Severe Asthma – Causes, Diagnosis, and Treatment Strategies

Asthma is a chronic condition that affects the airways, leading to inflammation and breathing difficulties. Common symptoms include wheezing, coughing, shortness of breath, and chest tightness. If these symptoms persist frequently and interfere with daily life, it may be a sign of severe asthma. Seeking timely medical attention is crucial for proper management and improved quality of life.

Since severe asthma symptoms can be similar to other respiratory diseases, an accurate diagnosis is necessary. Pulmonologists use the following assessments:

1. Physical Examination: Doctors evaluate symptoms and rule out other conditions like COPD or lung infections.

2. Lung Function Tests:

• Spirometry: Measures airflow and lung function.

• Peak Flow Meter: Determines how forcefully one can exhale.

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

Other tests may be performed for a deeper analysis:

1. Nitric oxide test – Measures inflammation in the airways.

2. Methacholine challenge – Tests airway sensitivity.

3. Imaging tests (X-ray/CT scan) – Helps identify structural lung issues.

4. Sputum eosinophil count – Evaluates inflammation-causing white blood cells.

5. Exercise or cold-induced asthma tests – Determines specific asthma triggers.

6. Allergy testing – Identifies allergic factors worsening asthma.

Managing severe asthma involves both 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 or intravenous corticosteroids

For allergy-induced asthma, allergy shots may help reduce reactions to allergens.

If medications do not sufficiently control symptoms, bronchial thermoplasty is a potential treatment. This procedure reduces the thickness of airway muscles using heat, helping prevent airway constriction and making breathing easier.

In addition to medical treatment, lifestyle adjustments can help manage severe asthma:

• Avoid allergens, pollutants, and strong chemical fumes.

• Maintain a healthy weight through proper nutrition and exercise.

• Avoid smoking and secondhand smoke exposure.

• Get flu and pneumonia vaccinations to prevent respiratory infections.

• Track breathing patterns to recognize early signs of an asthma flare-up.

By combining appropriate medical treatment with lifestyle adjustments, individuals with severe asthma can take control of their condition and enhance their overall well-being.