Asthma Classification and its types

Introduction

Asthma is a medical condition that causes breathlessness. Narrowing and swelling of the airways cause asthmatic symptoms. Asthma also results in mucus production in the airways. This condition results in wheezing, breathlessness and cough.

Asthma could be mild and requires no treatment medically. Whereas, it could also be severe or extreme, life-threatening and harmful. Professionals from a medical background, divide asthma into four types from mild to severe. The types depend on two things, i.e. how often the symptoms occur and how severe the symptoms are.

How is asthma classified?

The types of asthma division, depending on the below-mentioned factors:

• Medical History and Physical Examination
• Undergoing a lung function test
• The starting age of asthma
• In inflammation, the kind of cells included
• The outcome of allergy tests
• Lung and tissue characteristics
• In the past, the way of responding to the medications

Types of asthma consist of:

• Mild Intermittent Asthma
• Mild Persistent Asthma
• Moderate Persistent Asthma
• Severe Persistent Asthma

Mild Intermittent Asthma

This condition means asthma is a mild form. In this condition, the symptoms last for approximately two days a week or two nights in a month. This kind of asthma frequently does not affect any activities and can result in “exercise-induced asthma.”

Symptoms include

• While breathing, wheezing or whistling sounds occur
• Presence of cough
• Airways get swollen
• Mucus development in the airways

Treatment

The requirement of a rescue inhaler needed for the treatment of mild asthma. In this case, the provision of medications is not daily since the symptoms occur very rarely.

The assessment of medical needs depends on the severity of the medical condition. If allergies activate asthma, the physician will prescribe allergy medicines.

If the symptoms of asthma occur due to exercise, the physician will advise using the rescue inhaler before work-out to avoid symptoms.

Individuals to suffer from this type of asthma are:

A maximum number of individuals suffer from a mild form of asthma. The most common kinds of asthma are mild intermittent and mild persistent.

The risk of asthma increases due to various factors such:

• Family History of asthma
• “Smoking or Exposure to second-hand smoke.”
• Suffering from allergies
• Overweight or obesity
• When exposed to fumes or pollution
• Exposed to Occupational Chemicals

Mild Persistent Asthma

In this asthmatic condition, the symptoms are mild but occur more than two times in a week. For this kind of division, the symptoms do not happen greater than one time in a day.

Symptoms

• While breathing sounds like wheezing or whistling
• Cough
• Airways get swollen
• Mucus production in the airways
• Pain or tightness in the chest

Treatment

If an individual has this kind of asthma, the prescription by a physician is “low-dose inhaled corticosteroid” medicine. The inhaled corticosteroid is taken on a daily basis and inhaled quickly. In-case the symptoms occur regularly, the physician might also prescribe a rescue inhaler. Allergy medications are prescribed if the activation of asthma is due to allergies.

A round of oral corticosteroids is given to kids below the age of 5 years.

Which individuals often suffer from this type of asthma?

The factors that result in developing asthma are:

• Family history of asthma
• Smoking or exposure to second-hand smoke, i.e. active and passive smoking
• Allergies
• Overweight or obesity
• Exposed to fumes or pollution
• Exposed to occupational chemicals

Moderate Persistent Asthma

In this type of asthma, the symptoms occur once in a day or many of the days. The occurrence of symptoms will be every week, once a night.

Symptoms include

• While breathing, sounds of wheezing and whistling
• To cough
• Airways get swollen.
• Mucus production in the airways
• Pain or tightness in the chest.

Treatment

In this asthmatic condition, the physician prescribes a dose of medications that is higher than used for mild persistent asthma, i.e. inhaled corticosteroids. If any further onset of symptoms, a rescue inhaler will also be prescribed.

In-case of any allergies, the physician also prescribes an allergic medication.

For kids above the age of 5 or more, oral corticosteroids are injected.

The risk of developing any kind of asthma is due to factors such as:

• Family History
• Smoking or exposure to second-hand smoke
• Suffering from allergies
• Obesity or overweight
• Exposed to fumes or pollution
• Exposed to Occupational chemicals

Severe persistent asthma

This asthmatic condition, have symptoms many times throughout the day. Every-day the symptoms occur. The signs also happen every week for many nights. Severe persistent asthma does not respond properly, even though the medications consumed regularly,

Symptoms

• While breathing, there are whistling and wheezing sounds
• To cough
• Airways get swollen.
• Production of mucus in the airways
• Pain or tightness in the chest

Treatment

If there is severe persistent asthma, there is aggressive treatment required and requires treatment with various medicines and doses. The physician will work and find combinations or varieties for controlling the symptoms.

The medicines include:

• Inhaled Corticosteroids: “At a higher dose than with other asthma types.”
• Oral Corticosteroids: “At a higher dose than with other asthma types.”
• Rescue Inhaler
• Allergic medications

Individuals, who suffer from this type of asthma?

This type of asthma affects a group of any age. Initially, the asthmatic symptoms are mild when initially diagnosed, which then becomes severe.

Severe respiratory illness like pneumonia can activate persistent asthma. The onset of severe asthma is also a result of hormonal changes.

The risk of asthma is a result of various factors, such as:

• Family History of Asthma
• “Smoking or exposure to second-hand smoke.”
• Allergies
• Overweight or obesity
• Exposed to fumes or pollution
• Exposed to Occupational Chemicals

Adult-Onset Asthma

To develop asthma for the first time as an adult. Factors causing adult-onset asthma are multiple. The occurrence of asthma for the first time could be a result of room-mate who has a pet, working around some chemical fumes for the first time or viral infections. For example, affected by upper respiratory infections that result in cough sticking around for a few weeks.

Symptoms include:

• Coughing majorly at night, while exercising or laughing
• Tightness or pain in the chest
• Breathlessness
• Wheezing

Tests will be done by an allergist that helps in the diagnosis of adult-onset asthma.

You can work with an allergist to make a plan for managing asthma. They can help with quick-relief and long-term medicines.per44mz

Allergic Asthma

Several allergy-causing factors such as pollen from grass, trees and weeds, pets, pests, mites, moulds and dust trigger asthma. Not every individual who has allergies causes asthma and not every individual who has asthma will suffer from allergies.

Symptoms of asthma are:

• Coughing and majorly at night, dancing or exercise-induced
• Breathlessness
• Chest pain or tightness
• Breathlessness
• Wheezing

The allergist detects the diagnosis by determining the factors, causes of asthma, i.e. via allergies or no, and helps with the proper plan of treatment.

Individuals with quick-relief and chronic control by medications help in treating and managing the asthmatic symptoms.

Non –allergic asthma

The causes of non-allergic asthma could be due to extreme weather, illness or sickness, stress or related issues.

Symptoms are:

• Coughing especially at night, laughing or exercise-induced
• Problems in breathing
• Chest pain or tightness
• Wheezing

Non-allergic symptoms activate various factors, such as:

• Viral respiratory infections
• Exercise-induced
• Air-based irritants
• Stress-induced
• Drugs and other related food additives
• Certain weather conditions like extreme heat or chilled environment

For diagnosis need to visit a doctor who helps in planning a plan of treatment for allergies and asthma so the individual can live the life they want to live always. For diagnosis, the allergist can identify whether the issue is non-allergic or no. The allergist will prescribe the management by giving such quick-relief and long-term control medications.

Occupational Asthma

Individuals suffering from this asthmatic condition works around chemical fumes, dust or another irritant in the air.

Is asthma causing due to work?

• Did a change in job cause asthma to occur?
• When away from a job, does it improve asthma?
• Does breathing become difficult, when chemicals and other conditions are present near your work-place?

As per the Occupational Safety and Health Administration (OSHA), approximately 11 million workers in various industries and occupations in the US (United States), are made open to 250 substances that cause or exacerbate, i.e. increase the risk of occupational asthma. The activation of asthma due to various factors are chemicals used in manufacturing factories, paints, products used for cleaning, dust produced from woods, grains and flour, latex or rubber gloves, some specific moulds, animals and insects.

Factors that increase the risk for development of occupational asthma include presently suffering from asthma or allergies, family history and cigarette smoking.

As per the National Institute of Health, the below-mentioned workers are at a higher risk of developing occupational asthma:

• Bakers
• Manufacturers of detergent
• Manufacturers of drugs or medicines
• Farmers
• “Grain elevator workers.”
• Individuals working with laboratory or laboratory animals
• Workers in metal factories
• Millers
• Workers in a plastic factory
• Workers in a wood factory

Experts ask various questions to check whether asthma occurs due to work-related or not.

• Taking a family history
• Description About your past and present jobs. Essential to give information about the role and type of job, i.e. weather exposed to fumes, chemicals, smoke, pollens, irritants, gases and more. Whether exposed to environmental conditions like dryness, heat, cold or any exposure to manufacturing or processing conditions.
• How frequently the asthma attacks occur and how do they get activated
• The flow of air can be measured or tested by conducting a lung-function test such as spirometry.
• Physicians suggest the skin test, chest x-ray or blood tests.
• Essential to analyse and make the availability of the Material Safety Data Sheet (MSDS) to get an idea about the exposure of an individual to every chemical at work-place.
• Ways to manage occupational asthma needs development related to the environment, consisting of changes related to education or behavioural to avoid any triggers causing asthma, also includes drugs and medical follow-up. Talk to the allergist if activation of asthma is due to conditions at work or worsens at work-place.

Exercise-Induced Broncho (EIB) Constriction

This terms invented for what’s known previously as exercise-induced asthma for many years. Due to physical activity or work-out, there is narrowing of the airways.

90% of individuals with asthma suffer from EIB, but all EIB individuals do not have asthma.

Symptoms

The occurrence of EIB is a result of the loss of heat, water and both from the airways while exercising, i.e. when rapidly taking in dry air than what is already present in the body. The symptoms occur in some minute’s post the work-out starts and goes on till 10 to 15 minutes post-work-out. The signs present in anyone, but the severity of symptoms is higher in individuals suffering from EIB.

The initial symptom of asthma in children post-work-out is wheezing.

Symptoms observed in individuals are:

• Breathlessness or Wheezing
• Endurance (Strength) decreases
• Chest pain or tightness
• To cough
• Stomach upset
• Throat becomes sore

Air-borne irritants result in activation of EIB related to particular sports.

• While swimming, water contains chlorine
• While running or cycling, the presence of pollution
• While ice-skating or playing hockey, presence of cold or dry air
• During hot yoga, presence of air temperature
• Triggers or activation of asthmatic symptoms could also be gym, cleaners, paint, new equipment and carpets.

It was of a concern since many years that cold air worsens EIB, but as per new studies, the dry air rather than temperature is the mode of activation. There is a presence of less moisture in cold air than warm air, and rapid breathing of dry air dehydrates the bronchial tubes resulting in the narrowing and decreasing the flow of air.

The diagnosis of this condition is determined by an allergist, that identifies whether the symptoms are exercise-induced alone, allergen reactions or irritants in the air or an underlying asthma condition.

The allergist will collect information such as family history, specific details about physical activity and sports, how exercise affects breathing, measuring the breathe before, after and during the work-out by asking to run on a treadmill or ride an exercise bike.

The completion of treatment and management of asthma is by providing medication to provide relief from the pain and related issues.

Conclusion

With any type of asthma, educating oneself about the condition is essential in treating and managing the disease. Individuals who have asthma, need to have an asthma plan of action ready. In-case of an asthmatic response, the physician is required and listing the necessary steps in case of an asthmatic attack. Essential to avoid mild becoming severe and proper regular medical follow-ups.

References

1. https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0279-0
2. https://www.ncbi.nlm.nih.gov/books/NBK430901/
3. https://www.frontiersin.org/articles/10.3389/fmicb.2013.00263/full