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Advances in Asthma Diagnosis and Treatment

June 11, 2024

More than 25 million people are known to have asthma in the United States. In this Community Conversation, John Oppenheimer, MD, an allergy and immunology doctor with Atlantic Health System and the director of clinical research at AMG Pulmonology, Sleep, Allergy and Critical Care Medicine, explains the basics of the condition, explores treatment options, and offers guidance on how to keep asthma under control.

What is asthma and how common is the condition?

Asthma is a chronic lung condition that inhibits a person’s ability to breathe well. Symptoms of asthma include shortness of breath, coughing, and wheezing. Asthma symptoms can be triggered by allergic exposure, viral infection, exercise and cold air. According to Dr. Oppenheimer, asthma is a common condition: 1 in 12 people experience its symptoms. Those that suffer from asthma experience a range of afflictions and come in all shapes and sizes, from professional athletes to children to the elderly.

How serious are the symptoms of asthma?

Dr. Oppenheimer shares that on a daily basis, 40,000 people will miss school or work because of asthma. In addition, 30,000 people will have an asthma attack, 5000 will visit an Emergency Room, 1000 will be admitted to the hospital, and 11 will die from asthma in the United States.

What does an asthma attack feel like?

Each individual will experience asthma symptoms differently. Dr. Oppenheimer says some people may experience chest tightness while others can't breathe. “I think the term attack is really meant to make it palpable. You can feel what it is. The technical term is exacerbation, but when you're having an attack and can't breathe, it's scary.”

How is asthma diagnosed?

Dr. Oppenheimer explains that while asthma presents differently in each individual, he often looks for complaints of shortness of breath and frequent coughing, especially at night. If a patient has a viral infection and is given a diagnosis of bronchitis, near pneumonia or pneumonia repeatedly, it may be a sign of asthma. Children that have difficulty keeping up with their peers while exercising may be experiencing symptoms of asthma. Some patients are very sensitive to their symptoms, while others experience milder indicators of asthma. Dr. Oppenheimer notes that a lung function test is used to measure the severity of asthma. In addition, it is important to identify individual conditions and triggers that exacerbate symptoms.

What are some examples of conditions that can make asthma worse?

Allergy symptoms during the spring can exacerbate asthma. Other conditions that make asthma worse may include reflux or sinus disease, obesity, and sleep apnea.

Are there environmental conditions that can trigger asthma?

Cold, dry air is an asthma trigger. Dr. Oppenheimer also notes that smoke from forest fires can trigger asthma.

Can allergies develop into asthma?

Dr. Oppenheimer distinguishes the generic term “allergies” with atopy, or the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and eczema. For instance, if a child has eczema during infancy, or has a food allergy, there’s a chance they may develop asthma over time. Dr. Oppenheimer also says that asthma in one’s family is an additional predictor of developing the condition.

Can children outgrow asthma?

According to Dr. Oppenheimer, it is possible to outgrow asthma and the condition may peak and wane according to a number of factors. For example, some young children may have wheezing and by age 5, experience no further symptoms. Some girls may experience asthma as they go through their menses phase of development and some women may develop asthma when they are pregnant. The condition may go away as their underlying hormones stabilize.

How important is it for asthmatics to have an allergist who will focus on their condition?

Dr. Oppenheimer believes having an allergist is an important partnership, one that requires commitment on both sides. The doctor has to develop a trusting relationship with the patient, and the patient has to carry out the treatment plan. “I look at myself sometimes as a used car salesman. By that I mean I have to sell you that I've given you the right illness and I put you on the right therapy, and then you’ve got to drive the car. You've got to take the medicine.”

Why is it dangerous not to treat asthma?

Asthma inflames the airways of the lung, causing swelling and muscle spasms. Dr. Oppenheimer says that many patients neglect their treatment designed to prevent asthma attacks. Not treating these symptoms can make a person sicker and attacks may cause scarring on the lungs.

How are the symptoms of asthma treated?

Dr. Oppenheimer says there are great therapies available, and they are targeted to each individual’s symptoms and physiology. One treatment option for mild asthma is a bronchodilator. More serious asthma symptoms may be treated with inhaled steroids. Dr. Oppenheimer says this type of treatment can improve people's symptoms by treating their underlying chronic inflammation and can have significant, life changing results.

Can asthma be cured?

Dr. Oppenheimer is one of the physicians at the forefront of the treatment of asthma and is among the doctors who are rewriting the definition for remission of the condition. He says that experts are thinking about the treatment of asthma not in the short term but in the long term normalization and stability of lung function. Every patient is different and responds to therapies in unique ways. But even among the most severe asthmatics, Dr. Oppenheimer says targeted therapies and medicines can result in remission in between 30% and 35% of patients. And every year, new therapies and medicines are being developed that hold promise for asthma sufferers.

Are children with asthma limited in their ability to participate in sports and other activities?

Dr. Oppenheimer advises parents to not be frightened of asthma, to be proactive and to explore all of the treatment options that are available. Young athletes can still compete and be active. “The truth is that with appropriate targeted therapy, with partnership in taking the medicines and treating those comorbidities…you would be surprised what people can do. There's a lot of professional athletes (who) have asthma.”

How common is asthma?

Twenty seven million Americans, or 1 in 12 people in the United States have asthma.

The prevalence of asthma and allergic diseases is increasing around the world, especially in industrialized nations. The good news, according to Dr. Oppenheimer, is that mortality rates have decreased over the past 20 years.

More information on asthma, its symptoms and its diagnosis >


 

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