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David Baxter

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Types of Asthma
Michael W. Smith, MD
September 11, 2007

Do you know the different types of asthma? If you have asthma, you know how frightening the symptoms of wheezing, coughing, shortness of breath, and chest tightness can be. However, advances in our understanding of asthma have helped experts define specific types of asthma, such as exercise-induced asthma (asthma that occurs with physical exertion) and nighttime asthma (asthma that makes sleeping miserable and is quite serious). Understanding the type of asthma you have can help you seek the most effective treatment when you have a breathing problem.

Allergies and Asthma
Allergies and asthma often go hand-in-hand. Allergic rhinitis (also called hay fever) is inflammation of the inside lining of the nose and is the single most common chronic allergic disease experienced by people. In people with allergic rhinitis, increased sensitivity (allergy) to a substance causes your body?s immune cells to release histamines in response to contact with the allergens. Histamines along with other chemicals lead to allergy symptoms. The most common allergens enter the body through the airway.

With allergic rhinitis, you may feel a constant runny nose, ongoing sneezing, swollen nasal passages, excess mucus, weepy eyes, and a scratchy throat. A cough may result from the constant postnasal drip. Many times asthma symptoms are triggered by allergic rhinitis. Your doctor may prescribe medications to control the allergies and, in doing so, the cough and other asthma symptoms may subside.

For more detail, see WebMD?s article Allergies and Asthma.

Exercise-Induced Asthma
Exercise-induced asthma is triggered exercise or physical exertion. Many people with asthma experience some degree of symptoms with exercise. However, there are many people without asthma, including Olympic athletes, who develop symptoms only during exercise.

With exercise-induced asthma, airway narrowing peaks five to 20 minutes after exercise begins, making it difficult to catch your breath. Your doctor can instruct you if you need to pre-medicate with asthma inhalers before exercise to prevent these uncomfortable asthma symptoms.

For more detail, see WebMD?s article Exercise-Induced Asthma.

Cough-Variant Asthma
In cough-variant asthma, severe cough is the predominant symptom. There can be other causes of cough such as postnasal drip, chronic rhinitis, sinusitis, or gastroesophageal reflux disease (GERD or heartburn).

Asthma is a serious cause of cough that is common today. Cough-variant asthma is vastly underdiagnosed and undertreated. Triggers for cough-variant asthma are usually respiratory infections and exercise.

For any persistent cough, contact your doctor. Your doctor may order specific medical tests to show how well your lungs function. You might need to see a lung specialist for further tests before a diagnosis is made.

Occupational Asthma
Occupational asthma is a type of asthma that results from workplace triggers. With occupational asthma, you might have difficulty breathing and asthma symptoms from Monday through Friday but not on the weekends.

Many people with this type of asthma suffer with runny nose and congestion or eye irritation or have a cough instead of the typical asthma wheezing.

Some common jobs that are associated with occupational asthma include animal breeders, farmers, hairdressers, nurses, painters, and woodworkers.

For more detail, see WebMD?s article on Occupational Asthma.

Nighttime Asthma
Nighttime asthma is a common type of asthma. If you have asthma, the chances of having symptoms are much higher during sleep because asthma is powerfully influenced by the sleep-wake cycle (circadian rhythms). Your asthma symptoms of nighttime wheezing, cough, and trouble breathing are common and dangerous, particularly at nighttime.

Studies show that the most deaths related to asthma occur at night. It?s thought that this may be because of increased exposure to allergens (asthma triggers), cooling of the airways, reclining position, or even hormone secretions that follow a circadian pattern. Even sleeping causes changes in airway function.

If you have asthma and notice your symptoms worsening as evening progresses, it?s time to get your asthma re-evaluated by your doctor, so call today. Understanding the right asthma medications and when to take them are key to managing nighttime asthma and getting quality sleep.

For more detail, see WebMD?s article Nighttime Asthma.

Asthma Mimics
A variety of illnesses can cause some of the same symptoms as asthma. For example, cardiac asthma is a form of heart failure in which the symptoms mimic some of the symptoms of regular asthma.

Vocal cord dysfunction is another asthma mimic. Many recent reports have drawn attention to a peculiar syndrome in which an abnormality of the vocal cords causes wheezing that is frequently misdiagnosed as asthma. This is most common in young females who have loud and dramatic episodes of wheezing that do not respond to medications that open the airways.

SOURCES: Smolley, L. Breathe Right Now, Dell, 1999. Bruce, D. The Sinus Cure, Ballantine, 2007. Schachter, N. Life and Breath, Broadway Books, 2003. American Academy of Allergy Asthma & Immunology: ?Distinguishing Between Asthma and Heart Disease,? ?Vocal Cord Dysfunction in Children.? American Lung Association: ?Facts About Hayfever.?
 

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