Allergist Dr. Luiz Manoel Werber de Souza Bandeira explains the warnings of poorly controlled asthma and what to do to avoid attacks and regain quality of life
Asthma is a hereditary disease. The patient often has allergic relatives or presents other associated conditions, such as allergic rhinitis, atopic dermatitis and food allergies. It is no coincidence that the first signs usually appear in childhood, often with chronic coughing when playing, wheezing or during viral infections, such as common colds.
In these cases, it is essential that parents take the child to the doctor as soon as they notice these symptoms. The earlier the diagnosis, the better the response to treatment and the lower the chances of complications throughout life.
How to know if your asthma is under control
Well-controlled asthma is one in which the patient does not experience shortness of breath or presents it very rarely, at most once a month. This indicates that the body is responding well to the therapy in use, which generally combines an inhaled corticosteroid with a bronchodilator.
When attacks are frequent, appear at night, limit daily activities or require repeated use of a relief pump, the sign is clear: asthma is not controlled and it is necessary to seek medical evaluation.
The analysis considers symptoms in the last four weeks:
Controlled asthma: none or up to two days a week with symptoms
Partially controlled: more than two days a week with symptoms
Not controlled: three or more partial control features present
Other warning signs include waking up at night with coughing or shortness of breath, frequent need for relief medication, absence from work or school and impact on quality of life.
Incorrect use of the pump compromises the treatment
One of the main challenges in controlling asthma is the proper use of inhaler devices. Many patients only use the relief medication and stop the inhaled corticosteroid when symptoms improve, which increases the risk of attacks.
Inhaled corticosteroids must be continued daily, even in the absence of symptoms, as they are responsible for controlling airway inflammation.
Errors in technique are also common, such as not shaking the device before use, not exhaling completely before inhaling, inhaling too quickly or not cleaning the device. These factors reduce the effectiveness of the treatment.
When asthma can be considered serious
The persistence of symptoms even with adequate treatment may indicate severe asthma. In these cases, medical reassessment and investigation of associated factors are necessary, such as gastroesophageal reflux, nasal polyposis or sensitivity to medications.
It is also essential to identify the triggers of crises. Among the most common are dust mites, dust, mold, pollution and animal hair. These factors can be identified by allergy testing.
Controlling the environment helps prevent crises
Simple measures in the home environment help reduce exposure to triggering agents:
- Clean with a damp cloth, avoiding raising dust
- Frequent vacuuming of mattresses and upholstery
- Controlling air temperature and humidity
- Reducing items that accumulate dust
- Avoid fur animals indoors
These actions, associated with the correct use of medication, help to reduce the frequency of attacks.
Treatment goes beyond immediate relief
The aim of treatment is not just to alleviate symptoms, but to control inflammation and improve the body’s response. In this context, allergic immunotherapy has emerged as an effective alternative, especially in moderate to severe cases.
With proper diagnosis, adherence to treatment and continuous monitoring, it is possible to keep asthma under control and preserve quality of life. Ignoring signs or treating only crises can compromise the progression of the disease.
By Dr. Luiz Manoel Werber de Souza Bandeira – Allergist and Immunologist | CRM 52-29459-0/RJ | EQR 44511
