Asthma
Reviewed by: [Satya Narisety, MD – Board-Certified Allergist/Immunologist]
Affiliation: The Medical Group of New Jersey
Asthma is a chronic inflammatory disease of the airways that causes coughing, wheezing, and shortness of breath. Triggers include allergens, infections, exercise, and weather changes.
Our team works with patients to provide guideline-based care and a plan to address flare-ups quickly. With this, most patients achieve full control and prevent flare-ups.
Symptom Onset & Initial Evaluation
Symptoms may be intermittent or persistent and can worsen at night or during exercise. Common features include:
- Wheezing or chest tightness
- A cough that lingers after colds
- Shortness of breath during activity or allergy exposure
- Fatigue from disturbed sleep
Your allergist will review your triggers, medication use, and past hospital or ER visits, and perform a focused lung exam.
Diagnosis
Asthma is diagnosed using a combination of clinical evaluation and specialized testing to confirm airway inflammation and identify underlying triggers. Allergists typically use the following assessments:
- Spirometry with bronchodilator response: Measures lung function and confirms reversible airflow obstruction, a key feature of asthma.
- Fractional exhaled nitric oxide (FeNO) testing: Detects airway inflammation, helping to guide and monitor treatment response.
- Allergy testing: Identifies specific allergic triggers—such as pollen, dust mites, or pet dander, that may worsen asthma symptoms.
- Phenotyping: Classifies asthma into subtypes, such as allergic, eosinophilic, or exercise-induced, to help tailor therapy to your specific condition.
Treatment & Ongoing Management
Asthma management focuses on controlling inflammation, preventing flare-ups, and improving medication delivery. Your allergist at The Medical Group of New Jersey will tailor treatment based on your symptoms, triggers, and lung function results.
Rescue therapy:
- Quick-relief inhalers (e.g., albuterol) provide fast symptom relief during wheezing, coughing, or shortness of breath.
- Using a spacer device with your inhaler helps ensure the medicine reaches deep into the lungs, improving effectiveness and reducing side effects.
Controller therapy:
- Inhaled corticosteroids (ICS): The cornerstone of long-term asthma control, reducing airway inflammation and preventing flare-ups.
- Combination inhalers (ICS-LABA): Used as both daily maintenance and as-needed rescue therapy in select patients.
- Add-on medications: Long-acting muscarinic antagonists (LAMA) or leukotriene modifiers may be prescribed if symptoms persist.
Biologic therapies:
- Injectable medications that target specific immune pathways for patients with moderate to severe asthma, such as anti-IgE, anti-IL-5, or anti-IL-4R treatments.
Asthma Action Plan:
- A personalized, written plan outlining daily medication use, symptom zones (green, yellow, red), and emergency steps, empowering patients to recognize and respond quickly to worsening symptoms.
Monitoring & Follow-Up
Patients are typically re-evaluated every 3 to 6 months. Follow-up includes checking lung function, inhaler technique, and medication adjustments. Managing environmental triggers and comorbidities like allergies or acid reflux is key to long-term success.