Asthma Overview

Your colds typically conclude with a dry, hacking cough that lasts a few days. But after one particular cold, your cough went on for weeks. You figured you had bronchitis.

You’d had bronchitis before. It was annoying, but nothing to worry about. You knew what to do: You took a cough suppressant, sipped herb teas, made a big pot of chicken soup, and upped your daily dose of vitamin C. But your coughing continued, and not just during the day. You also developed a symptom you’d never had before, terrible coughing fits that kept you up at night.

“The Bronchitis from Hell,” your doctor sighed, as he scribbled a prescription for antibiotics and a codeine cough syrup. But they didn’t help.

Four days later, a call to your doctor’s office got you a referral to a lung specialist. He listed to your story and had you blow hard into a strange tube. “You don’t have bronchitis,” he said. “You have asthma.”

“Asthma?” you gasped. “At my age? I’m a 53-year-old woman. I thought asthma was a childhood illness. And I though it caused wheezing. My problem is coughing.”

“Asthma is best known as a childhood disease,” the specialist replied, “so few people know that the majority of Americans who have it are adults. Many people, particularly women, get diagnosed in their thirties, forties, and fifties. And asthma doesn’t necessarily cause wheezing. A classic symptom is persistent coughing at night.”

What’s Going On?

Asthma is the “childhood” illness that affects more adults than kids. Some 15 million Americans have it. About 5 million are under 18, while 10 million are adults, according to the American Lung Association (ALA). In other words, adult asthmatics outnumber kids two-to-one. In addition, few children “outgrow” asthma. The condition persists into adulthood in 72 percent of men and 85 percent of women.[i] Regardless of asthma sufferers’ age, it’s a serious condition. Childhood asthma is the leading cause of school absences caused by chronic illness, and it accounts for one-sixth of all pediatric emergency room visits. Adult asthma costs 3 million lost work days a year.

To make matters worse, the asthma rate is rising. In 1982, 3.5 percent of the population had it. Today, the figure is 5.6 percent. Asthma deaths are also rising: 2,600 in 1979, more than 5,100 today.[ii]

Until the mid-1980’s, doctors believed that you developed asthma when your bronchial tubes (or airway), suddenly narrowed (broncho- constriction), limiting your ability to move air in and out of your lungs. Doctors treated asthma with drugs that re-open the bronchi (broncho- dilators). Physicians still view bronchoconstriction as a key element in asthma, and still prescribe a variety of bronchodilators to treat it. But about 15 years ago, researchers discovered that another process is even more fundamental to asthma–airway inflammation–which, in turn, leads to bronchoconstriction.[iii]

What causes your airway to become inflamed? Many things:[iv]

• Inhalant allergies. “Allergies are the leading asthma trigger,” Homer Boushey, M.D.,[v] chief of the Asthma Clinical Research Center at the University of California’s San Francisco Medical Center. Allergic triggers include: pollens, dust, molds, pets (especially cats), cockroaches, and house dust mites (microscopic bugs that are ubiquitous in carpets, upholstered furniture, and bedding).

• Occupational exposures. A persistent cough and trouble breathing at work suggest job-related asthma, especially if symptoms get worse toward the end of the day and the end of the week. Triggering exposures might include: dust, molds, cleaning products, and work-related chemicals, including those in copy machines.

• Irritants. The major offender is cigarette smoke. Others include: volatile chemicals released from fireplaces, wood-burning stoves, and gas stoves and grills.[vi]

• Air pollution. In a study of childhood asthma attacks treated at emergency rooms throughout London over 12 months, British researchers documented a clear link between air pollutants–ozone, sulfur dioxide, and nitrogen dioxide–and asthma attacks.[vii] The good news is that in the U.S., sulfur dioxide, and nitrogen dioxide are much less of a problem than they were a generation ago.[viii] But ozone continues to fill the air, and exposure to ultra-fine particle pollution has increased, which, the ALA says plays a role in the increase in asthma.[ix]

• Strenuous Exercise. As workouts become more strenuous, risk of bronchoconstriction increases. Scientists are not sure why, but “exercise-induced asthma” is quite common. About 6 percent of the population has asthma, but 15 to 20 percent of people develop asthma symptoms during sustained workouts.[x] Many people with exercise-induced asthma experience no bronchial symptoms except when exercising.

• Weather. Cold weather is a respiratory irritant that can cause asthma attacks.[xi] Thunderstorms can also trigger asthma. In June 1994, a thunderstorm struck London, England, and immediately afterward, area hospitals reported 10 times the usual number of asthma admissions. The electrical activity of thunderstorms apparently breaks pollen particles into smaller pieces, increasing their respiratory irritation.[xii]

• Infections. Colds and flu are well-known for aggravating asthma. Sinus infections can do the same.

• Heartburn. For reasons that remain unclear, heartburn is associated with asthma, particularly night-time symptoms.

• Drug sensitivities. Aspirin, other drugs, and food-preserving sulfites may trigger asthma symptoms in sensitive individuals. Sulfites are found in beer, dried fruit, and processed potatoes and shrimp.

• The menstrual cycle. “Asthma is a major unappreciated women’s health issue,” says Emil Skobeloff, M.D.,[xiii] an associate professor of emergency medicine at Allegheny University of the Health Sciences in Philadelphia. His studies show that 75 percent of adults hospitalized with severe asthma are women, and that almost half of women’s asthma attacks occur around the time of their menstrual periods. Menstrual-related asthma attacks are often quite severe, Dr. Skobelloff says, which explains why women account for most asthma deaths—62 percent.[xiv]

Mainstream medicine treats asthma by encouraging trigger avoidance and with drugs, primarily anti-inflammatories and bronchodilators. “Drugs help,” says life-long asthma sufferer Richard Firshein, D.O., an assistant professor of family medicine at the New York College of Osteopathic Medicine and author of Reversing Asthma,[xv] “but they’re not The Answer. Mainstream medicine undervalues traditional health wisdom: diet, exercise, breathing re-education, and complementary therapies. I’m not opposed to drugs, but with my own asthma, I’ve had tremendous success with a comprehensive program that includes alternative approaches. The same goes for my patients. Within six weeks, 95 percent of them are able reduce their medications, and about 60 percent cut them in half.”