Asthma

Also known as: asthma, bronchial asthma, allergic asthma, non-allergic asthma, eosinophilic asthma, occupational asthma, exercise-induced bronchoconstriction, acute asthma exacerbation, status asthmaticus

Asthma is a chronic inflammatory disease of the airways characterised by variable airflow obstruction, bronchial hyper-responsiveness and reversible narrowing of the bronchial tubes. Symptoms commonly include wheezing, cough, chest tightness and shortness of breath that fluctuate over time and may worsen at night or early morning. Triggers include viral infections, allergens, exercise, cold air, smoke, pollution, occupational exposures, stress and some medicines such as NSAIDs or beta blockers in susceptible individuals. Diagnosis is based on clinical history together with objective demonstration of variable airflow limitation using spirometry, bronchodilator testing, peak expiratory flow monitoring or bronchial challenge testing where appropriate. Modern management includes inhaled corticosteroids as the foundation of treatment for most patients, reliever bronchodilators, written asthma action plans and trigger reduction. Severe asthma may require oral corticosteroids, biologic therapies or specialist management. Untreated or poorly controlled asthma can lead to respiratory failure and death. Acupuncture may be considered only as an adjunct to evidence-based asthma care and must never replace inhaled corticosteroids, bronchodilators, emergency treatment or specialist respiratory management. Chinese herbal medicine requires careful review for interactions and should never delay emergency treatment during an acute asthma attack.