Types of Asthma & How Is It Treated?

Asthma is a medical condition that affects millions of people worldwide. It causes breathing difficulties due to the narrowing on your airways and inflammation. Asthma also causes a buildup of mucus in the airways, which leads to shortness of breath, coughing, and wheezing. Asthma affects different people in different ways. Some people can have mild to moderate asthma that needs very little to no medical treatment, while others suffer from severe and life-threatening asthma that needs to be managed with prescription medications. The treatment of asthma also depends on what type of asthma you have. Read on to find out about the different types of asthma and how to treat them.

Asthma is an inflammatory medical condition of the airways of the lungs. People who have asthma find it difficult to breathe, which makes it difficult for them to carry out many physical activities.

According to statistics released by the US Center for Disease Control and Prevention (CDC), there are around 27 million Americans who have asthma. ⁽¹⁾ In fact, asthma is today one of the most chronic conditions that affect children in the US, with every 1 out of 12 children having asthma. ⁽²⁾

There are different types of asthma, ranging from very mild that does not need any treatment, to very severe and life-threatening.

The medical fraternity typically ranks asthma into four different types, ranging from mild to severe. These different types of the disease are determined by the severity and frequency of your asthma symptoms.

The four types of asthma include:

1. Mild intermittent asthma
2. Mild persistent asthma
3. Moderate persistent asthma
4. Severe persistent asthma

Let us take a look at each of these types and its treatment:

People who have mild intermittent asthma have very mild symptoms. This classification means that you are likely to experience symptoms of asthma up to just two days in a week or two nights in a month. This type of asthma does not interfere with any of your daily activities. Exercise-induced asthma can be included in this category.

The symptoms of mild intermittent asthma can include:

• Coughing
• Swollen airways ⁽³⁾
• Whistling or wheezing sound comes when breathing
• Development of mucus in the airways

Treatment For Mild Intermittent Asthma: Treatment revolves around using only a rescue inhaler. You do not generally need any form of daily medication as the symptoms tend to only occur occasionally.

However, the need for medication will be assessed by your doctor based on how severe the attacks are when you have them. If allergies trigger your asthma, then your doctor is likely to prescribe allergy medications.

If you have exercise-induced asthma, then your doctor will advise you to use your rescue inhaler before you begin exercising so as to prevent any symptoms.

The majority of people diagnosed with asthma are usually diagnosed with this mild form of asthma. Mild intermittent, as well as mild persistent asthma, are the most common types of asthma, and this type of asthma is also one of the more likely examples of asthma to be left untreated because the symptoms are so mild and infrequent.

Certain factors increase the risk of developing any type of asthma, though, and you should be aware of these risk factors. These include:

• Family history of asthma
• Having allergies
• Smoking
• Regular exposure to secondhand smoke
• Being overweight
• Frequent exposure to toxic fumes or pollution
• Exposure to occupational chemicals/toxins

This second type of asthma means that you will still have mild symptoms, but the frequency of your attacks is likely going to be more than twice per week. For being classified as mild persistent asthma, you do not need to have symptoms more than once a day.

The symptoms associated with mild persistent asthma include:

• Swollen airways
• Whistling or wheezing sound when breathing
• Coughing
• Chest tightness or chest pain
• Development of mucus in the airways

Treatment For Mild Persistent Asthma: Treatment usually involves a low-dose inhaled corticosteroid medication. Inhaled corticosteroid medication is taken by inhaling it quickly, and it is generally taken daily. ⁽⁴⁾ As per your condition, your doctor may also recommend a rescue inhaler to have with you in case your symptoms flare up from time to time. Allergy medications may also be prescribed if your asthma is induced by allergies.

In people over the age of 5, oral corticosteroids can also be prescribed.

Risk factors for developing this type of asthma are the same as mild intermittent asthma.

You will experience asthma symptoms once every day or on most days when you have moderate persistent asthma. You are also likely to experience symptoms at least once a night during each week. Symptoms of moderate persistent asthma include:

• Swollen airways
• Coughing
• Whistling or wheezing sound when breathing
• Chest pain or chest tightness
• Development of mucus in the airways

Treatment For Moderate Persistent Asthma ⁽⁵⁾: Treatment focuses on taking a slightly higher dose of inhaled corticosteroid medication. A rescue inhaler is also prescribed for use at the onset of symptoms. Allergy medications for allergy-induced asthma are recommended. For those above the age of 5, a round of oral corticosteroids may also be recommended.

If you have severe persistent asthma, then you are likely to experience symptoms several times a day. These symptoms are also expected to occur almost every day of the week, and you may experience symptoms during multiple nights every week.

It has been observed that severe persistent asthma does not respond well to medications, even if you are taking them regularly.

The symptoms of this type of asthma include:

• Coughing
• Swollen airways
• Whistling or wheezing sound when breathing
• Chest pain or chest tightness
• Development of mucus in the airways

Treatment For Severe Persistent Asthma: Treatment is going to be more aggressive, and your doctor is also going to experiment with several medication combinations and varying dosages to see which therapy works the best for you. You will have to work together with your doctor to find the best possible combination of medication that allows you to have the most control over your symptoms.

The medications that are generally used for treating severe persistent asthma include:

• Rescue inhaler
• Inhaled corticosteroids (given at a higher dose than what is prescribed for other types of asthma)
• Oral corticosteroids (also given at a higher dose than other asthma types)
• Medications to help fight the trigger or cause

This type of asthma can affect a person of any age group, and it typically starts as another type of asthma and then progresses to becoming severe at a later stage. In some cases, it can begin as severe, though it is more likely that the person probably had a mild case of asthma that was not diagnosed previously.

It is also possible that severe persistent asthma gets triggered by respiratory conditions such as pneumonia. Hormonal changes are also known to bring about an onset of severe persistent asthma.

Severe persistent asthma is the least common type of asthma.

Regardless of the type of asthma you have, it is always recommended that you educate yourself about the disease. This will help you in managing your symptoms. It is necessary that you have an asthma action plan in place. This is developed along with your doctor, and it lists out the steps that you need to follow in case of suffering an asthma attack. Keep in mind that even a mild asthma attack as the possibility of increasing in severity if not treated. This is why it is essential to adhere to the treatment plan given by your doctor and also continue to have regular checkups.

References

1. Centers for Disease Control and Prevention. (2019). Most recent asthma data available from CDC. [online] Available at: https://www.cdc.gov/asthma/most_recent_data.htm [Accessed 30 Oct. 2019].
2. Centers for Disease Control and Prevention. (2019). Asthma in Children. [online] Available at: https://www.cdc.gov/vitalsigns/childhood-asthma/index.html [Accessed 30 Oct. 2019].
3. Vignola, A.M., Chanez, P., Campbell, A.M., Souques, F., Lebel, B., Enander, I. and Bousquet, J., 1998. Airway inflammation in mild intermittent and in persistent asthma. American journal of respiratory and critical care medicine, 157(2), pp.403-409.
4. Pauwels, R.A., Pedersen, S., Busse, W.W., Tan, W.C., Chen, Y.Z., Ohlsson, S.V., Ullman, A., Lamm, C.J., O’Byrne, P.M. and START Investigators Group, 2003. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. The Lancet, 361(9363), pp.1071-1076.
5. O’Byrne, P.M. and Parameswaran, K., 2006. Pharmacological management of mild or moderate persistent asthma. The Lancet, 368(9537), pp.794-803.