Asthma: Treatment Methods, Nutrition, and Important Medical Information

Asthma is a relatively common disease, appearing mainly in childhood but also in older ages. Approximately 5-7% of the general population suffers from asthma. Treatments for asthma have developed over the years, making it a condition that can be managed relatively easily, and deaths resulting from it have become rare.

A (not so) pleasant introduction: What is asthma?

Asthma (also known by its Hebrew names "Katzarat" or "G'naht HaSim'fonot") is an inflammatory disease of the bronchi- the airways. The two bronchi branch out from the windpipe and lead to the lungs, with each connecting to a lung. Asthma is a condition where inflammation in the bronchi causes narrowing and, in severe cases, blockage.

The causes of asthma are not entirely clear. There is a hereditary element but also an environmental one, such as air pollution, which increases asthma cases. Allergies are often linked to asthma development, as it is a body reaction to allergenic exposure. In children, there's a clear link between allergic rhinitis and asthma — about 30% of children with allergic rhinitis will develop asthma, and vice versa — about 80% of asthma sufferers experience allergic rhinitis. If asthma already exists, allergic rhinitis can exacerbate it. Therefore, when there's a link between allergy and the patient's asthma, both issues are often treated simultaneously.

Asthma appears mainly in childhood, as mentioned. In about a third of childhood asthma cases, the condition will disappear around age six, especially in non-allergic cases. Other children will continue to suffer into adulthood. While asthma is more common in children, it can also first appear in older age and, in fact, at any age.

Asthma is characterized by quiet periods and attacks (also called "flares") of symptoms. The narrowing of the bronchi causes symptoms like coughing, wheezing, and more, and severe cases may cause bronchial obstruction necessitating immediate hospital care.

The disease attacks usually react to various causes like intense physical activity, cold, certain medications, stress, colds, or other respiratory viral infections, and as said — allergens like air pollution or exposure to allergy-inducing agents such as pollen, mold, dust, etc.

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Diagnosis: How do I know I have asthma?

Symptoms indicating asthma include recurrent episodes of shortness of breath, wheezing (with "whistling" sounds), strong coughing, and phlegm. Symptoms often worsen at night and early morning.

It's worth noting that some individuals have increased risk factors for asthma, and if they exist, it is advisable to be extra vigilant about symptoms and undergo a diagnosis if asthma is suspected. For instance, children with allergic rhinitis. Among adults, risk factors include a work environment exposing one to allergy risks, such as painters, chemical plant workers, bakers, welders, veterinarians, animal workers, nurses, etc.

When asthma development is suspected based on symptoms and environmental factors, a spirometry test is usually performed. The patient blows into a spirometer device to measure the volume of air expelled from the lungs within one second. The results are compared with normal results, helping identify asthma. Sometimes the test is expanded, performed with bronchodilator drugs (asthma treatments) or drugs constricting the airways to see their effect on the airways and refine the diagnosis. For children, instead of constricting medications, physical activity, a trigger for asthma attacks, may be used to conduct the test.

Some individuals need additional tests to confirm an asthma diagnosis, like an X-ray to exclude other lung diseases, or lung inflammation tests via phlegm sampling or measuring nitric oxide levels in exhalation — as high levels indicate airway inflammation.

In parallel, an allergy assessment is conducted to check for allergenic factors related to asthma. This test is a simple allergy test done at suitable clinics, identifying substances the patient is allergic to, potentially causing an asthma flare.

So I have asthma. How do we proceed?

Asthma treatment is divided into two: preventing attacks and treating them. When there is an allergy history, the patient is advised on avoiding allergens — avoiding allergenic foods, maintaining a clean environment free of dust mites, etc., based on specific patient data. If necessary, allergy medication can be prescribed, among other things, to prevent allergy development into an asthma attack.

Asthma cannot be fully cured, but with appropriate treatment — both preventive and active when needed — the frequency and severity of attacks can be reduced.

The main part of asthma treatment is through inhalers. The inhaler delivers medication through mouth inhalation. This treatment method is effective and safe as it sends the medication directly to the lungs — the target organ — without affecting other organs. Some inhalers distribute the medication by spray — these are recommended with a spacer linking the inhaler to the mouth, easing medication inhalation.

Inhalers contain various potential drugs tailored individually to each patient and each disease stage or condition. In the past, medications like Ventolin or Bricalin were widely used to widen the bronchi and ease breathing. These drugs act very quickly, making them very effective during an asthma attack, but their drawback is their steroid content, which can cause side effects and various damages in long-term use. Thus, nowadays, Ventolin and Bricalin are used only alongside other long-lasting drugs and mainly for immediate relief during an attack.

There is a large variety of long-lasting drugs personally tailored to patients per disease type, severity, and effect. Known drugs include Aerovent, Apovent, Budicort, Flixotide, etc. In cases of not very mild disease, these drugs are used consistently even when there are no attacks, aiming to widen the bronchi and clear the airways.

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These asthma treatment drugs often (especially in high doses) cause slight local side effects like hand tremors, headaches, heart palpitations, muscle cramps, and so on. These side effects typically pass within minutes.

Sometimes these drugs are combined with expectorants, taken orally, like Mocolite, etc. These are meant to ease phlegm expulsion, reducing breathing difficulties.

In cases of more severe disease or frequent attacks, other stronger medications are given. In rare cases of severe and frequent attacks, oral steroids are sometimes prescribed instead of the inhaler. This treatment is only given in special cases and for short periods, as long-term steroid use orally can lead to severe side effects like weight gain, high blood pressure, muscle weakness, osteoporosis, diabetes, eye diseases, and more.

With regular inhaler use, be aware that mouth fungal infection might occur as a side effect. This can be prevented by rinsing the mouth with water or mouthwash after using the inhaler.

In an asthma attack, it is crucial to use medications for immediate relief and avoid physical exertion. It is recommended to rest while sitting, not lying down, and often relief is achieved by sitting in a chair with arms on the knees and leaning forward with a straight back. If a child near you is having an asthma attack, stay calm and help them get into a suitable position, rest, and use an inhaler.

If symptoms worsen and breathing becomes severely difficult, seek urgent medical help immediately. In very severe cases, hospital evacuation may be necessary to prevent suffocation.

Nutrition: What should I eat if I have asthma?

Maintaining a healthy diet and overall lifestyle is important for everyone, especially for those with various chronic illnesses. For asthma patients, it's highly recommended to avoid smoking. Smoking worsens asthma symptoms and interferes with many drugs' effectiveness to alleviate the symptoms.

If asthma treatment includes oral steroid intake, it's important to maintain a healthy weight and a calcium-rich diet (to prevent osteoporosis), avoid excessive alcohol consumption, and engage in daily exercise. Physical activity is generally recommended for asthma patients, but it should be monitored properly to prevent excessive exertion that could trigger attacks.

There are studies indicating a connection between a high-fiber diet and the reduction of respiratory diseases, specifically offering relief in asthma attacks and their frequency. This refers to a generally healthy diet, making it highly recommended.

Many asthma patients report improvements in their overall condition and in the severity or frequency of attacks following complementary medicine treatments. Various massages may ease breathing; treatments like acupuncture, Shiatsu, homeopathy, etc., have also been found effective in providing relief and treating the disease. Naturopathic nutritional counseling is also highly helpful, so asthma patients are encouraged to explore different treatment options and find the methods that assist them best.