Asthma of any
cause is a chronic inflammatory disease of the airways. It can
be classified in following categories:
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
People with allergic asthma and their family members frequently
have other allergy related problems such as fever, skin rashes,
hives, eczema, and rhinitis.
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.
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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.
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
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
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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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.
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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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. Avoiding heavy meals, fried food, caffeine, and alcohol.
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
Medical management of GERD includes:
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 only refers to asthma that occurs only
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.
Exercise Induced Asthma < to know more.
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