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Dr. Andrew Labelle, St. Luke's Hospital

Among adults, asthma is more common in women

Asthma is a common lung disease affecting more than 22 million people in the United States.

It can develop at any age. Men are more likely to develop asthma as a child, but in adults, asthma is more common in women. Asthma typically occurs in people with allergies, but some patients do not have a history of allergies.

The exact cause of asthma is not known, but the airways of people with asthma become swollen and inflamed. The airway inflammation causes a reaction to substances that are inhaled. These substances can be allergens or other inhaled irritants such as smoke. The reaction in the airways leads to contraction of the muscles in the airways, mucous production and more inflammation.

The typical symptoms of asthma are wheezing, coughing, shortness of breath and chest tightness. The symptoms are typically intermittent and are worse with infections, cold air, exercise and airway irritants. Sometimes, the symptoms do not go away and can lead to an asthma attack, or exacerbation. An asthma attack is the most serious consequence of asthma and can lead to emergency room visits, hospitalizations or even death.

Asthma can be affected by pregnancy. In a study of 330 pregnant women, asthma worsened in 35 percent of the women. It improved in 28 percent and did not change in 33 percent of the women. In patients whose symptoms worsened, the majority of the problems occurred in the third trimester between weeks 29 and 36. In addition, between 20 percent and 36 percent of pregnant asthma patients will experience an attack during their pregnancy. However, women whose asthma is controlled prior to pregnancy generally have fewer complications than those whose asthma is not controlled.

Asthma is a difficult disease to diagnose, and lung function tests are frequently required. The goal of treatment involves minimizing both symptoms and asthma attacks. Treatment involves long-acting inhaled medication such as inhaled corticosteroids, which are frequently given in combination with long-acting airway muscle relaxants. Short-acting airway muscle relaxants are given for breakthrough symptoms. In patients with asthma and allergies, allergy control is also important. Clinical trials are available, and they help to identify new treatment options for people with asthma.

Dr. Andrew Labelle is a pulmonologist at St. Luke's Hospital. To learn more about asthma or to participate in a free asthma study, call 314-439-5864 or visit the CardioPulmonary Research Center page.

This article was published in the St. Louis Post-Dispatch on May 30, 2013.

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