Types of asthma  

Types of Asthma


Asthma of any cause is a chronic inflammatory disease of the airways. It can be classified in following categories:

Extrinsic asthma:

It is the most common form of asthma in all age group. It usually affect young age group. When any foreign particle either an allergen or an antigen enters into the body, the immune system of the body overreacts and forms antibodies and other chemicals to defend the body. This is a natural process of the body. The production of antibodies and the other chemicals bring specific changes in the airways which leads asthma.

Various inhaled allergens like pollens, animal dander and dust mites are most common causes to develop extrinsic asthma.

Extrinsic asthma is also known as atopic asthma or allergic asthma.

People with allergic asthma and their family members frequently have other allergy related problems such as fever, skin rashes, hives, eczema, and rhinitis.

Intrinsic asthma:

The intrinsic asthma is not related with the allergies. In fact it is caused by inhalation of certain chemical such as cigarette smoke, fumes of motor vehicles and factories, strong odors, intake of certain medicines like aspirin; chest infections, stress, laughter, exercise, cold air, food preservatives like azinomoto or a myriad of other factors.

Antibodies are not produced by the body and the cause of developing intrinsic asthma may be the irritation of the nerves or muscle in the airway.

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Mixed asthma:

It is mixture of allergic asthma and intrinsic asthma. These people react to some allergies but their asthma is also triggered by other things also. For example symptoms are aggravated in an asthmatic while facing the chest infection.

Apart from above classification of asthma you can further categorize asthma. Your condition may have been given one of the following labels.

Cough variant asthma:

Cough may be the sole manifestation of asthma or a distressing symptom. Although chronic cough can be a sign of many health problems, it may be the principal—or only—manifestation of asthma, especially in young children. This has led to the term “cough variant asthma.” Monitoring of PEF or methacholine inhalation challenge, to clarify whether there is bronchial hyperresponsiveness consistent with asthma, may be helpful in diagnosis.

The diagnosis of cough variant asthma is confirmed by a positive response to asthma medication. Treatment should follow the stepwise approach to long-term management of asthma.

(Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full Report 2007)

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Nocturnal asthma:

The patients presents themselves with the symptoms like wheezing, cough, breathlessness in the night in between 2.00am to 4.00am. Such night time symptoms disturb sleep and impair the quality of life. Nocturnal asthma is defined as an overnight fall of more than 20% in the FEV1 or PEFR. Sometimes this may be the sole manifestation of asthma or an important indicator of poorly controlled day time asthma. This night time propensity is due to a number of reasons:

  • Exposure to dust mite, animal dander.

  • Gastro-esophageal reflux.

  • Post nasal drip.

  • Decreased cortisol level.

  • Increased parasympathetic activity.

  • Increased level of histamine.

  • Increased sensitivity to histamine.

  • The effect of medicines may wear off.

  • Early morning fall in circulating adrenaline.

  • Overnight changes in vagal tone.

  • Airway cooling at night.

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  • Gastro-esophageal asthma:

    Asthma may be caused or worsened by to gastro-esophageal reflux. The symptoms of GERD are common in both children and adults who have asthma. Reflux during sleep can contribute to nocturnal asthma. Treatment with a proton pump inhibitor was reported to reduce nocturnal symptoms, reduce asthma exacerbations, and improve quality of life related to asthma. Surgical treatment has been reported to reduce the symptoms of asthma and the requirement for medication.
    For patients who have poorly controlled asthma, particularly with a nocturnal component, investigation for GERD may be warranted even in the absence of suggestive symptoms
    medical management of GERD be instituted for patients who have asthma and complain of frequent heartburn or pyrosis, particularly those who have frequent episodes of nocturnal asthma.
    Medical management of GERD includes:

  • Avoiding heavy meals, fried food, caffeine, and alcohol.
  • Avoiding food and drink within 3 hours of retiring.
  • Elevating the head of the bed on 6- to 8-inch blocks.
  • Using appropriate pharmacologic therapy.

    For patients who have persistent reflux symptoms following optimal therapy, further evaluation
    is indicated and surgical treatment may be advised.

    Exercise Induced Asthma:

    Exercise induced asthma only refers to asthma that occurs only with exercise.
    Before exercise pulmonary functions tends to be normal, but within 5 to 10 minutes of exercise they tend to fall. Pulmonary functions comes back to normal after rest but some times tend to remain low for a longer time.

    The mechanism is not clear; increased blood flow and mediator release due to change in osmotic pressure have been proposed as probable causes.

    Click > Exercise Induced Asthma < to know more.

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  •     Extrinsic Asthma
      Intrinsic Asthma
      Mixed Asthma
      Cough Variant Asthma
      Nocturnal Asthma
      Gastro-esophageal Asthma
      Exercise Induced Asthma

    Last edited 22-6-2008