In this article, I will describe the pathology of asthma and how it is generally treated by conventional medicine. Then I will discuss the shortcomings of this conventional approach by outlining how a complementary physician might approach the asthma patient. In doing so, I will emphasize how to prevent asthma attacks by working on one's environment, lifestyle and nutritional supplements.

Asthma is a disease that affects a person's ability to breathe. It is a chronic lung disease characterized by airway obstruction that is reversible (but not always completely so), airway inflammation, which results from edema or swelling in the lining of the bronchial tubes, and increased airway responsiveness to a variety of stimuli. The symptoms of an asthma attack include wheezing, shortness of breath and coughing. Breathing out is particularly difficult during an asthmatic attack and wheezing during expiration is particularly characteristic. Asthma may be periodic with relatively symptom free intervals or it may be relatively chronic with mild to moderate symptoms present most of the time. Either type of patient may have a severe acute life-threatening attack, which may require potent drugs in a hospital setting.

Asthma attacks may be triggered by a variety of stimuli, the nature of which varies from individual to individual. Upper respiratory infections, either viral or bacterial, often trigger an asthmatic attack. Exposures to tobacco smoke, perfumes, paints or other strong chemical odors are often culprits. Changes in weather or temperature, exposure to molds, animal danders, grass or tree pollens are all triggers for some asthmatic patients. For some patients, exposure to sulfites, used to preserve foods, has resulted in deaths due to asthma. Certain food colorings, such as the yellow dye tartrazine, as well as many other food additives may be triggers. Drugs, such as aspirin, non-steroidal anti-inflammatory drugs-like Advil, beta blockers-like Inderal, ACE inhibitors and many others can precipitate an asthma attack.

Diagnosis of Asthma
Aside from the clinical observations of shortness of breath, coughing and wheezing, how can asthma be diagnosed? In addition, to hearing the wheeze with a stethoscope, one can use two medical instruments to help with the diagnosis and response to treatment. The first is called a spirometer. Spirometry involves the patient taking a deep breath and blowing into the tube of the spirometer as hard and as fast as he can. The patient may also breathe in and out several times into the tube for additional information. The spirometer measures the amount of air expired and how much is expired at different phases of the expiration. With asthma, we'll see a reduced total amount of air expired or forced vital capacity. We'll also see a reduced volume expired during the first half second and second or forced expiratory volume 0.5 and 1.0. Finally, we'll observe a reduced volume during the middle cycle of the expiration. Each one of these measurements can be improved after the person breathes a bronchodilator drug, thus showing that these changes are at least partially reversible. This reversibility leads one to the diagnosis of asthma rather than a more fixed irreversible lung disease. Another instrument useful in monitoring the severity and response to treatment in asthma patients is a peak flowmeter. Again, the person expires a deep breath as quickly and completely as possible and the peak flow is measured. This instrument is important for monitoring treatment response.