6 types of asthma and how they're treated
Asthma can be triggered by food, dust, mold and even cold air. The treatment options are just as varied.
Wed, Aug 21 2013 at 3:34 PM
Asthma is a chronic potentially life-threatening airway disease where inflammation in the lungs causes narrow, swollen airways, increased mucus, shortness of breath, chest tightening, coughing and a characteristic wheeze. While most asthma starts in childhood, experts say that both allergies and asthma can crop up at any age.
About 1 in 12 people (25 million) have asthma according to the Centers for Disease Control (CDC). “Asthma is the most common respiratory ailment in the U.S., also the deadliest one, more so than cigarette smoking,” says Dr. Fred Pescatore, author of The Allergy and Asthma Cure and spokesperson and advocate for Pycnogenol, an antioxidant extract from the bark of the French maritime pine tree that’s been shown to improve asthma symptoms.
There are many different types of asthma each triggered by various culprits and no one treatment fits all. Treatment depends on the type of asthma, allergens and the environmental triggers explains Dr. Jennifer Lee, a clinical allergist and immunologist at ENT and Allergy Associates in Brooklyn, N.Y.
Here, the different types:
1. Allergic asthma
This type occurs when an allergy sets off an asthma flare up. Mold, roaches, pollens and pet dander are common allergies but the list can be endless. Food sensitivities may also play a role. “I think food can have a lot to do with it when it comes to the toxic burden that you put in your body,” says Pescatore.
Pescatore explains there is a strong correlation between casein, the protein in milk and cheese that may trigger asthma. Gluten, yeast and sugar may also be culprits. “I always look for the non toxic approach first so I have people do food elimination diets and a food sensitivity test,” says Pescatore.
“Most of the time we treat this type by finding out what patient’s are allergic to first, so they know what they should avoid,” says Lee. Patients may be prescribed inhaled corticosteroids depending on the severity of their asthma.
2. Asthma without allergies
People may also have asthma not triggered by allergies. Usually an upper respiratory infection (cold, flu, and rhinovirus) sets off their asthma. As soon as cold or flu symptoms appear patients are typically prescribed a short course of inhaled corticosteroids for 10-14 days.
Pescatore has patients eliminate known allergies, any food sensitivities and eat a clean diet of low glycemic index protein, fruits, vegetables and nuts to see if this makes a difference. “Anybody who has asthma has an inflammatory condition,” says Pescatore. “If you decrease inflammation in the body, you decrease your body’s need to ‘act out’ so to speak. When there is less inflammation around there is less need for your bronchials to constrict and your mast cells to activate and all of the things that occur during an asthma attack.”
3. Aspirin Exacerbated Respiratory Disease (AERD)
This type is triggered by aspirin. Patients may have nasal polyps, rhinitis, sneezing and a runny nose, and a history of aspirin sensitivity. When they take aspirin, they develop sneezing and a stuffy nose, which leads to wheezing and difficulty breathing. “If this type of asthma is severe enough, we actually recommend aspirin desensitization. The body is desensitized with incremental doses of aspirin usually done in a hospital setting,” says Lee. Once people tolerate the full dose of aspirin they take a daily maintenance dose, which has been shown to help with polyps, allergies and asthma.
4. Exercise induced asthma
For these asthmatics, any type of physical exertion or sports leads to coughing, difficulty breathing and chest tightness that improves when they stop the exertion. Typical treatment is an inhaled broncodilator medication to open their airway taken about fifteen minutes before exercise.
“There are multiple studies that say taking 2000 mg of vitamin C before exercise can relieve exercise induced asthma,” says Pescatore. Some folks also have cold weather induced asthma. Cold air can be a lung irritant just like perfume or cigarette smoke. This generally occurs in winter.
5. Cough variant
Cough variant is asthma that is characterized by a dry hacking cough. It can occur while awake or asleep and affect both adults and children. Patients usually respond well to inhaled corticosteroids. Vitamin D has also been shown to improve asthma. Studies show there is less incidence of asthma in the south, which may be related to people having less sun exposure and lower vitamin D levels in northern climates.
6. Occupational asthma
Occupational asthma occurs when something on the job sets off an asthma attack. Irritant induced asthma is usually from smoke or inhaled irritants like chlorine. It’s not related to an allergy; the irritant is inhaled and triggers an attack.
In occupations that deal with chemicals like paint or lab animals like rats or mice, patients may also be allergic to their trigger. They must find out exactly what sets off their symptoms and try to avoid it. If you can’t get away from your trigger, you may have to use a corticosteroid inhaler to ease symptoms. Pescatore also likes vitamin A, which has been shown to help get rid of the mucus in the respiratory tract, which can be an irritant.
He also likes Pycnogenol. The pine tree bark extract is an anti-inflammatory and antioxidant that clinical research shows helps to open the bronchial tubes and reduces asthma symptoms.
While corticosteroids and bronchodilators are often necessary in the treatment of asthma, there are many things that can help ease symptoms and prevent the various types of asthma attacks including learning your triggers, finding out what you’re allergic to, discovering food sensitivities, trying vitamins and herbal supplements, as well as lifestyle changes such as eating a healthier diet, removing shoes indoors and using a home air filter.
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