Remove asthma triggers to breathe more easily

Asthma is a disease that affects the lungs. The Centers for Disease Control and Prevention describes it as one of the most common long-term diseases of children, but adults may have it as well.

Dr. Willard F. Washburne has an immunology practice at Highland Clinic in Shreveport and is board-certified in allergy and clinical immunology.

“Asthma symptoms are the lungs’ response to inflammation,” Washburne said. “The symptoms of asthma are coughing, shortness of breath, tightness of the chest and wheezing. Asthma is usually related to allergy, especially in children, but it can also be related to allergy in adults. Peak times for asthma occur in the spring during the tree and grass seasons and in the fall with the weed season, but it can occur on a year-round basis with other triggers.

“With asthma, the mucus glands increase mucus production, the smooth muscles of the lungs constrict, and the mucus membranes swell. A quick reliever medication, including albuterol, can relieve the smooth muscle constriction and give relief within about 20 minutes, but this relief usually lasts only three to four hours.

If a person needs to continually use his or her rescue inhaler, it is best to add a longterm controller medication like an inhaled steroid. Doctors have access to several good inhaled steroids which are safe and give very good benefit. When an inhaled steroid is used, the chronic inflammation in the lung airways decreases, and symptoms are markedly improved. This decreases the need for a rescue inhaler. If a person with asthma has a persistent problem with asthma and is not improving with just an inhaled steroid, a long-acting bronchodilator along with an inhaled steroid is used. The combination almost always controls the symptoms and decreases the remodeling of the lungs [a condition in which airway membranes thicken, airway muscles and mucus glands become larger, and scar tissue growth under the airway lining makes the airways narrow]. Remodeling of the lungs is a bad thing to happen in the airways. With remodeling of the lungs, there are permanent and irreversible changes in the airway. Sometimes when children wheeze, doctors will use an antibiotic like azithromycin, which is helpful when an infection is present. Usually if an infection is not present, an antibiotic is of no great benefit.”

Despite studies that seem to suggest some anti-inflammatory effect of macrolide antibiotics, the National Institutes of Health states that insufficient data on the risk versus benefit of low-dose antibiotic treatment.

“With asthma it is best to avoid the triggers which can make a person wheeze, such as perfume, cigarette smoke, strong smells, house dust and pollen,” Washburne said. “Staying inside during the severe pollen season will be helpful if a person with asthma is allergic to pollen. If a water leak inside the house causes mold to grow, then stopping the leak and solving the problem with the house is very beneficial to decrease allergy and asthma. People with asthma need to know that both asthma and allergy are very controllable with the medications we have today. They do need to see their doctor on a regular basis to stay on top of their medical problem.”

The U.S. Department of Health and Human Services provides the following guidelines for avoiding various triggers which asthma sufferers may find exacerbates their symptoms:

Animal dander:

Keep furred or feathered pets out of your home.

Keep pets out of your bedroom and other sleeping areas at all times and keep the door closed.

Dust mites:

Encase your mattress and pillow in a dust-proof cover.

Wash your pillow each week in hot water (>130 F) or bleach to kill mites.

Wash sheets and blankets weekly in hot water.

Cockroaches:

Keep food and garbage in closed containers. Never leave food out.

Mold:

Fix leaky faucets, pipes or other sources of water that may encourage mold.

Clean moldy surfaces with a cleaner containing bleach.

Pollen:

Stay indoors with windows closed from late morning to afternoon when pollen and some mold spore counts tend to be highest.

Tobacco smoke:

If you smoke, ask your physician for help quitting and ask family members to quit as well.

Vacuum cleaning:

Try to get someone else to vacuum for you once or twice a week. Stay out of rooms while they are being vacuumed and afterward until any dust has settled.

If you do vacuum, use a dust mask, a microfilter vacuum cleaner bag or a vacuum with a HEPA filter.