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Triggers for Asthma in Young Children · Bryan Health Podcasts

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  Intro: At Bryan Health, we care for patients, educate tomorrow's
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  healthcare providers, motivate our community with fitness and health
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  programs and collaborate to continually improve how we serve others.
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  That's why we are proud to present another Bryan Health podcast.
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  Caitlin Whyte: Welcome to the Bryan Health podcast.
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  I'm Caitlyn Whyte.
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  And today we are discussing asthma symptoms and triggers with Dr.
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  Robert Szalewski, an allergist and immunologist with Allergy,
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  Asthma and Immunology Associates.
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  To start off doctor, what is asthma and what causes it?
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  Robert Szalewski, MD: So asthma is a common condition, unfortunately, that
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  affects millions of people worldwide.
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  It's most commonly diagnosed in children as well.
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  The global initiative for asthma defines asthma as a heterogeneous disease,
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  usually characterized by chronic inflammation, defined by the history of
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  respiratory symptoms, such as wheeze, shortness of breath, chest tightness,
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  and cough that vary over time and in intensity together with what they call
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  variable expiratory airflow limitation.
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  So in more simple terms, it is basically a chronic inflammation of the airways.
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  So when individuals with asthma are exposed to a certain trigger, their
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  lungs become more inflamed and irritated.
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  And in addition, the muscles around the airways can get very tight
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  because they are contracting too much.
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  So when this occurs, it makes it harder for air to move in and out of the lungs
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  and air ends up getting trapped in the lungs or you get some obstruction.
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  And this results in the symptoms, such as shortness of breath,
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  chest tightness, wheeze and cough.
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  And there are a lot of different mechanisms that can contribute to asthma.
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  In general, many of the same cells that contribute to allergies, so
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  various immune cells and antibodies like IgE also contribute to
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  airway inflammation and asthma.
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  In addition, hereditary causes also play a role because you're
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  more likely to develop asthma if other family members have asthma.
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  Caitlin Whyte: And what are some common symptoms?
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  Robert Szalewski, MD: So most commonly, asthma symptoms include
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  shortness of breath, chest tightness, wheezing, and cough.
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  And again, these symptoms tend to develop after exposure to a certain
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  trigger, which results in the muscles around the airways contracting too much
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  and causing obstruction of airflow.
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  These symptoms most often are reversible with medications, such as steroid
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  inhalers to help decrease inflammation in the airways and also inhalers like
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  albuterol to help open the airways.
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  Symptoms are usually the same in children and adults, and so it is
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  important to make an appointment with a provider if you do notice your child is
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  experiencing symptoms such as constant coughing or coughing that is worse with
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  infections or cold air or exercise.
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  Your child has shortness of breath or they're wheezing, or they're stopping to
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  catch their breath when they're playing or exercising more so than usual, or they're
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  having trouble sleeping at night because they're coughing or they're wheezing.
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  An allergist can help make the diagnosis of asthma by using breathing tests such
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  as spirometry and exhaled nitric oxide.
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  And they can also help identify potential triggers by doing allergy testing.
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  Caitlin Whyte: And that leads me into my next question,what triggers asthma?
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  Robert Szalewski, MD: So asthma can be triggered by many different factors.
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  Typical environmental triggers include various allergens, so pollens,
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  things like ragweed that cause hay fever, for instance, dust mites in
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  people's homes, animal dander, so people around cats or dogs or other
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  animals, various molds can trigger it.
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  In addition, irritants like air pollution can contribute, cigarette smoke.
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  Some people have their asthma triggered by respiratory tract infections,
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  whether it be viral or bacterial.
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  Some people have asthma triggered by exercise, even changes
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  in temperature and humidity.
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  Some people also have a condition called aspirin-exacerbated respiratory disease,
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  where their asthma symptoms are triggered by taking medications like aspirin.
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  And now in the working population, there are some studies that have shown 10 to
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  25% of cases of new-onset asthma in adults are due to exposures in the workplace,
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  which is called occupational asthma.
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  And there are many different chemicals that can contribute to occupational
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  asthma, various things like people who work in the metal industry, people
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  who work with dyes or flowers or other types of chemicals like that.
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  Caitlin Whyte: So if we have asthma, how do we manage it?
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  Is it at all curable?
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  Robert Szalewski, MD: So asthma is not curable, but it can be managed
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  very appropriately and effectively.
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  Things like continuing to use your medications that are prescribed by your
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  doctor, like steroid inhalers to decrease inflammation in the lungs, using your
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  short-acting inhaler like albuterol to help open your airways if you need it.
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  Really identifying your triggers, whether that be an allergen that you're
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  exposed to in the environment or some sort of irritation or exercise or the
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  things that I'd mentioned previously really can help kind of decrease
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  the burden that asthma has on you.
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  Now, there are some newer therapies called biologic therapies, which are
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  injectable medications that people can take that really target very
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  specific immune cells in the body that help improve asthma symptoms.
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  Caitlin Whyte: Are asthma and eczema at all related?
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  Robert Szalewski, MD: In short, yes, they are.
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  So one of the biggest risk factors for developing asthma is if you have other,
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  what we would call atopic conditions such as eczema or seasonal allergies.
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  Now there's something that we as allergists called the atopic march, which
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  is essentially the progression from eczema that starts in infancy to asthma and
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  seasonal allergies later on in childhood.
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  There may be a connection between eczema and asthma in regards to very specific
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  genes like the skin protein gene that's mutated in eczema, the filaggrin gene.
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  But other studies have shown that kids with eczema that are found to
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  be sensitized, meaning they have specific antibodies that are IgE
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  antibodies to an allergen, whether it's a food allergen or something in the
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  environment, are much more likely to develop asthma later on in childhood.
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  So it's important for these kids to be evaluated by an allergist to help
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  identify if there are any allergic triggers that are present that would
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  make it more likely for these kids to develop asthma later on, so that way
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  we can initiate appropriate treatment and help keep things under control.
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  Caitlin Whyte: That's so interesting.
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  I would've never linked those two because they seem so
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  different just on the surface.
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  Robert Szalewski, MD: Yup, they do.
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  But there are a lot of different factors that can contribute from a
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  genetic and an environmental standpoint.
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  Caitlin Whyte: Well, doctor, is there anything else you want our
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  listeners with asthma to know?
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  Robert Szalewski, MD: I think the most important thing is continuing to
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  take the medications appropriately.
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  And consistently, the most important thing would be making sure your
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  asthma stays under control.
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  We wouldn't want you to end up in the hospital or worse, especially given
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  this time of year with flu season and the pandemic and other viral infections
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  that trigger a lot of people's asthma.
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  Caitlin Whyte: And that wraps up this episode of Bryan Health podcast.
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  Head on over to our website at bryanhealth.org
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  for more information, and to get connected with one of our providers.
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  Please remember to subscribe, rate and review this podcast and all
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  the other Bryan Health podcasts.
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  I'm Caitlin Whyte.
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  Stay well.