Before it was known what was really happening in the lungs during an episode of asthma, doctors used many different terms- wheezy bronchitis, asthmatic bronchitis, “colds settling in the chest.” We now know that there are two main processes that occur in asthma or reactive airways disease (RAD).
The first phase is when the muscles that line the bronchial tubes of the lung go into spasm. The second phase is when the linings of the bronchials become inflamed- thickening and producing excessive mucous. These two processes- spasm and inflammation -cause trapping of air and difficulty breathing.
Different patients have different triggers that cause the spasm and inflammation. Allergies and colds/viral infections are the two most common triggers. Exercise, emotional stress, temperature changes, and tobacco smoke are others. A patient can have one or more triggers.
Depending on the frequency and severity of symptoms, asthma is divided into different categories –Intermittent or Persistent (which can be further broken down into mild, moderate or severe).
There are two classes of medications used to treat asthma. The first class is what we call Rescue medications. Rescue medications are bronchodilators, they work quickly to relax the bronchospasm. Albuterol (ProAir, Ventolin, Xopenex) is the most common rescue medication.
When symptoms of an asthma attack start-cough/wheeze/chest tightening-always reach for the rescue inhaler. The second class of medications are controller medications. These medications are for patients with more persistent asthma symptoms and are used to stabilize the airways, hopefully over time making episodes of asthma less frequent and less severe.
Controller medications work more slowly, ideally they are to be taken everyday, sick or well, to reach a maximum benefit. Common controller medications are Flovent, Singular or Advair.
Parents get scared when they hear that their child may have asthma. Your doctor can help identify triggers and discuss medications that can keep your child’s asthma in good control. Managing asthma is a partnership between doctor and family. The goal is to keep your child as symptom-free and active as possible.