Asthma Disease Summary

Overview

Asthma is a heterogenous disease that is characterized by chronic airway inflammation and the resulting symptoms are mentioned in the Introduction section.

Worldwide, asthma has affected an estimated 300 million people. A more detailed discussion on the prevalence of asthma can be found in the Epidemiology section.

The mechanism of airway hyperresponsiveness and the mediators of inflammation in patients with asthma are discussed in the Pathophysiology section.

The Risk Factors section discusses the factors that can contribute to poor asthma outcomes, including those from asthma exacerbation, development of persistent airflow limitation and medication side effects.

Asthma can be classified by asthma phenotypes or severity. The Classification section enumerates these different types. 

History and Physical Examination

The Clinical Presentation section enumerates the usual symptoms associated with airflow obstruction.

The History section identifies the information that needs to be elicited from the patient in diagnosing asthma and its severity.

The physical examination of an asthmatic patient upon presentation may be normal but the Physical Examination section mentions the variable signs that the patient may present with.

Diagnosis

Tests to measure the lung function are in the Laboratory Tests and Ancillaries section.

The Differential Diagnosis section enumerates the diseases that may also present with asthma symptoms, and these should be ruled out especially when the symptoms are not typical for asthma and lung function does not support a finding of asthma. This section also discusses the difficult diagnostic groups that may require specialist referral.   

Management

After the diagnosis of asthma is made, it is recommended to initially start treatment with corticosteroids (inhaled, low dose) as soon as possible for better outcomes. This depends on the patient's presenting symptoms, risk factors, comorbidities, and treatment preference.  

The goals of treatment and therapeutic strategies are discussed in the Principles of Therapy section.

The Pharmacological Therapy section includes Global Initiative for Asthma (GINA) recommendations on the initial treatment depending on presenting symptoms and management plans for long-term asthma control that includes the controller and reliever medications to be given in each treatment step. This section also further discusses the stepwise therapy based on control and its maintenance.

Other management options like allergen immunotherapy and bronchial thermoplasty are discussed in detail in the Nonpharmacological section.

Detailed evaluation and management procedures of Asthma Exacerbations have a separate section.

Measures that can be taken to prevent the development of asthma and to decrease exacerbation are in the Prevention section.

Patient monitoring is an important part of the management of asthma exacerbation. Frequency of follow-up and monitoring of patients with asthma is discussed in the Monitoring section.