persistent mild asthma

Persistent Mild Asthma: A Comprehensive Overview

Mild persistent asthma is a classification of asthma that affects individuals who experience symptoms more than twice per week, but not daily. This type of asthma can impact daily activities and may require regular medication to manage symptoms.

Key Characteristics:

• Symptoms occur on more than 2 days a week [6]
• Night-time awakenings 3–4 times/month [5]
• Reliever use ≥2 days/week (but not daily) [5]
• Activity levels may be affected by flare-ups [3]

Impact on Daily Life:

People with mild persistent asthma may experience symptoms that affect their daily activities, such as: * Reduced physical activity due to symptoms [3] * Increased reliance on medication to manage symptoms [7]

Classification and Severity:

Mild persistent asthma is one of four asthma classifications, ranging from intermittent (mildest) to severe. It is essential for individuals with mild persistent asthma to work closely with their healthcare providers to monitor symptoms and adjust treatment plans as needed.

References: [1] Not applicable [2] Not applicable [3] Step 2 – mild persistent asthma [5] Mild persistent asthma is defined as symptoms >2 days/week (but not daily), night-time awakenings 3–4 times/month, reliever use ≥2 days/week (but not daily), [6] Mild persistent asthma. Asthma is considered mild persistent if without treatment any of the following are true: Symptoms occur on more than 2 days a week [7] by N Shahidi · 2010 · Cited by 33 — Patients suffering from mild asthma are divided into intermittent or persistent classes based on frequency of symptoms and reliever medication usage.

Common Signs and Symptoms of Persistent Mild Asthma

Persistent mild asthma can manifest in various ways, affecting individuals differently. Here are some common signs and symptoms to look out for:

• Coughing: A dry, nonproductive cough is often the only symptom experienced by people with persistent mild asthma [5].
• Difficulty Breathing: Shortness of breath, rapid breathing, and a tight feeling in the chest can occur due to airway constriction [3][8].
• Nighttime Symptoms: People with mild persistent asthma may experience nighttime symptoms more than two times in a month, disrupting sleep patterns [1].
• Regular Symptoms: Mild persistent asthma is characterized by regular symptoms that occur more than twice a week but less than once a day [6].
• Flare-ups: Flare-ups can affect activity and may be triggered by various factors such as exercise, exposure to cold air, or upper respiratory infections [6][7].

Other Possible Symptoms

In addition to the above-mentioned symptoms, people with persistent mild asthma may also experience:

• Rapid breathing
• Sighing
• Fatigue
• Inability to exercise properly (exercise-induced asthma)
• Difficulty sleeping or nighttime asthma

It's essential to note that these symptoms can vary in severity and frequency from person to person. If you're experiencing any of these symptoms, it's crucial to consult a healthcare provider for proper diagnosis and treatment.

References: [1] Jan 28, 2019 [3] Asthma is a chronic inflammatory disease of the airways. [5] Your only symptom may be a dry, nonproductive cough; you may also experience difficulty breathing, shortness of breath, a tight feeling in the chest, or ... [6] Jun 2, 2021 — In mild persistent asthma, symptoms occur more than twice a week but less than once a day, and flare-ups may affect activity. Nighttime flare- ... [7] It can occur during various seasons of the year, with exercise and exposure to cold air, or with upper respiratory infections. [8] Aug 14, 2022 — rapid breathing; sighing; fatigue; inability to exercise properly (called exercise-induced asthma); difficulty sleeping or nighttime asthma

Diagnosing Mild Persistent Asthma

Mild persistent asthma can be diagnosed through various tests and evaluations. Here are some common diagnostic tests used to confirm the condition:

• Lung Function Tests: These tests measure how well your lungs inhale and exhale air, confirming asthma diagnosis. Spirometry is a type of lung function test that measures airflow through your lungs [6][9].
• Methacholine Challenge Test: This test involves inhaling methacholine, an asthma trigger, to see if your airways narrow slightly. A positive reaction indicates likely asthma [1].
• Peak Flow Meter Tests: These tests measure how well you can breathe out air quickly, helping assess lung function and diagnose asthma [12][13].
• Allergy Tests: While not used to diagnose asthma directly, allergy tests can help identify allergic conditions that may be causing symptoms or worsening existing asthma [5].

Interpreting Test Results

For mild persistent asthma, lung function is typically over 80% of predicted normal during FEV1 breathing testing. This means your lungs have the ability to forcefully breathe out over 80% of what's expected for someone without asthma [10].

Confirming Diagnosis

A diagnosis of mild persistent asthma is confirmed through a combination of medical history, physical examination, and test results. Your healthcare provider may also consider other factors, such as symptoms frequency and severity, to make an accurate diagnosis.

References:

[1] Additional tests to diagnose asthma include: Methacholine challenge. [5] Allergy tests can find which allergens cause a reaction in your body when you are around them. [6] Lung function tests measure your breathing to diagnose asthma. [9] Your provider may order spirometry. This test measures airflow through your lungs and is used to diagnose and monitor your progress with treatment. [10] People with mild persistent asthma have lung function of over 80 percent of predicted normal during FEV1 breathing testing. [12] Tests to measure how well your lungs are working may include: Peak flow meter. [13] adults with asthma. Onset can be at any age.

Treatment Options for Mild Persistent Asthma

Mild persistent asthma can be effectively managed through various drug treatments, which aim to reduce inflammation and control symptoms.

• Inhaled Corticosteroids (ICS): ICSs are the primary therapeutic option for mild persistent asthma. They work by reducing inflammation in the airways, thereby preventing a flare-up. Examples of ICSs include fluticasone, budesonide, mometasone, beclomethasone, and ciclesonide [1][2].
• Bronchodilators: These medications help relax the muscles around the airways, making it easier to breathe. However, they are not recommended as a long-term solution for mild persistent asthma but can be used as needed for quick relief [3].
• Leukotriene Receptor Antagonists (LTRAs): LTRAs are alternative therapy options for mild persistent asthma and can also be used as adjunctive therapy. They work by blocking the action of leukotrienes, which contribute to inflammation in the airways [4][5].

Additional Treatment Options

• Single Maintenance and Reliever Therapy (SMART): This approach is preferred for mild to moderate persistent asthma, reducing the potential adverse effects of long-term medication use.
• Long-acting Beta-agonists: These medications are not recommended as a first-line treatment for mild persistent asthma but can be used in combination with ICSs or LTRAs.

References

[1] Shahidi N. (2010) - ICSs are the primary therapeutic option for mild persistent asthma. [2] Lommatzsch M. (2020) - Pharmacohterapy is based on inhaled corticosteroids and bronchodilators. [3] Elward KS. (2021) - For mild to moderate persistent asthma, single maintenance and reliever therapy is preferred. [4] Elward KS. (2021) - LTRAs are alternative, but not preferred, therapy for the treatment of mild persistent asthma. [5] Shahidi N. (2010) - ICSs can reduce inflammation and help manage or prevent a flare-up.

Understanding Differential Diagnosis in Asthma

A differential diagnosis is a process used to rule out other possible causes of a condition, in this case, persistent mild asthma. This involves considering various conditions that may present with similar symptoms.

Conditions to Consider

When diagnosing persistent mild asthma, the following conditions should be considered:

• Chronic Obstructive Pulmonary Disease (COPD): A progressive lung disease characterized by airflow limitation, which can cause similar symptoms to asthma.
• Allergic or Non-Allergic Rhinitis: Conditions that affect the nasal passages and sinuses, which may present with respiratory symptoms similar to asthma.
• Gastro-Oesophageal Reflux Disease (GERD): A condition where stomach acid flows back into the esophagus, causing symptoms such as coughing and shortness of breath.
• Postnasal Drip: A condition characterized by excessive mucus production in the nasal passages, which can cause respiratory symptoms similar to asthma.

Key Symptoms to Consider

When differentiating between these conditions and persistent mild asthma, the following key symptoms should be considered:

• Coughing: While coughing is a common symptom of asthma, it is often absent or minimal in cases of COPD.
• Shortness of Breath: This symptom can be present in both asthma and COPD, but its severity and duration may differ between the two conditions.
• Sputum Production: The presence and quantity of sputum produced can help differentiate between asthma and COPD.

Diagnostic Considerations

To accurately diagnose persistent mild asthma, it is essential to consider these differential diagnoses and perform a thorough medical history, physical examination, and pulmonary function tests. This will help rule out other conditions that may present with similar symptoms.

References:

• [3] by N Ullmann · 2018 · Cited by 78 — Lower and upper recurrent respiratory symptoms with no obvious other cause, such as prematurity should suggest to rule out this diagnosis (30).
• [7] by J Kavanagh · 2019 · Cited by 127 — Box 1 Differential diagnosis of asthma. Chronic obstructive pulmonary disease (COPD). Allergic or non-allergic rhinitis. Gastro-oesophageal reflux disease. Post ...
• [13] Asthma is a prevalent chronic inflammatory respiratory condition affecting millions of people worldwide and presents substantial challenges in both diagnosis and management. This respiratory condition is characterized by inflammation of the airways, causing intermittent airflow obstruction and bronchial hyperresponsiveness. The hallmark asthma symptoms include coughing, wheezing, and shortness ...