• Inflammation means the bronchial tubes are swollen and irritated when an attack begins. This inflammation may reduce the amount of air you are able to breath in and out.
  
• Constriction means that there is a tightening of the muscles of the airways, called bronchoconstriction. This bronchoconstriction makes it difficult to breathe air in or out of your lungs.
  
• Mucous production - in some cases, the mucous glands in the airways produce excessive, thick mucous which further obstructs the airway.
  

Diagnosis of asthma - Often based on history and exam. A pulmonary function test or other diagnostic tests may be performed.

Do I have asthma?

1. Do you cough or have trouble breathing when exercising?
   
2. Do you hear wheezing noises inside your chest?
   
3. Do you cough or have trouble breathing when around pets, dust, smoke, pollen or other allergy triggers?
   
4. Do you cough or have trouble breathing when it’s very hot or cold outside?
   
5. Do you wake up at night because of breathing problems or coughing?
   

If you answered yes to any of these questions it is recommended that you follow up with your health care provider for evaluation and/or treatment.

Treatment for asthma is aimed at treating the two main components of asthma – inflammation and constriction.

• Maintenance (Preventative) Medications:
  Inhaled corticosteroids are used to help decrease the inflammation that is caused by asthma. This is the preferred initial therapy for patients with persistent asthma.
  Benefits:
  • Improve lung function
  • Prevent asthma symptoms
  • Minimize reliance on a quick relief inhaler
  • Minimize the potential for long-term lung damage
    
• Long acting beta 2 agonists (Bronchodilators) are used to relax smooth muscle surrounding the airways, thus reducing brochoconstriction. These agents are the preferred complementary treatment for moderate to severe persistent asthma and not intended for fast relief of symptoms.
  Benefits:
  • Reduce airway constriction
    
• Alternative Preventative Medications:
  Mast Cell Stabilizers (Intal)
  Leukotriene Modifiers (Singulair)
  Mexylanthines (Theophylline)
  
• Rescue Medications:
  Short acting beta 2 agonists (albuterol) are used to stop the tightening of the muscles around the airways. They act within minutes to relieve the sudden symptoms caused by asthma triggers. Sometimes people with occasional, intermittent asthma use short acting inhaled beta 2 agonists. If using the short acting medication more than twice a week to treat symptoms, this is a signal that asthma is not under control and you need to seek medical advice. Overuse of short acting beta 2 agonists will not relieve the symptoms any better and may cause harm.
  

Possible asthma triggers: Smoking, dust mites, pets, cockroaches, indoor mold, strong odors and sprays, pollen and outdoor mold, exercise, colds and infections, weather.

Asthma leads to 5,000 deaths, 2 million emergency department visits and 500,000 hospitalizations each year. Asthma left untreated or improperly treated may cause a long-term decline in lung function and lung scarring over time.

Allergies - are the sixth leading cause of chronic disease in the United States. The prevalence of allergic rhinitis has increased substantially over the last 15 years.

It is estimated that 15 to 20 percent of Americans have some type of allergy. In most people these allergies first appear during childhood, though allergies can be developed at any time throughout one’s life. Children may inherit the tendency to become allergic from their parents. Allergies in children may show up in different ways. Some may get rashes (atopic dermatitis), some may develop asthma and some may get hay fever (allergic rhinitis).

• Atopic dermatitis is an itchy rash commonly found on the face, inner elbows and knees of allergy prone individuals.
  
• Allergic rhinitis is the inflammation of the mucous membranes of the nose that occurs as a result of exposure to an allergen such as pollen, dust mites, mold or animal dander. It may produce sneezing, congestion, runny nose and itchiness in the nose, throat, eyes and ears. While allergic rhinitis is a common symptom of allergy, other symptoms might include headache, fatigue and chronic cough.
  

Diagnosis of allergies - often the history and physical exam are used to diagnose allergies. If indicated, allergy testing can be performed through skin testing and/or blood work.

Treatment of allergies:

• Antihistamines - Used to block the effects of histamine which is the compound released when exposed to an allergen. Histamine release is what causes the symptoms of allergy: runny nose, watery eyes, etc. Antihistamines come in the form of tablets, nasal sprays and eye drops. Both over-the-counter and prescription preparations are available.
  
• Steroids - Used to decrease the inflammation caused by the allergy. Steroids for allergies are most often delivered through nasal spray, but may be taken by mouth if indicated. A prescription is required.
  
• Decongestants - Used in combination with antihistamines to enhance effectiveness, and may also counterbalance drowsiness caused by some antihistamines. Decongestants have the potential of elevating the blood pressure and should not be used without the okay from your health care provider. Both over-the-counter and prescription preparations are available.
  
• Leukotriene Antagonists - Help to minimize inflammation and other effects of allergies. A prescription is required.
  
• Environmental Changes - Eliminating or minimizing exposure to known allergens may help to lessen symptoms.
  
• Allergy Injections (desensitization) - For those not getting relief from allergy symptoms with changes in environment and/or medications, allergy injections are an option.
  

If medication is necessary to treat allergies, it is most effective to use medication daily to prevent symptoms rather than wait until symptoms occur.

If you think you may be suffering from allergies, see your health care provider for evaluation and to develop a treatment plan that is best for you.