The Language of Asthma can be confusing, as you might know, if you ever look up medical definitions on the internet. They vary, sometimes ever so slightly, depending on the source. Because we thought it would be helpful to you, we have set ourselves the task of compiling an allergy glossary. In this glossary, we are trying to define and describe all the terms you might come across if you suffer with asthma or another allergic disease. The first instalment consists of 'the language of asthma' i.e. the ten most important asthma terms. Do you agree with our definitions? Are there other words you would like to add? Let us know!
Asthma. Three features affecting the bronchial tubes (airways) that distinguish asthma from other chronic lung conditions: narrowing (bronchospasm), inflammation with mucous production, and twitchiness (hyperresponsivity). Exposure to a trigger (allergen or irritant) causes the symptoms of an asthma attack which include wheezing, coughing and chest tightness.
Extrinsic asthma. Sometimes used interchangeably with 'allergic asthma', extrinsic asthma tends to affect younger patients and is usually triggered by a clear external allergen like house dust mite, animal dander, mould or certain foods. Often, the patient with extrinsic asthma will have a family history of asthma or another allergic disease. The term extrinsic asthma is not often used these days
Intrinsic asthma. Less common than extrinsic asthma, intrinsic asthma can affect patients of any age, but particularly those over the age of 30. Intrinsic asthma is not a true allergic disease. It is triggered by factors such as chest infection, such as bronchitis or pneumonia. There is a wide range of other triggers for intrinsic asthma, including exercise, stress, cold air, cigarette smoke, aspirin and other factors which are not classical allergens. Someone with extrinsic asthma will also often find their condition is worsened by these irritant factors. Again, the term intrinsic asthma is not often used these days (doctors will tend, instead, to refer to exercise-induced asthma and so on, referring to the trigger factor). But maybe it is still useful to be aware of the distinction if it helps people be aware that asthma is a complex disease.
Allergic asthma. Also known as atopic or extrinsic asthma, allergic asthma accounts for most asthma cases. It is caused by exposure of the lungs to an inhaled, airborne allergen like house dust mite or mould. The allergen causes the immune system to produce IgE antibodies, which bind to immune cells called mast cells in the lungs. The mast cells then release histamine, which makes the muscles of the bronchial tubes in the lungs contract (known as bronchospasm), narrowing the airways and making breathing difficult. Allergic asthma is the most common type of asthma, affecting 90% of children with asthma and around half of the adults.
Preventable asthma. Asthma is not usually thought of as a preventable disease in that there is no vaccine that can protect against it. Nor are there specific lifestyle changes, like a healthy diet, which are often used to prevent heart disease or diabetes. If you have a tendency to allergy and become sensitised, then no intervention that we know of can stop the allergy from taking hold. However, the latest research on air pollution suggests that at least some cases of asthma are preventable. Air pollution is considered an asthma cause in some genetically susceptible people. If these individuals live in a place with clean air, then they should not develop asthma. In other words, cleaning up air pollution could help prevent asthma.
Occupational asthma. Asthma that develops through exposure to allergens in the workplace is known as occupational asthma. Latex rubber, flour particles, detergent enzymes, paper dust, soya, wood dust and hairdressing products are just a few of the many workplace materials that can cause occupational asthma. To date, around 250 workplace allergens have been identified. Occupational asthma may be an exacerbation of pre-existing asthma or new onset of the disease.
Brittle asthma. Hospitalisation is not uncommon in brittle asthma, a rare and severe form of the disease. Patients with type 1 brittle asthma have symptoms on a daily basis and are also subject to unpredictable, severe asthma attacks which may require hospital treatment. Type 2 brittle asthma is easier to control but sudden severe attacks (as in type 1) will still occur. The usual asthma medications work for brittle asthma, but they are needed in much higher doses to be effective.
Bronchial asthma. Just another name for asthma.
Laryngeal asthma. Also known as vocal cord dysfunctional syndrome, laryngeal asthma is not asthma at all. The wheezing in this disease comes from the voice box, because of an abnormality of the vocal cords, and not from the lungs, as in asthma. Laryngeal asthma will not respond to asthma drugs; it should be treated by voice therapy instead.
The asthma march. Sometimes also known as the allergic march, the term asthma march refers to a child's tendency to develop one allergy after another, as their immune system develops and matures. For instance, the child that has eczema as a baby may grow out of it, only to develop a constant runny nose (maybe rhinitis) and then asthma.