Types of Asthma
with Steven M. Brown, M.D., pulmonary specialist, Columbia St. Mary's

Related Information: • Type of Asthma • What is Asthma • Tips to Prevent an Attack • Asthma & Aging • Asthma & Women • Ozone & Asthma

Asthma as a disease has some startling statistics. According to the National Institute of Health, 14 to 15 million people in the United States have symptoms of asthma and its prevalence is increasing. However, asthma has many different causes and determining the specific ones for each patient is important. This is because a physician will not want to merely prescribe some maintenance and rescue asthma medications, but will also want to deal with the underlying cause of the asthma. Here are some of the more common types of asthma and how they are often treated:

Allergy induced or "extrinsic asthma" is caused by an allergy to something outside the body. This will be different for different people, but common allergens include dust, mold or animal dander. In addition, foods or food additives, such as yellow dye, and some common drugs may cause allergic reactions and asthma attacks.

Dr. Steven M. Brown, pulmonary specialist, Columbia St. Mary's "I took care of a soccer player who was allergic to grass - talk about someone in need of vocational counseling. We were able to control the hyper-responsiveness of his airways and he was able to compete very well."

It is important for patients to work closely with their physicians to determine their personal "asthma triggers". Once these are identified, either through observation or allergy testing, a plan of action can be put into place. Depending on the severity of their problem, patients with allergies to dust may want to replace bedroom carpeting with hardwood, invest in a newer vacuum with special filters and put special filters on their furnace. Allergy medications or desensitizing allergy shots also may alleviate symptoms.

Occupational asthma is caused by exposure to chemicals or fumes in the workplace, to excessive amounts of mold or "sick building syndrome." One way to diagnose this type of asthma is to see if a patient's condition improves on weekends or during vacations. If the problem is related directly to a specific trade, an occupational change might be needed.

Exercise-induced asthma is believed to be caused by hyperventilation cooling the lungs during high-intensity activity. Following the activity, the rewarming of the airways leads to bronchospasms. Many people find that using an inhaler prior to an athletic event or workout alleviates the problem. Runners who suffer from exercise-induced asthma often benefit from wearing masks during workouts.

Respiratory tract infections, particularly those caused by viruses or chronic rhinitis, may lead to a lingering cough and intermittent asthma. This is a common cause of asthma in children. "In many cases, as children grow older these episodes of acute asthma attacks may diminish, both in frequency and severity," Dr. Brown said.

Those who suffer from intermittent asthma may benefit from early and intensive treatment of their initial infections to clear up the problem before it leads to asthma attacks.

Intrinsic asthma does not seem to be provoked by anything specific. Exposure to cold air or laughing or crying may bring on an attack. In some people, stress seems to trigger attacks. While this used to be termed "emotional asthma," the theory is not a popular one today. As the National Jewish Center for Immunology and Respiratory Medicine notes in their literature on asthma, "Asthma begins in the lungs, not in the head."