Severe Asthma – Symptoms, Diagnosis, and Effective Management

Asthma is a long-term lung disease that causes inflammation and narrowing of the airways, leading to breathing difficulties. Common symptoms include shortness of breath, wheezing, chest tightness, and persistent coughing, especially at night or early in the morning. When these symptoms become frequent and significantly impact daily activities, it may indicate severe asthma. Proper diagnosis and treatment are essential to managing this condition effectively.

Since severe asthma symptoms can resemble other respiratory diseases, a thorough medical evaluation is necessary. Pulmonologists use various methods to confirm the diagnosis, including:

1. Physical Examination: The doctor assesses symptoms and rules out other conditions like COPD or lung infections.

2. Lung Function Tests:

• Spirometry: Measures lung capacity and airflow obstruction.

• Peak Flow Meter: Evaluates the effort needed to exhale.

• Bronchodilator Test: Determines if lung function improves after using a bronchodilator, confirming asthma.

Additional diagnostic tests may include:

1. Nitric oxide test – Checks airway inflammation levels.

2. Methacholine challenge – Identifies airway hypersensitivity.

3. Imaging tests (X-ray or CT scan) – Helps detect any structural lung issues.

4. Sputum eosinophil analysis – Measures white blood cells involved in airway inflammation.

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

6. Allergy testing – Identifies allergens contributing to asthma symptoms.

Severe asthma management requires both long-term medications to prevent attacks and rescue medications for immediate relief during an episode.

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-related asthma, allergy immunotherapy (allergy shots) can help reduce sensitivity to allergens over time.

If medications are insufficient, bronchial thermoplasty may be an option. This procedure uses heat to reduce excess muscle tissue in the airways, preventing airway constriction and improving breathing.

Along with medical treatments, lifestyle modifications can help minimize asthma attacks:

• Avoid exposure to allergens, pollutants, and strong chemical fumes.

• Maintain a healthy weight through proper diet and exercise.

• Avoid smoking and exposure to secondhand smoke.

• Get vaccinated against flu and pneumonia to prevent respiratory infections.

• Monitor breathing patterns to detect early warning signs of worsening symptoms.

With the right combination of medical treatment and lifestyle changes, individuals with severe asthma can effectively manage their symptoms and lead a better quality of life.