Classifying Asthma

Over the years, there have been several ways of classifying asthma and of distinguishing one form of the disease from another. Traditionally, doctors have divided asthma into two general categories, Extrinsic (allergic) asthma and Intrinsic (non-allergic) asthma, depending upon the types of stimuli that trigger attacks. As well as these classifications, asthma is further split up into categories.

Asthma Classification
Based on the results of your visit with an asthma specialist, your asthma will be classified in one of the following categories (based on National Heart Blood and Lung Institute guidelines):

Symptoms/Day < 1 time a week Symptoms of cough, wheeze, chest tightness or difficulty breathing less than twice a week > 1 time a week but < 1 time a day Symptoms of cough, wheeze, chest tightness or difficulty breathing three to six times a week Daily Symptoms of cough, wheeze, chest tightness or difficulty breathing daily Continuous Symptoms of cough, wheeze, chest tightness or difficulty breathing continual

Symptoms/Night </= 2 times a month

PEF or FEV1 >/= 80%

PEF variability < 20%

Intermittent

> 2 times a month

>/= 80%

20-30%

Mild Persistent

> 1 time a week

60%-80%

> 30%

Moderate Persistent

Frequently

</= 60%

> 30%

Severe Persistent

Further Classification of Asthma

Extrinsic Asthma An "allergen" or an "antigen" is a foreign particle which enters the body. Our immune system over-reacts to these often harmless items, forming "antibodies" which are normally used to attack viruses or bacteria. Mast cells release these antibodies as well as other chemicals to defend the body. Extrinsic asthma is caused by this type of immune system response to inhaled allergens such as pollen, animal dander or dust mite particles. People with allergic asthma and their families frequently have other allergy-related problems such as hay fever, rhinitis, skin rashes, hives, and eczema and so on. Allergic asthma usually responds quite well to the use of inhaled steroids as these suppress the immune system, particularly in the lungs where the reaction is creating havoc. Intrinsic Asthma Intrinsic asthma is not allergy-related; in fact it is caused by anything except an allergy. It may be caused by inhalation of chemicals such as cigarette smoke or cleaning agents, taking aspirin, a chest infection, stress, laughter, exercise, cold air, food preservatives or a myriad of other factors. Antibodies are not produced and even when skin tested to various antigens shows a reaction, these substances do not lead to an asthma attack. The cause may be an irritation to the nerves or muscles in the airways. Asthmatics' airways are unusually sensitive or "hyper-reactive" and the asthma presents itself in the usual manner of constricted smooth muscle, airway inflammation and increased mucus production. Treatment of intrinsic asthma is not easy as it may not be known what triggers the asthma in the first place and therefore avoiding triggers can be impossible. Avoidance of things with strong odours such as perfume or cleaning agents may be possible at home. Not going to smoky bars or discos, avoiding air which is hot/cold/humid/dry - depending on your particular trigger and keeping calm can only be maintained up to a point.

Mixed Asthma As its name suggests, mixed asthma is a mixture of intrinsic and extrinsic asthma. These people react to some allergies but their asthma is also triggered by other things. As well as intrinsic, extrinsic and mixed, asthma has been further categorised into other types such as Nocturnal and Exercise Induced. Nocturnal Asthma Nocturnal asthma classifies asthma which suddenly worsens in the middle of the night, typically between 2 and 4am. With nocturnal asthma, asthmatics often fall asleep quickly because they are physically exhausted only to wake some three to four hours later with breathing difficulties. They cough and wheeze, take reliever medication, a visit to the bathroom or a drink of water and try to go back to sleep. This is difficult and when the person finally sinks into a deep sleep he is woken a short time later by the alarm. This type of asthmatic frequently feels totally exhausted during the day and needs catnaps to keep functioning at an adequate level. Nocturnal asthma should be taken seriously as there is a high frequency of respiratory arrest and death due to asthma in the early hours of the morning. Bronchial Asthma Bronchial asthma is usually an allergic reaction with breathing difficulties and wheezing. The smooth muscles wrapped around the airways spasm causing them to narrow and mucus is usually produced because the airways become irritated. Most attacks are caused by hypersensitivity to air-borne particles or allergies to foods. Exercise Induced Asthma Exercise Induced Asthma is noticed during or shortly after exercise. The person feels wheezy and short of breath. Exercising in the winter seems to be particularly bad for this type of asthma.

Occupational Asthma When a person develops asthma symptoms in response to an exposure to dust, fumes, gases or other irritants in the workplace, the condition is called occupational asthma. Industrial or Occupational asthma develops anywhere from a few months to years after starting a new job. Symptoms usually improve while on holiday or after leaving the position. Some common causes of Industrial asthma are: sawdust, chemical fumes, constant dusty conditions, close contact with animals, glue fumes, fluff off fruit, leaves etc.

Seasonal Asthma Seasonal asthma can be triggered by trees, grasses or flowers releasing pollen to the atmosphere or by a particular climate. For example, some people find the summer heat makes their asthma worse, while others find spring is particularly bad with the increase in flowering plants. Silent Asthma Asthma attacks which give very little or no prior warning and very little wheezing. They are usually severe and can be life-threatening. Cough Variant Asthma Asthma is displayed by a persistent and irritating cough.

Conclusion
When someone gets the symptom of asthma, he or she should go to nearest hospital or clinic to do some medical test and get doctor consolation to determine whether the disease is asthma or other disease. The patient should not simply take some medication because the dose and medicine is differing according to the severity or type of asthma. These classifications can be useful for you in understanding your disease and suggesting a path for treatment. The level of asthma severity will determine what types of medicine you will need to get your asthma under control.