In order to best help physicians develop asthma treatment programs specific to each individual asthmatic, researchers have grouped asthmatics with similar presentations, and who respond to similar treatments, into asthma subgroups. Listed below are 12 of these subgroups followed by a pithy description.
Now, before you read on, understand that most asthmatics probably fit into more than one subgroup. So, that said, see if you can recognize which ones describe your asthma.
1. Allergic. About 75% of asthmatics have allergies to dust mites, pollen, mold spores, animal dander, and certain foods like nuts, peanuts, fish, shellfish, eggs, wheat and soy. Onset is usually in childhood, although it may develop at any age. Good asthma control begins by identifying and controlling allergies.
2. Gastrointestinal Reflux Disease (GERD). About 75% of asthmatics have asthma symptoms secondary to GERD. This is asthma triggered by the gradual aspiration of stomach contents that work their way back up the esophagus. Onset usually occurs in adulthood. Good asthma control begins by identifying and controlling GERD.
3. Exercise Induced. About 75% of asthmatics have symptoms during and after exercise. Their challenge is to developing an asthma treatment program allowing them to stay physically active.
4. Typical. About 80-95% of asthmatics have symptoms in response to asthma triggers, which may include allergens, strong smells, strong emotions, GERD, cigarette smoke, wood smoke, fumes, etc. Their asthma symptoms may include shortness of breath, wheezing, coughing, and chest tightness. Their asthma responds well to asthma controller medicines, like inhaled corticosteroids.
5. Severe. About 10-15% of asthmatic continue to have asthma symptoms despite being compliant with their asthma treatment regime. They often respond poorly to inhaled corticosteroids. A treatment regime may involve looking beyond traditional asthma controller medicine.
6. Premenopausal. About 40% of women develop asthma in response female hormones during menstruation and pregnancy. Treatment may include asthma controller medicines and, possibly, synthetic hormones.
7. Aspirin Sensitive. About 10% of asthmatics have symptoms when exposed to nonsteroidal anti-inflammatory (NSAID) medicine, such as ibuprofen and Aspirin. Their asthma may be complicated by sinusitis, nasal congestion, and even nasal polyps, meaning all of these need to be diagnosed and treated to obtain ideal asthma control.
8. Cough Variant. About 2-4% of asthmatics have, as their main asthma symptom, a cough that may last up to three months, even though they never smoked. Their asthma triggers may include sinusitis or GERD. Controlling asthma means learning the true cause of that cough and getting proper treatment for it.
9. Obese. You have asthma and a body mass index over 30. Fearing exercise due to uncontrolled asthma may have caused your obesity. However, some evidence suggests that a hormone released from adipose tissue called leptin may cause asthma. In either case, your struggle to control your asthma is compounded by your struggle to control your weight.
10. Rhinitis Induced. Between 30 and 90% of asthmatics suffer from what was once called hay fever. It’s constant bouts of nasal stuffiness, congestion, runny nose, and postnasal drip. This may irritate your airways and trigger asthma symptoms, although the asthma response may cause rhinitis. Either way, your struggle to control your asthma is compounded with your struggle to control your rhinitis.
11. Vitamin D Deficiency. Various studies link asthma and asthma severity with vitamin D deficiency. It may be due to lack of sun exposure (perhaps due to uncontrolled asthma), or a diet lacking foods high in vitamin D (perhaps due to food allergies), such as fish, egg yolk, orange juice, and certain cereals. Controlling your asthma may involve taking a daily vitamin D supplement, changing your diet, or absorbing some rays.
12. Occupational. About 15% of asthmatics develop asthma after long-term exposure to fumes, chemicals, dusts, or other irritants in the air at work. An asthma treatment program must begin by identifying your work as the cause.
13. Psychiatric Induced. Around 40% of asthmatics have anxiety, and 25% have depression. While asthma isn’t a nervous disorder, nervous conditions may trigger asthma. Nervous conditions may also result in poor compliance with asthma treatment program, resulting in poorly controlled asthma. Good asthma control begins by identifying and controlling nervous conditions.
14. Non-Allergi. Onset is usually adulthood, and is usually due to long-term exposure to some irritant, such as frequent respiratory infections, GERD, occupational exposure, and cigarette smoke. Sometimes onset occurs in childhood, and culprits here may be premature birth and respiratory viral infections.
So, where do you fit in? What asthma subgroups define your asthma? Let us know in the comments below.