The good news is that since these treatment changes have been instituted over the past decade, the epidemic has plateaued, and may even have started to decline. The essence of this new approach is recognition of asthma not just as a disease of bronchial spasm, but of inflammation of the mucous membranes lining the bronchial walls. This inflammation results in extremely narrowed air passages, many of which are further obstructed by tenacious plugs of mucus. This has led to increased use of medications with anti-inflammatory properties such as Intal, Tilade, and especially inhaled steroids. Rather than simply treating the symptoms, these medications in a sense treat the cause of asthma.
Experts believe that most deaths from asthma are preventable.
The first strategy is to identify patients at risk. These include patients with a history of hospitalizations or emergency room visits for asthma, those with a history of sudden severe attacks, those without regular medical care for their disease, and those who are non-compliant. Although asthma is not a psychological disease, patients with psychosocial problems such as depression, denial, and family or social conflicts are also at much higher risk and warrant careful evaluation and treatment. The second strategy is to identify and remove the triggers to asthma. It makes little sense, for example, to treat an asthmatic who is allergic to cats with three or four medications if the cat who is causing the asthma continues to sleep in the bedroom.