by Rebecca Howerton
Asthma affects 300 million people worldwide, causing 250,000 annual deaths—almost all preventable, according to the World Health Organization. To increase awareness, diagnosis, and treatment of this chronic disease, in 1998 the Global Initiative for Asthma designated the first Tuesday in May World Asthma Day.
The theme for World Asthma Day 2018, on May 1, is “Never too early, never too late. It’s always the right time to address airways disease.”
Dr. Neil Kaoof Allergic Disease and Asthma Center, P.A., said approximately eight percent of the world population has asthma.
“It is under-diagnosed and under-treated. People needlessly suffer to the point of almost dying because they don’t recognize the symptoms, are in denial, or can’t afford treatment,” Kao said. “The worst case is that you don’t have access to medicine in a life-threatening asthma attack.The good news is that the worst outcome is 100 percent preventable with treatment.”
Asthma symptoms are caused by inflammation, which swells the airways, making them narrower and extra-sensitive to irritants, leading to recurring attacks of wheezing, breathlessness, chest tightness and coughing.
“About three quarters of cases are related to allergies,” Kao said. “If you identify the triggers to prevent inflammation, you can avoid the most serious symptoms.”
Allergies and asthma share genetic traits, and both tend to run in families, according to Dr. Emmanuel Sarmiento, also of ADAC.
In addition to allergens like pollen, animal dander, dust, and mold, other common airborne triggers include irritants like smoke and chemical fumes. Less common are neurological or emotional triggers like laughter or excitement.
Viral infections like colds, rhinovirus, and RSV can also trigger asthma, especially in young children, said Sarmiento, who is board-certified in pediatrics, as well as allergy, asthma, and immunology.
Exercise can also trigger an asthma attack in some patients, but that doesn’t mean people with asthma should avoid activity.
“With inhalers and other treatments, people with asthma should be able to participate in any sport, and I always encourage my patients to do so,” Sarmiento said. “Up to 17 percent of Olympic athletes have asthma.”
Complicating asthma treatment for many patients is the coexisting condition of obesity, increasingly common among Americans in recent decades.
“Obesity is a major risk factor for asthma because fat is very inflammatory,” Sarmiento said. “This inflammation is harder to treat, and sometimes they don’t respond to traditional therapy. These patients have a higher risk of hospitalization.”
In addition to changes in the immune and metabolic systems, the lungs may be restricted mechanically by extra weight.
“They may not seek treatment for shortness of breath because they think they are just out of shape. It becomes a vicious cycle, because they don’t exercise, and find it hard to lose weight,” he said. “In reality, they may have undiagnosed asthma. With diet, exercise and the right treatment, they improve their health and achieve a good quality of life.”
No matter the trigger, severity of symptoms, or age of the patient, seeking medical advice to rule out or diagnose asthma and obtain appropriate treatment is key to avoiding severe episodes, hospitalization, and lost productivity.
More treatment options are available than ever before, and ADAC can provide testing to determine which is most appropriate. The practice conducts clinical trials for new drugs and receives referrals from across the state for new biological therapy to treat some of the most difficult cases.
“If you can’t breathe, life is hard, but you don’t have to live with it,” Sarmiento said. “Our motto is, ‘Get tested, get treated, get better. We love making a difference in patients’ lives.”