While lung function tests were not always used for diagnosis in the past, the NHLBI (National Heart, Lung, and Blood Institute) Guidelines for the Diagnosis and Management of Asthma state that "Pulmonary function studies are essential for diagnosing asthma and for assessing the severity of asthma in order to make appropriate therapeutic recommendations. The use of objective measures of lung function is particularly important, because subjective measures, such as patient symptom reports and physicians' physical examination findings, often do not correlate with the variability and severity of airflow obstruction."
Lung function tests include measuring peak flow with a peak flow meter, the use of a simple spirometer, or may involve a battery of spirometry tests in a pulmonary function lab.
More on Peak and Flow Meter
More on Spirometer
Symptoms may occur during the day or at night. If they happen at night, they may disturb your sleep.
When the bronchi become irritated and/or infected, an asthma attack may be triggered. The attack may be acute onset and happen suddenly, or develop gradually over several days or hours. The main symptoms that can signal an impending asthma attack are as follows:
Wheezing is the most common symptom of an asthma attack. Wheezing is defined as a whistling noise in the chest during breathing when the airways are narrowed or compressed. Not all asthmatics wheeze, and not all people who wheeze are asthmatics.
The characteristics of wheezing include:
Current guidelines from the National Asthma Education and Prevention Program (NAEPP) and its Expert Panel Report 2 (EPR 2) have set forth the grading of asthma severity into the following four categories based on frequency of daytime and nocturnal symptoms, peak flows, and as-needed use of inhaled for the care of people with asthma including:
Mild intermittent asthma:
This includes asthma attacks no more often than twice weekly and nighttime attacks no more than twice a monthly, with attacks lasting no more than a few hours to a few days. The severity of attacks may vary, but there are no symptoms between attacks.
Mild persistent asthma:
This includes asthma attacks more than twice weekly, but not daily and nighttime symptoms that may occur more frequently than twice monthly. Sometimes the asthma attacks are severe enough to interrupt regular activities.
Moderate persistent asthma:
This includes daily attacks and nighttime symptoms more than once weekly. In addition, more severe attacks occur at least twice weekly and may last for days. Asthma attacks require daily use of quick-relief (rescue) medication and interrupt some daily activities.
Severe persistent asthma:
This includes frequent, severe attacks, continual datime symptoms, and frequent nighttime symptoms daily. Asthma symptoms limit daily activities.
People with mild and moderate asthma are susceptible to the occurrence of asthma attacks. The severity of asthma may change over time, either for better or for worse.
When to seek medical care for asthma symptoms
If you think you or your child may have asthma, make an appointment with your health-care provider to determine the cause of your symptoms. Some clues pointing to asthma may include the following:
Depression and asthma symptoms
The medical community is uncertain as to the mind-body connection between asthma, anxiety and depression. Both anxiety and depression alter the body's healthy balance of hormones and brain chemistry, and this alteration may somehow set the stage for disease. Once a person has been diagnosed with asthma, feelings of sadness or worry can cause subtle physiological changes that may play a role in further asthma attacks.
Researchers at the State University of New York at Buffalo tested this theory by showing the movie ET: The Extraterrestrial to a group of children with asthma. During the sad parts, the children's heart rates and blood oxygen levels became erratic. Such physiological changes may leave the asthmatic vulnerable to further adverse physiological changes that could lead to the symptoms of asthma.
Depression can also contribute to a higher incidence of asthma symptoms by suppressing the immune system. People suffering from depression report more frequent viral and respiratory infections. Once such an infection takes hold, it can inflame the airways and trigger an asthma attack.
Asthma patients who feel depressed might not monitor their breathing and take medications as promptly as when they feel normal and emotionally healthy. Treatment aimed at resolving depression and anxiety may improve the effectiveness of preventative asthma medicines and decrease the occurrence of asthma attacks.
If you have been diagnosed with asthma, a bout of depression or anxiety can trigger asthma attacks and require more medical intervention in order to manage, according to recent medical research. Studies have found that asthmatic children suffering from psychological distress need higher doses of medication and spend more time in the hospital than emotionally settled children with asthma. It has become routine for some health care providers to inquire of their patients seeking medications for exacerbations of their asthma symptoms to ask them questions such as “What has gone wrong in your life lately?” and “Are you feeling upset or depressed recently?”
In 1999, researchers at the Centers for Disease Control and Prevention published a study that, for the first time, provided strong evidence that depression and anxiety can actually help cause the respiratory disease. Investigators gave psychological tests to more than 5,000 asthma-free people aged 25 to 74 and then checked their health records 13 years later. After adjusting for age, sex, race, and other factors, the researchers found that severe depression and anxiety more than doubled a nonsmoker's risk of developing asthma.
Buteyko is a Russian method of breathing exercises for asthma. Buteyko links hyperventilation with asthma, and is based on techniques to normalize breathing patterns, reducing symptoms and possibly lessening the need for medication
Deep breathing exercises address all cycles of the breath, including inhalation, retention and exhalation. For people with asthma, exhalation is the focus of deep breathing exercises.
Instructions for khapalbhati pranayam
To repeat, the exhalation is done using conscious sharp force, while the inhalation is just a recoil action bringing the air back into the lungs. All the breathing takes place through the nose. Right after the passive inhalation, exhale again forcefully and continue at a steady rhythm.
Several scientific studies conducted in India have shown a correlation between yoga breathing exercises and various physiologic improvements. Some of these improvements include:
Some studies on yoga breathing have also demonstrated positive effects on patients with asthma. Two studies showed the beneficial effects of yoga breathing exercises for asthmatic patients. In the first study, peak expiratory flow rate values improved after yoga. PEF is used to monitor the effectiveness of asthma treatments and medications. A majority of the patients were able to reduce or eliminate their cortisone medications.
The second study showed overall decrease in asthma attacks and medication usage in patients using yoga breathing. This study demonstrated an improvement in the measured breathing parameters of all patients over baseline. It also showed a statistically significant increase in the dose of histamine needed to cause a 20% reduction in FEV1 during pranayam, demonstrating a tendency towards reduction in allergic asthma.
The above-mentioned studies were conducted using the pranayam called "khapalbhati."
Some studies on yoga breathing have demonstrated positive effects on patients with asthma. Two studies showed the beneficial effects of yoga breathing exercises for asthmatic patients. In the first study, peak expiratory flow rate values improved after yoga. PEF is used to monitor the effectiveness of asthma treatments and medications. A majority of the patients were able to reduce or eliminate their cortisone medications.
The second study showed overall decrease in asthma attacks and medication usage in patients using yoga breathing. This study demonstrated an improvement in the measured breathing parameters of all patients over baseline. It also showed a statistically significant increase in the dose of histamine needed to cause a 20% reduction in FEV1 during pranayam, demonstrating a tendency towards reduction in allergic asthma.
The above-mentioned studies were conducted using the pranayam called "khapalbhati."
Yoga breathing exercises, Kapalabhati pranayam, is also known as "skull shining breath," due to it's reputation for opening the nasal passages, and thus making the head clear. It is used as a “cleansing” breathing exercise. The breathing technique uses a forced exhalation with the premise of ridding the lower lungs of “stale” air, allowing the intake of oxygen-rich air, thereby purifying the body. A passive inhalation is followed by forceful exhalation through the nostrils, as if attempting to blow out a candle through one’s nose. It is recommended that one should gradually increase to an active breath at a rate of 45 to 60 exhalations per 30 seconds.
Since this breath emphasizes exhalation, it has been found useful for reducing wheezing in asthmatic patients.
The USDA and the US Department of Health and Human Services have redeveloped the Food Guide Pyramid to educate Americans about healthy eating. You may be familiar with the old Food Guide Pyramid, or its predecessor the Four Basic Food Groups. The new symbol, called "MyPyramid", represents a personalized approach to eating a healthy diet and staying active through physical activity.
While the new food guidelines emphasize a personalized approach, here are some additional tips:
Include a variety of foods in your diet. Each of the food groups provides nutrients that are important to you, and foods in one group can't replace those in another. Try to include each of the food groups in your daily diet.
Choose a variety of foods within each food group and eat small amounts of fats, oils and sweets, and include essential fatty acids (EFAs) from flax, sesame oil and fish in your diet.
Talk with your health care provider about your specific nutritional needs. Eating a healthy diet can help you feel and breathe better.
6-8 % of children and 2-4% of adults suffer from food allergies, in a landmark survey of asthmatic in the U.K., 66% said that they experience exacerbation of asthma symptoms with certain foods. The most common foods that produce allergies in sensitive individuals are given below.
For Children:
For Adults:
Nutrition Management - Eating with Asthma
Many people with chronic lung disease such as asthma feel more short of breath when their stomach is full. This is because the diaphragm can not work as well when the stomach is full. You can satisfy your nutritional needs, keep your stomach comfortable and help your diaphragm to work better by eating smaller, more frequent meals. Small, frequent meals also reduce the chance of reflux. Here are more suggestions of helpful eating and cooking habits when living with asthma:
Foods to Avoid
The following foods are common offenders. Keep a food diary to find out if they are a problem for you.
An asthma action plan can make it easier to understand which medication is best in different situations. An asthma action plan is based on a set of treatment guidelines given by the NIH (National Institutes of Health), and is completed by your doctor, so that you know what medications to take when your asthma is symptomatic or asymptomatic, when to notify your physician or emergency care center, and what classification of asthma you have. Three separate "zones", i.e., the Green Zone (asthma under control), the Yellow Zone (asthma control slipping), and Red Zone (danger, take action now!) include a description of signs and symptoms tied to each zone with specific treatments and actions tied to each zone.
When you have been diagnosed with asthma and you aren’t sure which treatment is best, review your asthma action plan. If you don't have asthma action plan, ask your health care provider for one that also includes asthma education.
If you take steroid pills for asthma, it is very important to remember to:
(Grindelia spp.) Grindelia is traditionally recommended for the treatment of spasmodic respiratory conditions such as asthma and bronchitis. The British Herbal Pharmacopoeia 1983 lists the specific indication as bronchial asthma with tachycardia.
National Institutes for Health and National Center for Complementary and Alternative Medicine. 2005. Traditional Chinese Herbs May Benefit People With Asthma. (Online) http://nccam.nih.gov/research/results/spotlight/061609.htm accessed 02-01-2010
Staff. 2006. Natural Herbs for Asthma. (Online) http://www.hebalsupplementesourcement-resource.com/herbs-for-asthma.html accessed 02.01.10
National Institutes for Health and National Center for Complementary and Alternative Medicine. 2005. Traditional Chinese Herbs May Benefit People With Asthma. (Online) http://nccam.nih.gov/research/results/spotlight/061609.htm accessed 02-01-2010
Staff. 2006. Natural Herbs for Asthma. (Online) http://www.hebalsupplementesourcement-resource.com/herbs-for-asthma.html accessed 02.01.10
http://www.umm.edu/altmed/articles/skullcap-000273.htm
National Institutes for Health and National Center for Complementary and Alternative Medicine. 2005. Traditional Chinese Herbs May Benefit People With Asthma. (Online) http://nccam.nih.gov/research/results/spotlight/061609.htm accessed 02-01-2010
Staff. 2006. Natural Herbs for Asthma. (Online) http://www.hebalsupplementesourcement-resource.com/herbs-for-asthma.html accessed 02.01.10
