April 2014

In general terms, asthma is characterized by airway narrowing, inflammation, and a tendency for the airways to react to a variety of stimuli. These stimuli include:
• allergens (i.e. dust, pollen, danders)
• irritants (i.e. perfume, cigarette smoke, cleaning supplies)
• infections
• exercise
• emotion (stress, laughter)

As asthma doctors are finding out, asthma is not a single entity or a disease, but a variety of diseases that manifest in a similar manner. These differences make a major impact on treatment.

Asthma may be differentiated based on the level of severity and degree of control.

Severity refers to the extent of symptoms in an untreated state. Severity is gauged by the frequency of daytime/nighttime asthma symptoms, requirements for rescue medications, ER visits, unscheduled physician visits, and treatment with oral steroids.

Asthma “control” refers to the extent of symptoms a patient has while receiving appropriate therapies and medications from an asthma doctor. This term recognizes the fact that severe asthma may be controlled if effective therapies are chosen. On the other hand, mild asthma may cause patients significant symptoms if therapies are chosen unwisely.

Many asthma doctors and asthma clinics assume that asthma symptoms develop secondary to inflammation of the airways. As a result, they focus treatment on “controller” medications that “control” airway inflammation.

Interestingly, our allergy doctors have found that inflammatory airway response may differ between individual asthmatics. These differences may influence which medications will work and which will not.

Until recently, there was no practical way to non-invasively measure airway inflammation or determine whether or not asthma controllers are having their intended affect.

Starting in 2010, our asthma clinic initiated with great success Fractional Excretion of Nitric Oxide (FeNO) testing as a way to sort out the presence/absence of eosinophilic airway inflammation. The eosinophil is one of the major allergy cell types that is involved with many, but not all, cases of asthma.

If you or your child may be suffering from asthma, please call us at any of our 3 locations listed below. We are here to help you.

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About our Asthma Clinic
Since 1951 our asthma doctors have been successfully treating adults and children for asthma in Virginia Beach, Norfolk, Chesapeake, Portsmouth, and throughout Hampton Roads, where the climate is conducive to asthma problems.