In this section you will find information about conditions that can mimic asthma or can influence asthma.

Gastroesophageal Reflux Disease (Acid Reflux)

A backflow of acidic stomach juices into the esophagus.

Signs and Symptoms

•  Indigestion, heartburn

•  Sour taste in mouth

•  Recurring sore throat without signs of infection

•  Nighttime coughing and/or choking spells

•  Belching

•  Sometimes stomach juices actually rise up in your mouth leaving a bitter taste

Treatment

•  Avoid foods such as coffee, alcohol, citrus juices, high fat foods, caffeine and peppermint.

•  Eat several small meals a day rather than three large meals.  Eat slowly.  Wait at least two hours after eating before you lie down.

•  Elevate the head of your bed 6 to 8 inches on blocks so that your head is higher than your stomach.

•  Avoid lifting heavy objects or bending over.

•  Weight reduction (when applicable).

•  Medications as directed by physician.

•  Laparoscopic surgery.

Sinusitis

An inflammation usually associated with infection of the membranes that line the sinuses.  Exacerbating of sinusitis often trigger exacerbations of asthma.

Signs and Symptoms

•  Nasal congestion

•  Headache

•  Pain, pressure; a feeling of fullness over the sinus areas

•  Achiness that radiates to the teeth

•  Cough

•  Increased post nasal drainage

•  Green/yellow mucus

•  Fever may or may not be present

•  Nausea

•  Sore throat (due to increased drainage)

•  Bad taste in the mouth/bad breath

Diagnosis

•  Symptoms

•  Rhinoscopy

•  Sinus CT scan

Treatment

•  A 5-10 day course or longer of an antibiotic is usually effective in treating acute episodes of sinusitis.

•  Nasal sprays

•  Nasal washes

•  Functional endoscopic surgery

Nocturnal Asthma

This is characterized by a worsening of one's asthma during nighttime hours.  Research has shown the human body doesn't remain constant over a 24 hour period.  There are fluctuations in hormone levels (circadian rhythm) during this 24 hour period.  The fluctuations in epinephrine and cortisol levels affect airway hyper-reactivity and bronchospasm. When these levels are at their lowest, around 4 AM, some asthmatics have an increase in their symptoms. When they are at their peak levels, 4 PM, the body is better able to protect itself.  Therefore, people tend to have a decrease in symptoms in the afternoons.

Signs and Symptoms

•  Worsening of your asthma symptoms at night or when sleeping

•  Sudden awakening with cough and /or sneezing

•  Shortness of breath at night

Treatment

•  May vary depending on the specific cause or causes

•  Medication

•  Environmental control

Vocal Cord Dysfunction

Vocal cord dysfunction is characterized by the abnormal closure of the front 2/3 of the vocal cords during breathing, leaving only a tiny diamond shaped opening at the base of the throat for passage of air.  Sounds from the throat are transmitted to the chest and may mimic asthmatic wheezing.

Sign and Symptoms

•  Chest x-ray is usually normal.

•  Symptoms continue despite aggressive therapy with bronchodilators and steroids.

•  Majority of the patients are females between the age of 20 and 40 years.

•  May be mistaken for exercise induced asthma.

•  Arterial blood gases and pulmonary function tests are usually normal.

Diagnosis

•  Flow volume loop

•  Fiberoptic laryngoscopy/rhinoscopy

Treatment

•  Clear explanation of symptoms.

•  Halting of unnecessary medications

•  Speech therapy to learn relaxed throat breathing.

•  Psychiatric consultation may be useful to uncover psychological issues and to provide appropriate care.

Exercise induced bronchospasms (exercise asthma)

Most people with asthma experience some symptoms of bronchospasm with exercising.  There are some asthmatics that only have bronchospasm when they exercise.

Signs and Symptoms
Worsening of asthma symptoms usually peak after 6 to 8 minutes of continuous exercise and may occur after halting exercise.  The symptoms usually disappear within several minutes, but can last up to an hour.

Diagnosis

•  Establish that the event is a case of asthma worsening with exercise and not a case of poorly controlled asthma.

•  Pulmonary Function Testing

•  Exercise Challenge Test

Treatment

•  Patients with asthma are encouraged to exercise.

•  Have a pre-exercise medication plan prescribed by your physician.

•  Proper pre- exercise warm-up period.

•  Exercising in a cold and dry environment is often associated with exercise-induced asthma.  If exercising in cold weather, placing a scarf or a mask over your mouth may help.

•  Choose an exercise that is compatible with your level of physical fitness and lung capacity.

Smoking

Harmful Effects

•  Smoking increases

  •  the frequency and severity of asthma attacks.

  •  the chance of infection.

  •  the metabolism of theophylline leading to the need for increased dose of theophylline.

  •  the risk of developing irreversible airway disease or emphysema (COPD).

   

•  Smoking also

  •  prevents one from reaching the best possible control over asthma.

  •  decreases exercise tolerance.

  •  causes 90% of all lung cancer.

  •  is linked to stomach ulcers, emphysema, chronic bronchitis, stroke and heart disease.

Benefits of Quitting

•  Respiratory infections are less severe and less frequent.

•  There are fewer incidents of strokes and ulcers.

•  The irritation caused by smoke to the mouth, throat, esophagus, stomach and lungs stops when the smoking stops.

•  There is less risk for developing cancer.

•  Symptoms of asthma have a greater chance of being controlled.

•  Improved life expectancy and quality of life.

Methods of quitting

•  Decide that you are going to quit.

•  Pick a date to halt cigarette use.

•  Join a cessation clinic. Cessation clinics include classes on stress, changing lifestyles and habits and sometimes hypnotism.

•  Nicorette Gum.  When this gum is chewed, nicotine is released and absorbed into the body.  It works by decreasing the body's addiction to nicotine. It is often used in conjunction with classes or counseling.

•  Nicotine patches prescribed by you physician. When the patch is applied, nicotine is released on a continuous basis into the body. It also works by decreasing the body's addiction to nicotine. The dose of the patch is gradually decreased over a period of 2 to 3 months until nicotine is no longer craved.  However, one cannot smoke at all while wearing the patch.

•  Nicotine-free oral medications.  Zyban and Wellbutrin S.R. (Bupropion hydrochloride) are prescribed medications to assist in smoking cessation. The medication reduces the craving for smoking and withdrawal symptoms from nicotine.  It is safe to use in conjunction with nicotine patches and/or gum.  To maximize success in quitting it is essential to participate in a smoking cessation support group or behavior modification program.

Asthma and Pregnancy

As A General Rule:

•  About one-third of all pregnant asthmatic women will experience an improvement, one-third will have worsening, and one-third will have no change of their asthma symptoms.

•  Usually those women that experience more difficulty with their asthma during pregnancy are also more difficult to manage when they are not pregnant.

•  Asthma that is under good control and is well managed has little effect on pregnancy.

•  It is essential to be followed by your physician to receive prenatal asthma care at every two months.

•  Most medications for asthma are safe to use during pregnancy.

•  Serious maternal and fetal complications can occur if asthma is uncontrolled during pregnancy, therefore, asthma control is essential.

•  Asthma should not prevent a pregnant woman from continuing her regular physical activities.