthma type. In this variant of the disease, asthma symptoms occur either during or after physical exertion. Some people never develop asthma symptoms at any other time – they are not allergic to any substance. Their symptoms develop only after exercise.
This type of asthma is often not recognized as asthma. Instead, poor physical health or heart related issues are blamed for the symptoms. If the person is in general good health, asthma should be considered as a possible cause of breathlessness and other symptoms that occur after exercise.
Any activity or sport that calls for continuous movement – particularly in cold air conditions – is more likely to act as a trigger for exercise induced asthma.
Sometimes, the only asthma symptom present may be coughing. This makes it difficult to identify asthma as the underlying cause, because coughs can be brought about by many other health conditions. Coughing can occur at any time of the day or night. However, in some patients, coughing occurs mostly at night. This can lead to disturbed sleep and other health issues that flow from lack of sleep.
Asthma can be triggered by a wide variety of substances. Many of these substances occur in the workplace rather than in the home. Asthma that is set off at the workplace due to one or more factors is called occupational asthma. Possible triggers for such asthma include dust from a factory, chemicals of various kinds, industrial gases / vapors, industrial smoke, etc. Other triggers may include things like pollen, moulds, animal dander, etc which are common in homes as well. Occupational asthma attacks may start sometime after the person arrives at the workplace and often subsides when he leaves the workplace.
While there can be many variations of the disease, the above are some of the most common asthma types.
Asthma symptoms in children to be aware of
You’d think that asthma symptoms in children would be quite obvious. After all, you would definitely notice it if a child is gasping for breath or wheezing uncontrollably. However, it is quite easy to mistake asthma for health conditions like allergies, chest colds and other problems.
As is the case with adults, asthma symptoms in children sometimes go unnoticed or are misdiagnosed. It is easy for both parents and doctors to think the child has spring allergies or a cold, particularly if they are looking at just one episode in isolation.
Asthma must be recognized as soon as possible. In children, asthma can be a particularly distressing disease once it reaches a full-blown stage. Not only do children have to endure the agony and terror of not being able to breathe normally during an asthma attack, the disease can also affect other aspects of their lives like performance at school and their self-esteem.
Asthma symptoms in children may include coughing, shortness of breath and wheezing. They may occur alone or in combination. Since these symptoms are common to other illnesses as well, it is easy to mistake asthma for something else. Undiagnosed asthma can be a serious health issue.
You should watch out for the following asthma symptoms in children
If the child has coughs even when there is no cold, it might be due to asthma. Watch out for coughing that starts during or after physical exertion. Asthma often produces a racking kind of cough. Night-time coughs may also be due to the disease, particularly if it appears to be chronic.
This is one of the classic asthma symptoms in children and in adults. Wheezing on exhalation is more common than during inhalation. The wheezing is often loud and can be heard from another room. Any wheezy, squeaky sounds from your child may be warning signs of asthma and you must consult the doctor. Of course, many children with asthma do not have wheezing at all.
- Shortness of breath
This is again a classic asthma symptom. Keep in mind that children will usually not be able to identify shortness of breath. You must look out for shallow and/or rapid breathing. There are also other signs of short breath due to asthma such as:
- Restlessness at night during sleep
- Nostrils flaring while inhaling
- A frightened look on the child’s face
- Trying to draw in breath through pursed lips
- Deepening of spaces between the ribs while breathing
- General fatigue or exhaustion even when there has been no physical activity
- Hunched over posture
- The hollow of the throat moving in and out while breathing
- Chronic / frequent illnesses of the respiratory system
Diseases like bronchitis, frequent colds, pneumonia, etc may indicate that asthma is present, even when other symptoms like wheezing are not obvious.
Other symptoms you need to watch out for include excessive throat clearing, noisy breathing and irregular breathing in general.
The above are the most common asthma symptoms in children. If any of them are present, you must consult a doctor for a thorough evaluation.
Facts about the two major types of childhood asthma medications
What appears to be a persistent cold and cough that refuses to go away often turns out to be childhood asthma.
Over the past two or three decades, childhood asthma cases have skyrocketed. Many health professionals consider it bad enough to call it an epidemic. Asthma is a chronic condition that will require long term medical attention and treatment if it is to be managed well. In addition, asthma will affect practically all other aspects of a child’s life.
However, that is no reason to panic. The good news is that there is a huge amount of ongoing research into asthma. And there are new, improved treatments becoming available all the time, both for childhood asthma cases and for adults.
A few decades ago, most medical professionals thought that the only way to manage asthma was to ensure that it was triggered as infrequently as possible. And if it did rear its ugly head, they treated it with bronchodilators which provided short term relief and allowed the patient to breathe normally.
Today, there is a far greater understanding of the disease. Treatment now involves a multi-pronged approach. Of course, bronchodilators are still used to manage asthma attacks and to provide immediate relief.
Apart from rescue medication, the doctor will very likely prescribe what is called preventive or maintenance medication. The objective here is to reduce the inflammation in the airways and hence reduce the frequency and severity of attacks.
There are two basic kinds of preventive medication available. One kind is the inhaled corticosteroids (abbreviated ICS) which are anti-inflammatory drugs. They help keep the airways open by reducing inflammation in the bronchi.
Leukotriene receptor antagonists are the other kind of maintenance medications. The lungs contain a substance called leukotrienes, which cause the airways to swell and narrow, thus creating breathing difficulties. The leukotriene receptor antagonists inhibit the production of leukotrienes.
Corticosteroids are the preferred treatment according to the National Asthma Education and Prevention Program.
In practice, doctors have found that different children respond differently to these classes of medication. Some children seem to do best by using ICS every day while others don’t respond to ICS but do well with leukotriene inhibitors.
One of the problems with this is that many parents accept whatever medication the doctor has prescribed as the best possible cure and if it doesn’t work, they don’t go back to him with that feedback. As a result, alternate drugs don’t get prescribed and the problem does not get managed well.
Fortunately, the need for trial and error may soon be eliminated to an extent, thanks to research findings that allow doctors to predict which type of medication will suit a particular child best.
Researchers discovered that inhaled corticosteroids work best on children who had high levels of inflammation along with low lung function. Children who were younger and have had asthma for a fairly short period of time tend to do well with leukotriene receptor antagonists. Other cases of childhood asthma may require actual use of medications to find out what works best.
Childhood asthma can usually be controlled well with the right drugs and lifestyle changes.
Do you have cough variant asthma?
In some people, the only asthma symptom present is a dry cough. Other common symptoms like wheezing, labored breathing, chest constriction, etc may not be present. This kind of asthma, termed cough variant asthma, frequently goes undiagnosed for a period of time because the patient has no other reason to suspect the presence of the disease.
The cough itself may be a dry, non-productive cough. The term non-productive here means that the coughing does not bring up phlegm or other substances. However, in many patients, coughing brings up sticky mucus; such coughs are also symptomatic of asthma.
A cough is basically a reflex action. It is caused when the mucosal receptors in one or more locations like the larynx, parts of the lungs, nasopharynx, trachea and ears are stimulated. When that happens, a specific cough center in the brain becomes active and it sends out appropriate messages to the diaphragm and other muscles to produce a cough.
Many things can provoke a cough. The presence of foreign bodies in the nose or even wax in the ear can stimulate a cough. So can breathing in smoke or dust particles. Bronchospasms can produce coughs, as can lung infections and allergic reactions.
A cough that lasts less than a month is classified as an acute cough. It may be the result of an inflammation. Coughs that last over a month are termed chronic coughs. Chronic coughs can subside after a period of time only to reappear many times.
It is essential to see a doctor if a person has a severe cough or if the cough does not go away even if it’s not severe. This is particularly true of asthma patients who previously did not have cough as an asthma symptom, but do now. In all cases, it is necessary to identify the true cause of the cough – and it may have nothing to do with asthma.
In persons with cough variant asthma, the coughing often persists throughout the day and night. It is usually very dry. It often has a tendency to get worse during or after exercise and if the patient exposes himself to cold air.
Cough variant asthma tends to run in families – so one of the first things a doctor will look for is the family history, if he suspects this type of asthma.
It is the asthma that must be treated and not just the cough. Very often, people consume cough syrups to try to get rid of the symptom. While this might provide temporary relief, it will obfuscate the asthma symptom. The doctor will have a tougher time unearthing the real cause of the cough – and that can be dangerous.
The onset of coughing may also be a sign that the person’s asthma problem is deteriorating. Therefore it is doubly important to consult a doctor. In such cases, the right treatment is critical; otherwise the disease can worsen. With appropriate medication, many patients with cough variant asthma can bring the disease under control.
What exercise induced asthma is all about – and what you can do about it
Until recent decades, medical professionals thought that exercise induced asthma and asthma resulting from allergic reactions were entirely different illnesses. However, subsequent research proved that assumption wrong.
As the name implies, exercise induced asthma is brought on by physical exertion. Asthma symptoms like coughing, shortness of breath, wheezing, etc show up during or after exercise. Bronchial and lung tissues may become inflamed, which could be the result of tissues becoming irritated. It could also be due to an allergic reaction. The inflammation can cause shortness of breath. Inflammation can also act as a trigger for bronchial muscle spasms, which may cause severe breathing problems.
Many people are not allergic to common asthma triggers and do not normally experience asthma symptoms. Yet, they may have exercise induced asthma. It is theorised that this might be due to the breathing pattern changes caused by exercise. People who have exercise induced asthma might have a greater sensitivity to changes in the air or to temperature changes.
Rapid Breathing Can Induce Asthma
During exercise, breathing becomes rapid and tends to be shallow. This kind of breathing brings allergens into close contact with the bronchi and lung tissues. Also, when breathing is rapid, the air that reaches the lungs does not warm up as much as usual. We normally breathe through our nose, which humidifies and warms the air before it reaches the lungs. During heavy exercise, oxygen requirements go up and so we tend to take in air through the mouth. This does not allow the air to become sufficiently warm before it hits the lung tissues.
When air that is cool and dry reaches the lungs, it irritates the bronchi and lung tissues. This may release histamines, which results in inflammation and makes the irritation itself worse. This chain of events can set of an asthmatic reaction.
Fortunately, there are several steps that people affected by exercise induced asthma can take to slash the risk of developing asthma symptoms. In some cases, it may be possible to totally eliminate asthma attacks due to exercise.
The bronchodilator inhaler is a critical element in asthma care. It should be used about fifteen minutes prior to exercising, or as directed by the doctor. This one action can greatly cut the risk of asthma. Bronchodilators act to relax muscles in the vicinity of the bronchial tubes. This will prevent asthmatic changes occurring in response to changed breathing patterns during exercise.
Proper warm up before going into an exercise routine will help tremendously. If the body is gradually eased into a new breathing pattern instead of being plunged into it all of a sudden, the chances of having an asthma attack go down. In any case, adequate warm up is essential for many other reasons. After exercise, the body should be allowed to cool down gradually.
Cold air is a very common asthma trigger. Whenever possible, do not exercise outdoors in cold weather. It helps to cover the nose and mouth with a scarf. This will trap humid, warm air in the region of the nostrils so that cold air is not inhaled directly.
Apart from cold weather, the quality of air is another important consideration. During pollen season, or when the air quality is poor due to other factors, it is best to avoid outdoor exercise. As mentioned earlier, the rapid breathing associated with exercise will being pollen and other allergens into closer contact with the lung tissues. That may be enough to trigger an attack.
Having exercise induced asthma does not mean that the affected person cannot enjoy physical activity or life outdoors. With the right precautions and by following the doctor’s advice, it is possible to take part in a wide range of sports and exercise activities.
What bronchial asthma really means
Actually, there is no difference between bronchial asthma and what is normally referred to as asthma. The former is just an old name for the disease. The name came about because asthma involves inflammation of the bronchial tubes. These tubes become constricted and results in breathing difficulties.
Victims of bronchial asthma develop symptoms of the disease at certain times while remaining disease-free at other times. When they have an attack, they exhibit symptoms like shortness of breath and wheezing. In some patients, there are no acute asthma attacks and the only symptom may be a cough at night. This may remain unnoticed for years.
An asthma attack can be fatal. Alarmingly, the incidence of fatal attacks has risen in urban areas, particularly among children.
During the last quarter-century, the incidence of bronchial asthma has increased significantly from around three percent to almost eight percent of the population. The increase is much sharper in the inner cities. The reasons are not hard to find – inner cities have excessive crowding and poor environmental conditions. Common allergens and asthma triggers like cigarette smoke, dust mites and cockroach parts are present in greater quantities.
Tackling Bronchial Asthma
There are several components to tackling bronchial asthma. They include preventive medication, rescue medication, environmental management, education about asthma and regular monitoring.
When someone is diagnosed with bronchial asthma, one of the first things the doctor will do is to explain to the patient what asthma is all about, what signs and symptoms to watch out for and how to take medication (particularly the rescue inhaler). He will also explain how the patient himself can monitor his condition. He may also ask the patient to regularly take peak flow meter measurements. The idea is to become aware of a developing attack before it reaches a critical stage.
Preventive medication is an important element of bronchial asthma control. The doctor may prescribe inhaled or oral corticosteroids. Asthma is associated with chronic inflammation – this medication helps to control inflammation.
Rescue medication – usually a bronchodilator – is used when there is an attack. As the name implies, a bronchodilator expands the bronchial passages making it easier to breathe. It also relaxes the muscles around the bronchi.
Bronchodilators are commonly delivered through an inhaler. When the plunger on an inhaler is depressed, it delivers a measured dose of medication in the form of a fine mist. This is inhaled though the mouth directly into the lungs where it does its work. Asthma-prone persons usually carry an inhaler with them at all times.
An asthma patient must monitor his or her condition continually. In many cases, this means paying attention to body signals. Patients need to watch out if they are getting out of breath more often, or if they are taking longer to recover from exertions, for example.
Sometimes, the doctor may prescribe using a peak flow meter. This instrument measures the person’s ability to breathe. Daily readings using a peak flow meter may be necessary. Monitoring is important because it tells the doctor if the current treatment plan is working. If it isn’t, he will need to modify it.
Lastly, managing the environment is a critical component of dealing with bronchial asthma. This means removing allergens and asthma triggers from the environment or avoiding exposure to such triggers. Affected persons may need to remove carpeting, heavy upholstery, avoid keeping pets in the house and so on. The doctor will be able to provide specific advice based on what triggers the symptoms in each patient.
With the right treatment plan, bronchial asthma can be controlled well in most cases.