Lesson 3: What Is Asthma?

Asthma is a lung disease that creates inflamed, constricted bronchi (the major airways leading to each lung). The constriction results from contraction of the smooth muscles surrounding the airways. The inflammation stimulates excess mucus production. Because of these and other symptoms, asthma often resembles chronic bronchitis, a form of COPD. But there are differences.

Asthma tends to strike young children, though it can persist for a lifetime. Chronic bronchitis is more often a disease that begins in middle age or later. The genetic component that contributes to cause asthma is a much larger factor than in CB, though both diseases result from environmental or lifestyle factors and heredity. Also, asthma, while it almost never goes away completely is more likely not to worsen. Chronic bronchitis tends to get progressively worse over the years.

There are two different types of asthma – allergic and non-allergic.

The first is the most common. Here, the reactions result from an allergen that stimulates an immune system overreaction. The agent may be dust mites, animal dander, or any other common allergic-reaction producing material. In CB, the cause is not related to an allergen. Instead, while the underlying cause isn’t known, major risk factors include irritants such as cigarette smoke or long, repeated exposure to industrial chemicals.

Non-allergic asthma is more similar to CB, but there is still a difference between the two diseases.

CB is an airway obstruction, resulting from irritated bronchi or bronchioles (the smaller passages that lead to the alveoli). In asthma only the larger airways are affected. Also, in an asthma attack the airways constrict, i.e. become narrower from muscle contraction. In CB they are obstructed, one of the reasons they are considered a form of COPD.

Still, there is considerable symptomatic overlap – coughing, shortness of breath, and others. But asthmatics much less often expectorate the clear or white sputum characteristic of bronchitis. Asthma tends more often to produce wheezing, which can be present in bronchitis but need not be. Also, asthma attacks tend to come on suddenly, where chronic bronchitis – as the name suggests – is always present.

Initial diagnostic techniques are similar between the two diseases. In both cases, a physician will perform one or more pulmonary function tests (PFTs). The most common is a spirometry test in which the patient breathes into a tube and the amount and rate of airflow is measured.

Treatments for asthma overlap that of chronic bronchitis, too. Asthma inhalers are a common tool, used by nearly 20 million Americans. They very often contain corticosteroids of one type or another, a drug less often used to treat CB because of long-term side effects. But, beta-agonists are sometimes prescribed in either condition, as are anti-cholinergic drugs.

In the more common case of allergic asthma, a cure of sorts is sometimes possible, since therapies exist to desensitize patients to some allergens. Treatment regimes of this type have met with some success. By contrast, there is no cure for chronic bronchitis.

Only a professional diagnosis by your doctor, usually in consultation with a specialist, can distinguish between these or any other lung disease.

End of Lesson 3

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