What is Asthma?
Asthma is a chronic, inflammatory disorder characterized by tightening and swelling of airways which causes symptoms such as wheezing, breathing difficulties, coughing and chest tightness. People with asthma have very sensitive airways that are constantly on the verge of over-reacting to asthma "triggers". They may also have frequent colds, chest infections, a blocked nose and allergies. Signs and symptoms of asthma range from minor wheezing to life-threatening asthma attacks and vary with each individual in frequency and severity.
What happens during Asthma attack?
Asthma attack is usually characterized by rapidly worsening shortness of breath, coughing or wheezing leading to breathing difficulty.
Severe chronic asthma may cause a number of complications such as
Asthma statistics in the United States
according to the statistics published on the American Academy of Allergy, Asthma & Immunology site
Cause of Asthma(Conventional)
The cause of Asthma is unknown(Buteyko)
Asthma is caused by prolonged hyperventilation (overbreathing) and it is a body's defense mechanism against the loss of carbon dioxide.
Diagnosis and Treatment(Conventional)
Patients are usually questioned about their medical history and symptoms range and frequency. Pulmonary function tests are performed to determine lung capacity (Spirometry test) and in some cases airway reaction to Methacholine agent (Methacholine challenge test). If allergic asthma is suspected, allergy tests might be taken. Often asthma medications are prescribed for a period of time to see if they are alleviating the symptoms. Once asthma is diagnosed, an individual treatment plan is devised. This usually requires the patient to carefully monitor their symptoms (e. g. using peak flow meter), avoid triggers and take prescribed preventive medications on a daily basis and "emergency" inhalers when needed.(Buteyko)
Asthma is just one of the few (and most pronounced) conditions that represent body's physiological response to imbalances due to prolonged hyperventilation (overbreathing). Different individuals acquire different conditions, depending on their genetic predisposition. A Control Pause test will show the severity of a patient's asthma. The treatment plan is aimed at reconditioning the patient's breathing permanently which will increased Control Pause and alleviate asthma symptoms.
Asthma is a life-long, long-term (chronic) disease. Asthma causes are unknown, it is not curable, but with proper medication and trigger avoidance it can be "controlled". Some children with mild asthma will have significant reduction in symptoms by the time they reach their teenage years. Asthma does, however, often recur in adulthood. For middle age and older patients poorly treated asthma usually gets worse with age, and their lungs function less efficiently.
Since asthma's cause is chronic hyperventilation, as soon as person's breathing pattern is restored to a healthy level, asthma symptoms will disappear. To stay free of symptoms, patients must continue correct breathing.
|(short-term) Bronchodialators||Albuterol (Ventolin, Proventil, Proventil-HFA), Levalbuterol (Xopenex, Xopenex-HFA,)Ipratropium (Atrovent)||Act by relaxing bronchial smooth muscle and relieving acute bronchoconstriction Used as "emergency" drug during bronchospasm.|
|(long-term) Bronchodialators||Salmeterol (Serevent)||Is active for up to 12 hours and used for moderate to severe asthma. Used as daily preventive drug usually paired with steroid medication.|
|Leukotrene modifiers||Montelukast (Singulair)||Used as supportive therapy. Can be used for long-term control and prevention of symptoms for mild persistent to severe persistent asthma.|
|Corticosteroids - inhaled||Fluticasone (Flovent),Triamcinolone (Azmacort),Beclomethasone (Vanceril, Beclovent, QVAR), Budesonide (Pulmicort Turbuhaler, Rhinocort)||Highly potent drugs that are the primary choice for treatment of chronic asthma and prevention of acute asthma attacks.|
|Corticosteroids - oral||Prednisone (Deltasone, Orasone, Meticorten)||Highly potent drugs that are used as short term therapy for severe uncontrolled asthma.|
|Combination drugs||Salmeterol/Fluticasone (Advair Diskus)||Consists of a long-acting bronchodialators (salmeterol) and inhaled corticosteroid (fluticasone).|
Most documented side effects of bronchodialators include nervousness, tremor, heart palpitations, headache,
worsening of asthma symptoms, bronchitis and other respiratory tract infections.
A safety study found that salmeterol (Serevent), may be associated with rare cases of serious asthma
attacks or asthma-related death.
Side effects of inhaled steroids include mouth infections (candida), back pain, flu symptoms, sore throat, headache and sinus inflammation. Prolonged use of oral corticosteroids may cause serious side effects such as thin, fragile skin, muscle weakness, brittle bones and eye problems.
While it is not known exactly how steroids work, it is accepted that they treat inflammation which is the underlying airway obstruction.6 Professor Buteyko regards steroids as the treatment of choice. His belief is that steroids work by reducing breathing and this occurs as quickly as one hour after being taken. By reducing the breathing, airways are opened without a further loss of carbon dioxide. Professor Buteyko believes that taking the correct dosage of steroids is fundamental to maintaining safe control but unfortunately many people do not take the correct dose. Some people take too low a dose with the result that the asthma is uncontrolled and the risk of a severe attack remains present. Alternatively, some people start with a too-high dose that is not tapered downwards in accordance with the improvement in their condition. The British Guidelines on Asthma Management 7 advocates that "there is evidence that all of the inhaled steroids are absorbed to some extent from the lung and hence will have some systemic activity. It is prudent therefore, as with all treatment, to give the lowest dose of inhaled steroid compatible with asthma control". It is also advised to step down the dosage of steroids once the asthma is under control, although the Guidelines recognizes that this "is often not implemented". Any reduction in steroid intake should be slow and only in conjunction with your doctor because patients respond at different rates when their doses are tapered.
Other patients rely too heavily on reliever asthma medication and are fearful of steroid medication. Patients who rely predominantly on large doses of reliever medication for many years will have continuous symptoms and feel debilitated. Reliever medication can also pose a risk to a person's health and life. The management of asthma has changed over the years and people no longer need to rely on large amounts of reliever asthma medication for their treatment.
Long-acting reliever inhalers which have become popular in recent years are very powerful and are taken at regular intervals regardless of whether they are needed or not. In addition, it has been reported that tolerance to long-acting bronchodilators may develop, meaning that the effect of the drug, especially when used as the mainstay of treatment, diminishes with constant use. Intermittent use would therefore be preferable.8
The ingredients of long-acting reliever inhalers are also present in a number of combination inhalers. For example the brand name Seretide is a combination of Serevent (long-acting reliever) and Flixotide (preventer).
Buteyko's view is that regular intake of bronchodilator medicine via inhaler or nebulizer overrides the body's defense mechanism. When the airways are forced open by bronchodilating drugs, hyperventilation is increased and the body will activate an even greater defence to prevent the further loss of CO2. This leads to deterioration with a greater amount of reliever medication necessary to maintain control and, for this reason, it is important that the amount of reliever medication taken is minimal. History has proved his view to be correct and now the death rate has begun to decline as the treatment of choice has switched from relieving the sufferer to a more preventative approach.