If you have asthma, an allergic lung disease, you’re not alone.  At least 14 million Americans have asthma.  It’s getting more common and children outnumber adults 2:1.

 Just how frequent is asthma?  Eighty percent of patients are children, and 20% of asthmatics develop asthma after age 30.  About half of the children with asthma wheeze all their lives, while 20% outgrow their asthma.  In up to 40% of patients, allergies can trigger asthma, and sometimes treatment for allergies alone can prevent asthmatic symptoms.  This is extremely important because research has shown that allergies, if left untreated, can cause asthma.

 Research has also shown that inflammation of the airways, due to allergies or viral infections, is responsible for the shortness of breath, chest tightness, coughing and wheezing that children and adults have with asthma.  Inflammation will cause airways to become overly sensitive.  And asthma, if not properly treated, can worsen over time.

 The best treatment for inflammation is corticosteroids (or steroids), not to be confused with anabolic steroids used by some athletes to build muscle.  Corticosteroids decrease inflammation.  Oral steroids are sometimes used to control inflammation, but are not recommended due to side effects.  Steroids sprayed directly in the lungs work at the site to control inflammation.  Commonly used inhaled steroids today include Pulmicort, QVAR and the newest steroid, Asmanex.

 Surprisingly, only 10 to 15 percent of inhaled steroids actually reach the lungs; the rest is swallowed.  And yet, inhaled steroids are safe and effective long term, in preventing symptoms.  Local side effects (mild hoarseness, cough or thrush) may occur in 5% of users and are easily treated.  Recent studies have shown that inhaled steroids used at moderate to high doses may affect growth, causing a slight decrease in height (about a ¼ inch).  The growth spurt, however, that teenagers have will overcome any small effect on growth, and teenagers will reach their normal full adult height.

 Finally, research has shown that steroids combined together with bronchodilators are more effective than inhaling steroids alone in treating the inflammation found in asthma.  This observation lead to the development of Advair, and may soon lead to other combination asthma products.  Bronchodilators alone are never indicated for treating the inflammation found in asthma.  Therefore, always see your physician for evaluation and treatment of asthma, especially if your asthma is poorly controlled or worsening.

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