What Are the Three Types of Asthma?

Asthma is a chronic medical condition that causes breathing difficulties.

Asthma is a long-term medical condition that causes breathing difficulties due to airway narrowing, airway swelling, and excessive mucus production in the airway. 

An asthma attack is a reversible condition, but it may be severe. During an asthma attack, the muscles around the airways may tighten, and it becomes difficult for air to move into and out of the lungs. 

An asthma attack occurs when the symptoms become severe. Attacks can begin suddenly and range from mild to life threatening. Symptoms of asthma include:

• Chest tightness
• Wheezing
• Breathlessness
• Coughing
• Weakness
• Dizziness

The three common types of asthma are as follows:

• Nocturnal asthma: This is the most common type of asthma. Usually, the symptoms are more prominent at night. The patient may wake up coughing, wheezing, or with chest pains. Studies show that most deaths related to asthma occur at night. This may be because of increased exposure to allergens (asthma triggers), cooling of the airways, reclining position, or even hormone cycles at night. Sometimes, normal heartburn can trigger asthma symptoms at night. Doctors may recommend diet changes, eye drops, nasal decongestants, and saline nasal rinse regularly to wash out allergens.
• Exercise-induced asthma or exercise-induced bronchoconstriction: Physical exertion of patients during an exercise can trigger asthma in some cases. Coughing and wheezing are the most common symptoms of exercise-induced asthma. With exercise-induced asthma, airway narrowing is maximal at 5-20 minutes after the exercise begins, making it difficult to catch breath. The symptoms begin within a few minutes of exercise and peak or worsen a few minutes after stopping the exercise. Usually, an asthma inhaler (bronchodilator) is recommended by a doctor in this type of asthma. 
• Allergic asthma/seasonal asthma: Inhaling allergens is the most common trigger for inducing allergic asthma. Allergens may include dust mites, pet dander, pollen, or mold. Sometimes, allergic asthma may be due to patients’ occupation (paint, metal, or gas); hence, patients may require knowing the exact trigger and consult an allergist or immunologist. A few drugs (such as aspirin) may also cause asthma. Few patients may develop asthma only during the winter or cold season because cold may trigger asthma attacks. Anyone who has an allergy due to allergens, season, or occupation may require immunologist or allergist intervention. A preventive inhaler and reliever inhaler are recommended by the doctor for this type of asthma.

Other types of asthma include the following:

• Occupational asthma: This is common in carpenters, hairdressers, animal breeders, and farmers who are exposed to allergens at their workplace. Medication and counseling may be needed.
• Cough variant asthma: Severe coughing is the main feature of this asthma rather than wheezes. It may be triggered by infections or exercises.

Long-term control and prevention are key methods to stop asthma attacks before they start. Treatment usually involves recognizing and avoiding the triggers as much as possible. 

There is currently no cure for asthma, but treatment can help control the symptoms, so patients may be able to live a normal, active life. The following are treatments commonly used for asthma.

• Inhalers: This may relieve symptoms when they occur (reliever inhalers) and stop symptoms developing (preventer inhalers). Some people need an inhaler that does both (combination inhalers). The inhalers are generally beta-agonists such as salbutamol, salmeterol or a combination of beta-agonist and steroid.
• Tablets: Patients may also need to take tablets if using an inhaler alone is not helping control their symptoms.
  • Leukotriene receptor antagonists (LTRAs): LTRAs are the main tablets used for asthma. They also come in the syrup and powder form.
  • Theophylline: Theophylline may also be recommended if other treatments are not helping to control the symptoms.
  • Steroid tablets: Steroid tablets may be recommended if patients are unable to take any of the above medications to control the symptoms. They may be given as an immediate treatment or every day or as a long-term treatment to prevent the symptoms.
• Injections: For some people with severe asthma, an injection such as Fasenra (benralizumab), is given every few weeks to control the symptoms. These medicines are not suitable for everyone with asthma and can only be prescribed by an asthma specialist.
• Surgery: A procedure called bronchial thermoplasty may be offered as a treatment for severe asthma. It works well, and there are no serious concerns about its safety. Patients may be sedated by general anesthesia during a bronchial thermoplasty. The procedure involves passing a thin, flexible tube down the throat and into the lungs. Heat is then used on the muscles around the airways to help stop them narrowing and causing asthma symptoms.
• Breathing exercises: Some evidence suggests that breathing exercises can improve symptoms and reduce the need for reliever medicines in some people, but they should be used in addition to the prescribed medicine.