​Asthma - Different Types of Asthma, Symptoms, Causes, and Treatment

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​What is Asthma?

Asthma is a chronic inflammatory lung disease that can affect your normal breathing due to airway defects. Swollen muscles constrict and narrow your inflamed airways, which leads to breathing difficulties.

In various asthma cases, the inflammation may produce some mucus blocking the airway either partially or entirely, leaving you gasping and laboring for breath. Doctors would refer to such a case as having an asthma attack.

Although asthma is a common respiratory disorder, it is not contagious.

Children are more susceptible to getting asthma than adults. However, adults are mostly affected by the disease, which may often lead to mortality.

According to some most recent asthma data by the Centers for Disease Control and Prevention (CDC), about 25 million people in America alone have asthma. The figure translates to 8.4 percent asthma cases in children and 7.7 percent of adults. Approximately 300 million people worldwide are asthmatic (having asthma), with about 100 million expected to have asthma by 2025.

Boys are more prevalent in asthma than girls in childhood asthma. As they get older, such prevalence reverses roles during adolescence. The level of asthma cases in girls rises against boys'. Therefore, female adults are more prevalent in asthma than males.

The gender reversal roles from childhood to adulthood is due to less testosterone hormone, a male sex hormone in females. The hormone inhibits innate immune cells that link to asthma development.

Thus male adults who have adequate testosterone hormones are less at risk of asthma compared to females.

An asthma case can either be mild when it occurs occasionally or Chronic with persistent flares and severe symptoms, leading to a life-threatening asthma attack.

A Recap on How Your Lungs Work

Your lungs are two vital organs in your body. Besides the food you eat, oxygen from the air to the lungs is essential for the body cells for energy production from the food you eat. You breathe in oxygen through the lungs for your body to use.

The oxygen you breathe in would get in through your nostrils or your mouth to your lungs. Inside the lungs, the airways receive oxygen, which they take to the blood vessels through the alveoli. The airways are tube-like bronchial passages.

The large airways are known as bronchi. They branch out into smaller airways called bronchioles.

Although very tiny, the alveoli play a significant role in exchanging the two gases, oxygen going to the blood and carbon dioxide coming from the blood.

Asthma triggers may cause inflammation, leading to mucus or phlegm production in the lungs' airways. The phlegm is the reason for coughing when trying to remove it and wheezing due to struggling for air through semi-blocked airways.

The inflammation can also cause chest tightness due to muscle constriction in the airways, often leaving you out of breath.

Asthma can occur differently due to a variety of triggers. Some asthma cases are mild, while others are severe, depending on the triggers, age, and the immunity reaction.

Occupational, Extrinsic (allergic) and Exercise-Induced Asthma are just a few types of asthma.

Types of Asthma

Your asthma case may differ from another person's because of its form. The following are the common types of asthma:

Cough Variant Asthma (CVA). Cough variant asthma is characterized by a persistent nonproductive or dry cough. Unlike other asthma that hav4 classic symptoms of wheezing, coughing, and breathlessness, CVA is different. The predominant symptom of CVA is a persistent cough. Other common signs of asthma, such as wheezing and shortness of breath, can be present in a few cases. Some doctors can mistake CVA to a chronic cough condition.

Child-Onset Asthma. Children are susceptible to asthma compared to other age groups. This is due to their weak immunity that cannot prevent asthma onset when exposed to triggers.Asthma can cause discomfort and affect a child's everyday quality of life. It is especially when the child has a persistent dry cough, wheezing, and in the worst situation, short of breath. Child-onset asthma ranks third top of childhood diseases that lead to hospitalization in America. Although this asthma type might be difficult to treat, it can improve later in life as the immunity strengthens and when the child recognizes the triggers to avoid them. Other child-onset cases can progress to adult-onset asthma.

Adult-Onset Asthma. As the name suggests, adult-onset asthma develops in adulthood. It is a type of asthma that develops at above age 20. Most often, adult-onset asthma is classic asthma with typical symptoms. Adult-onset asthma is most common at the working-age due to occupational exposure. It affects about 16.3 percent of this age-related asthma. An asthmatic adult's symptoms are generally persistent, which would require continual medications to manage it. In comparison, children-onset asthma whose symptoms occur intermittently and hence easy to manage.

Extrinsic asthma (allergic asthma). Allergic asthma, as the name implies, occurs due to an immune response from exposure to allergens. You can know that you have allergy-induced asthma when the flares happen in a specific environment. For instance, if one of your asthma triggers is pollen, your flares would start when you expose yourself to pollen or pollen season. Allergic asthma is an atopic type or genetic related that is typical in children and adolescents. You can have flare-ups when around some allergy triggers or allergens such as pollen, mold, pet dander, or dust mites.

Intrinsic Asthma (nonallergic asthma). Intrinsic asthma is contrary to extrinsic asthma. It is an immune response to non-allergens exposure, such as weather changes, exercises, chemicals, or cigarette smoke. Nonallergic asthma is less common compared to allergic asthma. It is typical after middle age when the body immunity is compromised due to the age factor.

Exercise-induced Asthma Bronchoconstriction. Exercise-induced asthma is a type that is induced or triggered by strenuous exercise. Your airways constrict and narrow when subjected to heavy breathing, causing an asthmatic response. You begin to cough, wheeze, and sometimes experience shortness of breath. If you are in this category, you should take it easy with your exercises. Choose exercises that don't strain you or cause heavy breathing. You can manage your symptoms and enable you to continue with your daily routine exercises without asthma symptoms.

Occupational Asthma. One of the common occupational respiratory diseases is asthma. Your workplace cannot be the cause of asthma; rather, it can trigger an asthma flare-up if you are asthmatic. Toxic substances, including chemicals, paints, certain gases, rubber latex, and animal dander, are workplace asthma triggers. If you remain exposed to the said asthma triggers, your asthma worsens and can damage your lungs, eventually becoming fatal.To prevent asthma exacerbation, you should avoid such exposures or use PPE (personal protective equipment) when you can't prevent working near your asthma triggers.

Asthma-COPD Overlap (ACO). Asthma can take another cause to become ACO, which would make the condition severe than average. ACO (Asthma-COPD Overlap) includes both asthma and COPD (chronic obstructive pulmonary disease) symptoms. COPD is a chronic respiratory condition. It comprises multiple chronic lung diseases such as chronic bronchitis and emphysema, and in this instance, it includes asthma. Can you figure out what would happen when the multiple severe lung conditions overlap in one person? It would lead to an acute constraint of airflow into the lungs. It is challenging to diagnose and treat ACO since asthma and COPD have similar symptoms, most often misdiagnosed. Please try and get the right treatment as soon as possible to restore your health and prevent lung damage.

Nocturnal Asthma. It is a type of asthma that worsens during the night. Although a significant number of asthma patients experience night asthma attacks, it may not be persistent. The regular few asthma flares at night cannot be said to be nocturnal asthma. Some factors, such as allergens, night cold, obesity, and sinusitis, can exacerbate asthma symptoms and worsen it at night. You may experience coughing, breathing difficulty, wheezing, and chest tightness to interfere with adequate sleeping during the night. Nocturnal asthma patients suffer from poor-quality sleep, which, if persistent, can destabilize your day's activities, lead to lung damage or cognitive impairment.

Categories of Asthma

The different types of asthma conditions have varying categories based on how often the flares occur. There are four asthma classifications, which are:

Intermittent. Intermittent asthma is mild with rare flare-ups. It can happen about twice a month, either day or night. This category may not need medications to manage it if it does not interfere with your daily life activities.

Mild Persistent. When asthma symptoms are not frequent such as occurring once or twice a week, it is mild persistent asthma.

Moderate Persistent. Moderate persistent has slightly frequent asthma attacks, such as occurring daily and some, only in a few, nightly attacks about once or twice a week. You may need to strictly avoid exposing yourself to your triggers, which would prevent frequent attacks.

Severe Persistent. Severe persistent asthma is the type that has frequent signs of asthma. The symptoms frequently occur in one day and frequent nights. Such constant asthma attacks in a day or night can leave you exhausted and hinder your daily activities.
Lack of probiotic-friendly bacteria in early life, heredity and environmental pollutants can all cause asthma.

What Causes Asthma?

Scientists are yet to prove the real cause of asthma. However, some factors are known to contribute to the worsening of asthma symptoms or attacks. Some of the asthma risk factors include:

Heredity. Most cases of asthma are heritable respiratory disease. The disease may run in the family such that a child is at a high risk of asthma if the mother or father is asthmatic. One study review of 2014 describes asthma as a 'multifactorial disease with complex genetic inheritance." Asthma is a genetic condition that can move from an asthmatic mother or father to the unborn child. Children from parents with genetically related asthma are highly susceptible to the disease. However, not all end up having it.

Environment. The environmental risk factor is a significant key player in asthma development. 
You may know, infants or growing children who have weak immune systems would fail to compete with asthma causing allergies. Quite a number of children growing up near an industrial area that emit toxic fumes or gases may be exposed to industrial allergens. Such children are highly susceptible to childhood asthma. For an adult, exposure to chemicals and toxins while working can put you at risk of developing adult-onset asthma. It is essential always to wear the right protective gear to offset such risks.

Respiratory Infections. Some respiratory conditions, such as viral respiratory infections, can cause inflammation of the lungs in a child's early life. This can impair lung development and damage the lung tissue to affect its function even long beyond childhood. Frequent respiratory inflammatory conditions such as flu, common cold, pneumonia, and bronchitis can lead to asthma onset.

Probiotic Friendly Bacteria. Limited probiotic friendly bacteria in the developed world due to extremely clean environments could be the reason behind childhood asthma prevalence in such regions. According to research by B. Brett Finlay, a Canadian Microbiologist, and his research team, four types of gut good bacteria or microbiome are essential for immunity development in a child. According to Dr. Brett, a child should acquire the four gut bacteria types in the first three months of life to decrease asthma onset risk. The four gut bacteria are Faecalibacterium, Lachnospira, and Veillonella and Rothis (collectively known as FLVR).

What Triggers Asthma?

Some substances or irritants can trigger and flare your asthma condition. Different forms of asthma cases have varying triggers. If you know your type of asthma, you can recognize what triggers the symptoms and avoid them.

Some of the asthma triggers are:

Air Pollutants. Some air pollutants can irritate the airways and most often exacerbate asthma symptoms. Some of the air pollutants are:
  • Smog
  • Strong odors, fumes, and vapors
  • Smoke from wood fires, charcoal grill, or cigarettes
  • Chemical fumes
  • Dust, air particles, pollen, mold, and pet dander

Medicines. Some drugs, and most OTC (over the counter), can trigger asthma. Such medications are:
  • NSAIDs drugs (nonsteroidal anti-inflammatory drugs) such as naproxen and ibuprofen
  • Aspirin
  • Beta-blockers - are drugs for heart disease, which can trigger asthma symptoms.

Exercise or Physical Activities. Strenuous exercise that causes hard breathing and especially during the cold season can trigger symptoms of asthma.

Other Diseases. Some health conditions can set off asthma symptoms. Such diseases include:
  • GERD or gastroesophageal reflux disease
  • COPD or chronic obstructive pulmonary disease
  • Obstructive sleep apnea

Weather. Sudden extreme weather changes such as moving from warm weather to cold air can cause asthma flare-ups.

Strong Emotions. Expressions of strong emotions such as extreme anger, excitement, fear, and feeling ecstatic can cause breathing changes, hence triggering asthma symptoms such as wheezing.
What triggers asthma? Exposure to irritants like dust and pollen, sudden changes in temperature and even strong emotions can all induce an asthma attack.

Asthma Symptoms

As we mentioned earlier, asthma occurs in different forms. Therefore, symptoms might vary slightly depending on the triggers and asthma classifications. However, some of the general symptoms of asthma are:

  • Coughing
  • Wheezing
  • Chest pain or tightness
  • Shortness of breath
  • Inadequate sleep due to frequent coughing, wheezing and being short of breath

Asthma Prevention

It may not be possible to prevent asthma disease since we know little about its cause. However, you can prevent asthma attacks or flare-ups by doing the following:

  • Please keep a record of your asthma triggers to avoid them
  • Use your medications as directed
  • Note the rising need to use a nebulizer and visit your doctor immediately
  • Keep a peak flow meter near you always to monitor your asthma situation

Asthma Complications

The following are some of the asthma complications:

  • High blood pressure due to inactivity and inability to exercise
  • The permanent decline of lung functioning in children
  • Frequently feeling fatigued
  • Poor sleep, especially during coughing and wheezing moments
  • The underperformance of any activity due to exhaustion and health decline
  • Slow growth in children

How Would a Doctor Diagnose Asthma?

The initial diagnosis is to answer questions from your doctor, which would reveal your asthma condition. Your doctor would want to know the following:

  • How you are feeling
  • About your asthma attacks
  • How they happen
  • What triggers the attacks
  • How often they occur.

Your doctor may also wish to understand your personal and family history and your background on allergies, asthma, and other respiratory diseases.

From the information, your doctor would be able to adduce at what level your case is, for the right treatment to manage the attacks.

The next step of diagnosis is for your doctor to listen to your chest, both the front and back, using a stethoscope. By listening to your breathing, your doctor would detect wheezing and the state of congestion.

Your doctor would also be careful to note whether you have labored breathing and any other inadequate oxygen sign.

Using a peak-flow meter, your doctor can detect the airways' tightness early enough by the force you use to exhale and inhale.

Another test using a spirometer would reveal the performance of your lungs and how you inhale and exhale.

Blood tests for comorbidity are to know whether another health condition is involved in triggering your asthma symptoms. The same blood test would check the oxygen level in your blood, which might be the last part of the diagnosis.

A peak-flow meter (left) and spirometer (right) are two tools your doctor may use to test the performance of your lungs.

Asthma Treatment

It is always prudent to visit your doctor immediately when you sense an asthma attack. Your doctor would know how best to treat your condition.

Asthma treatment would also vary with severity. Your doctor might use the following types of medication and therapies for your asthma treatment:

Medications

  • Instant Relief Medicines
  • Bronchodilators or Short-acting beta-agonists using a nebulizer
  • Anticholinergic agents
  • Corticosteroids oral or intravenous for short-term use
  • Allergy medicines
  • Anti-inflammatory medicines - to prevent airways constriction by reducing mucous collection

Other Therapy

  • Immunotherapy - to control the immune system reaction
  • Bronchial thermoplasty - heat therapy to reduce smooth muscles in the airways to reduce tightness
  • Breathing exercise - It is useful to get oxygen into your lungs enough for your body use

Your doctor can use any treatment suitable for your asthma case and change some medications depending on how well you respond or how worse you are getting.

You may need to have a peak flow meter at home to track and monitor your asthma symptoms for early alerts.

Visit your doctor immediately if you find that you frequently use your bronchodilator and when your symptoms persist. 

Bottom Line

The bottom line of your asthma case is for you to take care of yourself.

Keep in mind the triggers of your asthma attacks to avoid them by all possible means. If your type is occupational asthma, then wearing the right PPEs would be inevitable to inhibit triggers.

To keep fit in health and weight, you need to schedule regular exercise. You can discuss with your doctor which activities would be most suitable for your case and age. Remember, strenuous exercise is another risk factor for asthma symptoms exacerbation.

Change your lifestyle, such as quitting smoking and eating a healthy diet to boost your health. Watch your weight as well. Being overweight is another risk factor for asthma exacerbation.

Do you wish to talk to our Natural Health Practitioner, Yvonne, about your health? Please do so. She has a broad experience of more than thirty years in natural treatments using herbs and other therapies.

You can talk to her directly if you call her on our telephone number +250.468.7685 or use our email address to write to us. This email address is being protected from spambots. You need JavaScript enabled to view it.

Do you have any questions or suggestions? Please write us your comments in the section below and remember to give us your email address. Our health experts can answer all your queries through email.

Here is what one of our patients commented after a successful therapy on his allergy:

"Ben & Yvonne helped to reduce my severe allergy symptoms after ten years of suffering through shots and supplements that didn't work. They introduced me to Herbal Remedies. I now have more energy and am able to go to the gym and workout instead of feeling sick with allergies" - Rick C. 


Yvonne Dollard Perc: Owner of Island Healthworks, Natural Health Practitioner, Teacher, Writer and Editor.
Elizabeth Njuguna: Researcher, Freelance Writer, with a Focus on Natural Health.
Sherry Robb: Print, Web and Social Media Designer Specializing in the Natural Health and Fitness Industries.

Island Healthworks offers in-person and virtual consultations for assessment of your specific needs, with health & lifestyle coaching, featuring the best of integrative natural health care. To book your consultation, please call 250-468-7685!

This article is intended for educational purposes and the information contained within is not intended to treat, diagnose or cure any disease or health problem. Please seek appropriate medical attention for any health complaints. We cannot take responsibility for your health care decisions. Our intent is only to offer health information to help you with your search for better health. 

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Wednesday, 03 March 2021