What Is Severe Asthma?
Asthma is a chronic lung disease that, according to the Asthma and Allergy Foundation of American (AAFA), affects over 26 million people. Some people have a mild form of the disease. However, for others, asthma is severe and, in some instances, can be life-threatening.
This condition involves asthma symptoms that do not respond well to typical treatments. The AAFA reports that about five to ten percent of people with asthma have severe asthma.
When symptoms are difficult to control, asthma attacks may become more frequent and increase a person’s risk of complications, such as respiratory failure. There is also some evidence that repeated asthma attacks may cause a decrease in lung function.
People with severe asthma may have uncontrolled symptoms frequently. Symptoms may limit daily activities and interfere with your quality of life. Standard treatments that work for mild to moderate asthma may not be effective, which is why it can be challenging to treat.
What Causes Severe Asthma?
The reason why some people develop this condition is not entirely known. It might be a combination of factors that increase a person’s risk of severe attacks. For example, many people with severe asthma also have allergies, which may trigger attacks.
Severe asthma may also develop due to an increase in a type of white blood cell called eosinophils, which triggers inflammation. People with asthma that continue to smoke also increase their risk of developing severe asthma. Being obese may also make you more likely to develop severe symptoms.
Environmental factors may play a role in the development of severe asthma. For instance, children that are exposed to cigarette smoke might have an increased chance of developing it.
Symptoms of Severe Asthma
The symptoms of severe asthma include the following:
- Shortness of breath
- Chest tightness
People with this condition experience the above symptoms often and more intensely. According to the National Institute of Health, severe asthma often includes the following:
- Symptoms that occur most nights out of the week
- Waking up at night due to asthma symptoms
- Symptoms that cause a significant decrease in regular activities
- The need to take a fast-acting inhaler several times a day
Severe asthma can lead to hospitalizations as well as missed days of school and work. Complications can also develop. Over time, the inflammation from frequent asthma attacks can lead to scarring in the lungs. When symptoms become severe and hard to treat, it can cause dangerous attacks, including flare-ups that lead to respiratory failure.
Treatment for Severe Asthma
An effective treatment plan is vital to decrease the risk of life-threatening attacks, as well as improve quality of life. Treating severe asthma typically involves a combination of therapies and strategies to manage the condition. This includes the following:
Reduce Asthma Triggers
Keep a log to determine your asthma triggers. Once you find a connection between specific allergens and asthma flare-ups, reduce your exposure as much as you can. Frequent asthma triggers may include pollen, mold and smoke.
Biologics are a class of medication that is sometimes helpful in treating severe asthma. The drugs work by targeting certain cells in the body that lead to an inflammatory response. Some biologics are administered at a physician’s office, and others are taken at home. They are usually given intravenously or administered by injection under the skin. One example of a biologic medication is mepolizumab, which targets cells that trigger inflammation.
Decrease Your Risk of Infections
Respiratory infections increase your risk. People with asthma are at an increased risk of severe attacks when they develop a respiratory infection, such as a cold or the flu. Take precautions to prevent lung infections; this includes avoiding contact with people that are sick, getting a yearly flu shot and washing your hands often.
Corticosteroids might be prescribed to treat severe asthma. Steroids work by reducing inflammation in the airways. Higher doses of corticosteroids may be needed to control severe asthma. Corticosteroids inhalers are usually taken once or twice a day to prevent symptoms.
Combination medications are also available that include a steroid with a long-acting beta-agonist. Both combination medications and steroids alone can have side effects — including hoarseness, dry mouth and an oral yeast infection. Steroids may also be administered orally or intravenously in cases of severe asthma attacks that are not responding to other treatments.
Short and Long-acting Bronchodilators
Although their effectiveness may vary, both short and long-acting bronchodilators may have a role in treating severe asthma.
Bronchodilators work by relaxing the muscles around the airways. As the muscles relax, they widen, which eases typical asthma symptoms. Bronchodilators may have side effects that include nervousness, increased heart rate and headache.
Although it can be challenging, it is possible to control severe asthma. But it’s essential that people with this condition see a lung specialist to develop an effective treatment plan.