Asthma Attacks - Causes And Treatment

Asthma is often caused when - for reasons not fully understood - cells in the lungs react to irritants in the air. The cells inflame and release mucus; the muscles around the bronchioles constrict. Relaxing the muscles around the bronchioles provides temporary relief, opening the tubes and making breathing easier. It also allows more irritants into the lungs, leading to continued problems.

The first step is identifying and removing the agents that trigger the asthma, like pollutants and secondhand cigarette smoke. Other triggers are allergens such as dust, mold, pollens and flakes of skin released by pets.

The next step is using preventive medicines designed to decrease swelling of the bronchioles and ward off future attacks. Doctors once thought direct assault was the best way to attack asthma. Now they know it's better to be a bit sneakier.

Asthma attacks are brought on when small tubes, called bronchioles, in the lungs swell and constrict. Exhaling is particularly difficult because doing so involves squeezing the lungs, making the tubes even narrower. Five years ago, doctors were likely to prescribe drugs that relaxed muscles, causing bronchioles to open and breathing to improve. Doctors have since discovered that depending on such medicines can actually hurt patients.

We know that continuing that form of therapy may actually do more harm than good. Sporadic use can make the disease worse. Now doctors recommend less dependence on bronchodilators, which relax muscles around the bronchioles, and more use of drugs and programs designed to prevent the tubes from becoming inflamed.

Until recently, doctors prescribed anti-inflammatory steroid pills only for severe cases because long-term use could stunt growth, cause bones to thin and prompt diabetes to develop. But over the past 10 years, inhaled steroids have been introduced. They're much safer because they're applied directly to the lungs without being absorbed by the body.

Another drug, cromolyn sodium, is used to prevent the lungs from having allergic reactions.

The problem, is that too many asthmatic people are still depending on bronchodilators. That's particularly true in inner cities. Not many are treating asthma properly. There's crisis of management.

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