What is Asthma?

As common, and potentially dangerous, as asthma may be, surprisingly little is known about it—including its cause and the cure. Doctors, then, have turned to a medical version of the old sports adage that says, if you can’t stop the guy you’re trying to beat, try to contain him.

The symptoms of the disease are well-documented: persistent coughing, irregular breathing, interrupted sleeping because of coughing or breathing problems, and trouble exercising.

Other illnesses, including bronchitis, respiratory viruses and even colds, show some of the same symptoms. As a result, doctors often have a hard time recognizing asthma, especially among infants, who are vulnerable to infections. But the key to asthma is that it’s a chronic condition.

“The classic story is ‘My child has a cold, and it never goes away,'” says Dr. Alyna Chien, a pediatrician at The University of Chicago Children’s Hospital. “But a regular cold only lasts three to seven days. Kids with asthma just can’t do what other kids do. They just can’t run and play as much.”

The lungs of asthmatics also behave differently. Certain substances cause the muscles of the lung passages to inflame, as if “you took a brush and rubbed them until they got red,” Chien says. And, “if you have ongoing inflammation, the scars may never heal.”

When these allergens are toxic or concentrated enough, they trigger the muscles to tighten up and mucus to accumulate, restricting the air flow. This is an asthma attack.

Researchers, and asthmatics themselves, have determined that a range of allergens trigger attacks, and some may even contribute to causing asthma. But the key is finding the allergen that is a specific trigger for a child. Secondhand tobacco smoke, cockroach feces and dust mites—common microscopic organisms that like to live in linens, curtains, carpeting and furniture—top the list, according to the federal Centers for Disease Control and Prevention.

Studies have also identified cat and dog dander, rodent fur and feces, molds, fungi, pollen, smog and soot, auto pollution, frigid air, respiratory infections, and high humidity as triggers.

Asthma seems to be a result of genetics as well as environment, since children of asthmatics tend to get the disease more frequently than others. One explanation, according to the CDC, is that some people may produce excess amounts of a chemical called immunoglobulin E when exposed to allergens. At certain levels, the chemical provokes the lungs to clinch up. Other studies have linked asthma to old housing, poverty and community stress. Run-down homes are more likely to have indoor allergens, and poorer families tend to live closer to air pollution sources and lack access to health care, medical information and community support.

But doctors are quick to point out that asthma is treatable, and that some of the potential triggers can be avoided.

The first and most crucial step is to see a doctor and get the right prescription. Then continue taking the medication as suggested.

Asthma medications come in a variety of forms—pills, liquids, aerosols—and are administered in a variety of ways, including through inhalers, pumps and discuses. Doctors can help patients develop their own asthma plans, day-to-day flow charts showing what medications to take at what times for what environmental conditions. Over time, most people on asthma plans are able to avoid or greatly reduce emergency attacks and missed school days. The goal, Chien says, is to avoid waiting for an emergency before treating asthma.

Parents can also take steps to make their homes more asthma-friendly. First, keep cigarette smoke out of the house. Chien points out that children’s lungs develop until age 8, on average, and exposure to tobacco smoke can stunt them.

Mattress and pillow covers can keep dust mites at bay. Linens should be washed in hot water. Avoid carpeting, if possible; if not, special dust-free vacuum bags should be used. Anything that might attract roaches or rodents—trash, food, water—should be cleaned up. And dehumidifiers and air conditioners will cut down on mold.

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