Understanding Severe Asthma – Symptoms, Diagnosis, and Treatment

Asthma is a chronic respiratory condition that leads to airway inflammation and swelling, making breathing difficult. Common symptoms include chest tightness, shortness of breath, wheezing, coughing (especially at night), and increased sensitivity to colds or respiratory infections. When these symptoms persist on most days of the week and significantly impact daily life, it could indicate severe asthma. Proper medical intervention is essential to managing this condition effectively.

Since severe asthma shares symptoms with other respiratory illnesses, early diagnosis is crucial for effective management. A pulmonologist will conduct a thorough evaluation using the following methods:

• Physical Examination – To rule out conditions like COPD (chronic obstructive pulmonary disease) or lung infections, the doctor will assess symptoms and medical history.

• Lung Function Tests – Tests like spirometry and peak flow measurement help determine how well air moves in and out of the lungs. These are often done before and after using a bronchodilator to see if lung function improves, confirming an asthma diagnosis.

Additional tests may be performed for a more accurate assessment:

• Nitric oxide test – Measures inflammation in the airways.

• Methacholine challenge – Tests airway sensitivity.

• Imaging tests – X-rays or CT scans help detect structural lung issues.

• Sputum eosinophils – Examines white blood cells linked to airway inflammation.

• Exercise or cold-induced asthma tests – Evaluates asthma triggers.

• Allergy testing – Identifies potential allergens that worsen asthma symptoms.

Asthma management includes both long-term control and rescue medications:

1. Long-term medications (taken daily to prevent attacks):

• Leukotriene modifiers

• Long-acting beta-agonists

• Inhaled corticosteroids

• Combination inhalers

2. Rescue medications (used during attacks for symptom relief):

• Short-acting beta-agonists

• Oral or intravenous corticosteroids

For allergy-related asthma, allergy shots may help strengthen the immune system.

If medications do not provide sufficient relief, bronchial thermoplasty may be recommended. This procedure uses heat to reduce airway muscle thickness, preventing airway constriction and reducing asthma attacks.

In addition to medical treatments, the following lifestyle changes can help manage severe asthma:

• Avoid allergens, pollutants, and chemical irritants.

• Maintain a healthy weight.

• Refrain from smoking or exposure to smoke.

• Get vaccinated against flu and pneumonia to prevent complications.

• Monitor breathing patterns for early warning signs of flare-ups.

By combining proper medical treatment with lifestyle adjustments, individuals with severe asthma can better control their symptoms and improve their quality of life.