A Comprehensive Guide to Severe Asthma – Causes, Diagnosis, and Management

Asthma is a chronic lung disease characterized by airway inflammation, leading to breathing difficulties. Symptoms include wheezing, chest discomfort, shortness of breath, and persistent coughing, especially at night. If these symptoms occur frequently, severe asthma may be the underlying cause. Managing this condition with appropriate treatment is crucial for maintaining a healthy lifestyle.

Diagnosing severe asthma can be complex, as its symptoms resemble other respiratory conditions. A pulmonologist will use the following assessments:

1. Physical Examination – To distinguish asthma from other lung conditions like COPD or infections.

2. Lung Function Tests –

• Spirometry: Measures airflow and lung capacity.

• Peak Flow Meter: Determines lung function and worsening asthma symptoms.

• Bronchodilator Response: If lung function improves after using a bronchodilator, asthma is confirmed.

Additional tests for further analysis include:

• Nitric oxide test – Measures airway inflammation.

• Methacholine challenge – Assesses airway sensitivity.

• Chest X-rays/CT scans – Detects structural abnormalities.

• Sputum eosinophil count – Evaluates airway inflammation.

• Exercise or cold-air challenge tests – Identifies asthma triggers.

• Allergy testing – Determines allergic factors contributing to asthma symptoms.

Severe asthma treatment includes preventative long-term medications and rescue medications for sudden attacks.

1. Long-term control medications:

• Leukotriene modifiers

• Inhaled corticosteroids

• Long-acting beta-agonists

• Combination inhalers

2. Rescue medications:

• Short-acting beta-agonists

• Oral/intravenous corticosteroids

Patients with allergic asthma may benefit from allergy shots.

In cases where medication does not control symptoms, bronchial thermoplasty is an option. This treatment reduces muscle thickness in the airways, preventing excessive tightening and making breathing easier.

Along with medical treatments, lifestyle adjustments can help minimize asthma flare-ups:

• Avoid allergens and environmental pollutants.

• Maintain a balanced diet and healthy weight.

• Avoid smoking and secondhand smoke.

• Get flu and pneumonia vaccinations to prevent respiratory infections.

• Monitor breathing for early signs of worsening symptoms.

By following the right treatment plan and adopting healthy habits, individuals with severe asthma can significantly improve their quality of life.