8 misconceptions about asthma!

What is asthma?

Asthma is an inflammatory disease of the airways, characterized by acute episodes ranging from simple breathing discomfort to exacerbations known as asthma flare-ups or attacks. In a person with asthma, the bronchial mucosa is irritated and thickened, making the bronchial tubes sensitive and prone to overreaction when in contact with triggering factors.

It is a chronic respiratory disease with a multifactorial cause, which may be genetic and/or environmental. Not all people with asthma are sensitive to the same triggers.

These triggers can be :

• Indoor allergens, found at home or at work (dust mites, molds),

• Outdoor allergens (pollen),

• Respiratory infections,

• Respiratory irritants (tobacco smoke, pollution),

• Cold air,

• Physical exercise,

• Certain medications.

Asthma attacks can be recognized by repeated dry coughing, difficulty breathing, shortness of breath, wheezing or tightness in the chest. Asthma attacks lead to multiple hospital admissions each year, as well as emergency room visits and visits to the GP, and result in impaired quality of life, if left untreated.

Asthma has different stages of severity: mild, moderate and severe. There is also intermittent asthma, characterized by infrequent attacks, and persistent asthma, a more severe form with regular attacks that can occur at night (

nocturnal asthma). These stages are determined by the amount of treatment needed to control the disease.

To diagnose the disease, the GP (or the pneumologist) questions the patient in a detailed way and carries out pulmonary function tests (PFT), which allow them to confirm the diagnosis and track the disease progression.

To treat asthma, the patient is first asked to reduce contact with all the substances that trigger the attacks, as much as possible. Desensitization is sometimes recommended to induce tolerance to an identified allergen or irritant.

Disease-modifying treatments are then prescribed in order to ease the symptoms, increase respiratory capacity and prevent the attacks, among other things. These treatments include inhaled corticosteroids and slow-acting bronchodilators.

To treat asthma attacks, patients use fast-acting bronchodilators (Ventolin®).

Asthma cannot be cured, but its symptoms can be alleviated, and with appropriate treatment, monitoring and disease management, its impact on patients' quality of life can be significantly reduced. According to the Inserm data, 95% of asthma cases are well managed, and yet there are many misconceptions about this disease.

What are the most common misconceptions about asthma?

Asthma is a childhood disease: FALSE!

Although the disease mostly affects little boys, girls are more often affected at puberty and women after the onset of menopause. Hormonal changes may alter the clinical expression of asthma. The difference in prevalence between men and women remains unexplained.

You cannot practice sport if you have asthma: FALSE!

Exercise improves respiratory capacity and strengthens the muscles involved in breathing. Sport is therefore indicated in the treatment of asthma. However, it is important to ensure that your asthma is well controlled.

Also, certain types of asthma are triggered by intense physical effort (this is called exercise-induced asthma), in which case it is necessary to take a bronchodilator prescribed before starting the exercise.

I don’t have any more asthma attacks, that means I am cured and can stop taking the treatment: FALSE!

When the attacks cease and your general health improves, it means that your asthma is under control, thanks to the appropriate long-term treatment you have been taking. If you stop taking the medication, symptoms may reappear, as asthma is a chronic condition and persists throughout life.

Treating asthma with cortisone is dangerous: FALSE!

Cortisone has a bad reputation, it is an anti-inflammatory drug that belongs to the corticoid family. There is a confusion between inhaled cortisone (dosed in micrograms) and cortisone in the form of injections or tablets (dosed in milligrams, i.e. 1000 times more). Like all medicines, cortisone has its side effects. Patients are advised to rinse their mouths after inhalation.

Treatment must be discontinued during pregnancy: FALSE!

Medicines used in asthma treatment are safe for the baby. On the contrary, poorly controlled asthma increases the risk of prematurity. Asthma is the most common chronic disease in pregnant women.

My asthma treatment loses its efficiency if I have been taking it for too long: FALSE!

There is no addiction to anti-asthma drugs, their effectiveness remains unchanged. If the patient’s health deteriorates and the attacks become more frequent, it is linked to the worsening of the disease.

To prevent asthma attacks, nothing is better than natural remedies: FALSE!

The origin of asthma is mostly allergic. The use of natural, organic and plant-based products to prevent attacks can cause irritation of the bronchi, as they are often allergenic. Such remedies can include, for example: air purifying plants, home perfumes, scented candles, incense and Armenian paper.

All medications for asthma are similar: FALSE!

Anti-asthma drugs have different functions. There exist:

• Inhaled bronchodilators (Foradil®), short or long acting: they dilate the bronchial tubes and prevent their contraction,

• Inhaled corticosteroids (Flovent® Diskus®, Pulmicort®), which prevent inflammation of the bronchi,

• Oral corticosteroids (Orapred®),

• Anti-leukotrienes (Montelukast® ), which reduce inflammation and obstruction of the bronchi,

• Specific immunotherapy drugs, used in desensitization to a specific allergen,

• Anti-IgE, a drug directed against type E immunoglobulins (Xolair® ), prescribed in certain cases of severe asthma.

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