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Asthma

What is asthma?

Asthma (also called essential asthma, bronchial asthma, and atopic asthma) is a lung disease involving heightened sensitivity to diverse stimuli and variable airway obstruction that is reversible. It is a controllable ailment, but can be seriously debilitating and even life threatening. There is no cure for asthma. Your comfort and piece of mind depend on how well you learn to live with it.

Asthma attacks can come suddenly or gradually, last for minutes or go on for days. Muscles around the airway (bronchi, bronchioles) contract, the lining of the airway swells due to inflammation, excess mucus is released and clogs the airway. Breathing becomes harder and harder. Asthma attacks are episodes manifesting one of more characteristic symptoms, such as:

• shortness of breath
• wheezing on breathing out
• coughing
• rapid breathing
• tightness in the chest
• itchiness in the chest and throat

Some individuals have "mild" asthma. They may be free of symptoms much of the time, with coughing and wheezing episodes once or twice a week. "Moderate" asthma involves attacks more than twice a week. Some very unfortunate patients have "severe" asthma, with daily bouts of coughing, wheezing, and trouble breathing. Any asthma sufferer exposed to a sufficiently powerful causative factor or combination of asthma "triggers" can experience a severe, even life-threatening, attack requiring emergency intervention.

What causes an asthma attack?

Things that people without asthma may not even notice can cause distressing and dangerous narrowing of the airway of someone with asthma. The list of environmental, behavioral, emotional, or hereditary triggers that can cause asthma attacks is long and varied:

Allergens (substances that cause allergic reactions):

• dust and dust mites
• pollen
• grass
• mold
• tobacco smoke (or smoke from burning wood, leaves, paper, etc.)
• animal dander
• feathers
• cockroaches and related insects
• chemicals and chemical fumes, including perfumes, room deodorizers, paint, adhesives, and cleaning products
• outdoor air pollution (such as ozone and sulfur dioxide)
• NSAIDS (nonsteroidal anti-inflammatory drugs such as aspirin, indomethacin, and ibuprofen)
• sulfites (commonly used as a preservative for processed foods and beverages)
• some cooking odors

Exercise

Getting chilled (especially due to changes in weather involving exposure to very cold air)

Viral infections (colds and flu)

Stress

Crying, laughing, shouting

Acid reflux

Heredity (some people inherit a predisposition to the sensitivities that give rise to asthma)

Remember: not every item on this list triggers an asthma attack in every person with asthma. Each individual has a highly individualized set of triggers that he or she must learn to recognize and avoid.

Who typically suffers from asthma?

Between 10 and 20 million people in North America have asthma and the percentage of people with asthma has been increasing in recent years. It is seen more often in children than adults. Boys are twice as likely as girls to get asthma between 3 and 8 years of age. Adolescents of both sexes are equally affected. It is a principal cause of kids missing school. Many outgrow it; some have it return later in life. Fortunately, children with asthma respond very well to chiropractic treatment.

What can chiropractic do?

Many chiropractors consider their role in caring for patients with asthma, especially those subject to severe attacks, as complementary to the medical management of the disease. They do regular spinal adjustments to make asthma sufferers more comfortable by helping relieve the muscle soreness and discomfort that can develop during asthmatic flare-ups. Chiropractic adjustments may help reduce the frequency and severity of asthma attacks. The achievements of chiropractic in promoting overall wellness, including enhancing the patient's capacity to cope with chronic ailments, make chiropractors an important part of the health care team that can help asthma patients live more normal lives, minimally encumbered by this incurable, but controllable condition.

The principal goal of chiropractic is to reduce asthma sufferers' need to rely on the many medications prescribed to prevent and treat asthma. These medicines (or combinations of medicines) can have many troublesome and even dangerous side effects, including making patients increasingly dependent on ever-larger doses. Preventing asthma attacks is the key to living a normal life in spite of having asthma. In practical, day-to-day, quality-of-life terms, stopping asthma attacks before they start is better than taking medicines to stop the attack and restore pre-attack normality.

Chiropractors have the knowledge to provide a highly supportive program of "clinical ecology" to teach patients how to identify and avoid the particular environmental factors or irritants that cause their asthma attacks. Your chiropractor can help you pinpoint exactly which causes (see the list of causes above) trigger your attacks and how to keep those causes out of your life.

A chiropractor can help you, or your child or other family member with asthma, try to meet the Asthma Treatment Goals set by the U.S. National Institutes of Health:

• To have the longest possible periods free of symptoms
• To sleep through the night without asthma symptoms
• Not to take time off from school or work because of asthma
• To participate fully in physical activities
• Not to have to visit an emergency rooms or stay in a hospital
• To have little or no side effects from asthma medicines
• To live a normal life without having to accept asthma symptoms as normal

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References

• Lines DH. A wholistic approach to the treatment of bronchial asthma in a chiropractic practice. Chiropractic Journal of Australia, Mar. 1993; vol. 23, no. 1, pp4-8.
• Nielsen NH, Bronfort G, Bendix T, et al. Chronic asthma and chiropractic spinal manipulation. Clinical and Experimental Allergy, Jan. 1995; vol.25, no, 1, pp80-88.
• Roberts RA, Sammut J. Asthma: An Alternative Approach, New Canaan, CT: Keats Publishing, 1997.
• Jamison JR, McEwen AP, Thomas SJ. Chiropractic adjustment in the management of visceral conditions: A critical appraisal. Journal of Manipulative and Physiological Therapeutics, Jul.-Aug. 1992; vol. 15, no. 6, pp408-9.
• Blackmam MP. Diagnosis and management of exercise-induced asthma: A review of the literature. Journal of Sports Chiropractic & Rehabilitation, 1997; vol. 11, no. 4, pp143-46.
• U.S. Department of Health and Human Services. Your Asthma Can Be Controlled: Expect Nothing Less, NIH Publication 91-2664, Washington D.C.: Public Health Service-National Institutes of Health, 1991.
• Nilsson N, Christainson B. Prognostic factors in bronchial asthma in chiropractic practice. Journal of Australian Chiropractors' Association, 1988; vol. 18, no. 3, pp85-87.
• Christie GL, Helms PJ, Godden DJ, et al. Asthma, wheezy bronchitis, and atopy across two generations. American Journal of Respiratory and Critical Care Medicine, 1999; vol. 159, pp125-29.
• Hvid C. A comparison of the effect of chiropractic treatment on respiratory function in patients with respiratory distress symptoms and patients without. Bulletin of the European Chiropractic Union, 1978; vol. 26, pp14-34.


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