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| Home > Asthma Facts from Dr. Crim > Asthma Facts from Dr. Crim : Part I |
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Speaking out about asthma
Learn more about asthma in a conversation with Dr. Courtney Crim, a board-certified pulmonologist and Group Director of the Respiratory Medicine Development Centre at GlaxoSmithKline.
Recently, Dr. Crim participated in an interview about the prevalence of asthma, as well as the importance of educating patients with asthma, their families, and healthcare providers about this potentially serious respiratory disorder.
Here is a transcript of part of this interview.
There has been a dramatic increase in the number of asthma cases. Some sources say asthma has increased as much as 160% in children since 1980. Is this because people are more aware and actively seeking treatment, or is this increase due to something else, like changes in the environment?
Dr. Crim:
It's probably a combination of both. Today, there's a greater awareness among healthcare professionals and patients concerning asthma. More than ever before, healthcare professionals are recognizing the symptoms and accurately diagnosing asthma. Patients are more health-conscious and more actively seeking medical attention for their health problems. And the number of managed care plans may have also given more people the opportunity to see a healthcare professional. These factors may contribute to what seems to be an increase in the number of asthma cases.
Is there a known cause of asthma?
Dr. Crim:
Currently, there's no one specific thing that you can point to and say, "This causes asthma." In general terms, we know that asthma is a result of an interaction between a person's genetic makeup and his or her environment.
Then, will a child be more likely to have asthma if both parents have it?
Dr. Crim:
It's not 100% certain that someone with a family history of asthma will develop it as well. What you can say is that a child living in a household in which one or both parents have asthma is at a greater risk. However, this child's asthma may be triggered by environmental factors, not heredity. Right now, we can only say that asthma results from an interaction between the environment and genetics.
Why is it so important for people with asthma to avoid cigarette smoke and other triggers, such as dust and mold?
Dr. Crim:
People with asthma have very sensitive airways. Often, it doesn't take much to cause their airways to go into spasm. For example, a person who doesn't have asthma can go into a smoke-filled bar and not have any immediate problems. On the other hand, a person with asthma has hypersensitive airways. Even a little smoke could cause these airways to go into spasm and cause an asthma attack.
Is it the same for all people with asthma?
Dr. Crim:
Not at all. Everybody's asthma is unique. If you study a hundred people with asthma, each will have varying sensitivities to an irritant such as cigarette smoke. One person will only go into spasm if he or she is in a room with people who are actively smoking. Another person with asthma may have an attack by just going into a room after someone has just finished smoking.
This is also true with air pollution. Days with heavy smog or ozone have a different effect, depending on the individual. For example, some people with asthma can go outside and work in the yard and not have any problems. Yet, other people with asthma who are experiencing the same exposure will have spasms of their airways. All in all, it is an individual disease.
There are many myths surrounding asthma. One that we often hear is that it's possible to "outgrow" asthma. Is this true?
Dr. Crim:
There are at least two possible explanations for this myth. First, there's the child who wheezes because of some type of infection and gets mislabeled as having asthma. As the child grows, the symptoms go away. He or she is mistakenly believed to have outgrown asthma. In this case, he or she never had it to begin with. It is simply a misdiagnosis.
Second, there's the person with asthma who has minimal symptoms or who has learned to adapt to the symptoms. Some children, for example, stop participating in physical education, sports, and other activities. Now that they've dropped their activities below the level that can trigger an asthma attack, they may believe they've outgrown their asthma.
Recent research has demonstrated that inflammation in the airways persists even in individuals with asthma who are free of symptoms and have normal lung function measurements.
To go back to an earlier point, are the people in this second group who mistakenly view themselves as having outgrown their asthma at risk of having a severe asthma attack?
Dr. Crim:
Absolutely. People are at increased risk for a serious asthma attack if their disease is not properly diagnosed and treated.
What role can education play in helping people with asthma lead a healthier, more active life?
Dr. Crim:
In my opinion, it's critical. I think it's the number one issue concerning asthma management. The extent to which patients are educated about asthma—what it is, what triggers it, how to monitor it, and what can be done to alleviate symptoms or minimize asthma attacks—has a direct impact on helping them live a healthier, more enjoyable life.
A patient with asthma only sees a healthcare professional at one particular point in time, but has asthma 24/7. So it's definitely important for the person with asthma to play an active role in asthma management.
Pets are a trigger for many people with asthma. Is there a pet people with asthma can live with safely?
Dr. Crim:
If an allergy to animals causes asthma symptoms or asthma attacks, the best pets are fish, turtles, or any other animals that don't have fur or feathers. It's commonly believed that there's a relationship between the length of an animal's fur and asthma symptoms or allergic reactions. This is simply not true.
It's animal dander (dandruff) and its saliva that can trigger symptoms. Also, feathers—whether on a pet or in a pillow—can also cause asthma symptoms in some people.
Can heartburn trigger asthma?
Dr. Crim:
Heartburn is also called gastroesophageal reflux disease (GERD). Heartburn is caused by stomach acid backing up into your esophagus, or sometimes into your airways as well. When this acid gets into the back of your throat, or is inhaled into your lungs, it can trigger asthma symptoms. Many people with asthma have heartburn. Many doctors believe that treating GERD aggressively may help improve asthma in people who have both conditions.
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Asthma Facts
from Dr. Crim |
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