Suspect Asthma if Shortness of Breath Occurs at Dawn Even if Checkup Results are Normal

If you experience recurring symptoms such as shortness of breath every dawn or rapid breathing during exercise despite normal health checkup results, it is necessary to suspect asthma. This is because asthma is a disease where symptoms do not always appear consistently.

According to a Seoul National University Hospital TV video, asthma is characterized by repeated changes where symptoms such as shortness of breath or wheezing appear as the bronchi narrow and then improve again. Due to this, even if symptoms are severe at night or dawn, cases may occur where they appear normal when visiting a hospital for testing during the day.

Suspect Asthma Even if a Cough Persists for Only 2 Months

The four representative symptoms of asthma are dyspnea (difficulty breathing), wheezing, coughing, and chest tightness. These symptoms do not necessarily have to appear simultaneously; even if only one or two appear, if they repeatedly come and go, the possibility of asthma should be considered.

In particular, the most common symptom in daily life is coughing. If a cough persists for more than two months even after a cold has fully recovered, asthma can be strongly suspected. Additionally, since asthma is an allergic disease, it is often accompanied by allergic rhinitis, chronic urticaria, and atopic dermatitis, and these diseases tend to have a family history.

The most basic method to diagnose asthma is a pulmonary function test. Through the process of inhaling as deeply as possible and then exhaling strongly and quickly, the changes in the internal diameter of the bronchi are objectively measured. Asthma patients are characterized by a large range of changes in the internal diameter of the bronchi, which shrinks and expands compared to normal individuals. Depending on the situation, additional tests may be conducted to check how pulmonary function changes after inhaling medication that widens or narrows the bronchi.

Why Inhaler Treatment is Prioritized Over Pills

The core of asthma treatment is controlling chronic inflammation in the bronchi. Since asthma inflammation does not heal completely with a single treatment but persists chronically, consistent medication use is essential. In this regard, steroids are the most effective drugs for controlling inflammation.

While many people worry about the side effects of steroids, they are mainly used in the form of an 'inhaler' in asthma treatment. Because the medication enters the airways directly, it is not absorbed systemically, allowing one to avoid the scary systemic side effects concerned with oral medication (pills). Furthermore, since it acts directly on the lesion, the effect is fast and the duration of action is good. However, caution is required as fungal infections can occur in the mouth if the mouth is not rinsed with water after inhalation, and side effects such as hoarseness may appear due to action on the vocal cords.

It is dangerous for patients to stop using inhalers on their own just because symptoms have improved. While medication can be reduced if symptoms improve, this must proceed slowly after consulting with a specialist following a sufficient treatment period of more than 1 to 2 years. If medication is stopped arbitrarily, inflammation can rise again, worsening the asthma.

Exercise is Recommended, but Emergency Situations Must Be Distinguished

Regarding whether asthma patients should avoid exercise, the video explains that if asthma is well-controlled, regular physical activity is actually recommended. Symptoms of shortness of breath during exercise can be sufficiently overcome by using an inhaler before exercising after consulting with a doctor.

On the other hand, there are warning signs that require an immediate visit to the emergency room. Especially for patients who find it difficult to describe symptoms accurately, such as children or the elderly, the condition can be assessed through their ability to converse. If the state is so severe that they cannot finish a sentence due to shortness of breath and can barely speak in single words, it is a very serious worsening situation, and they must visit a medical institution quickly.

Currently, in medicine, asthma aims for 'remission,' a state where symptoms are almost non-existent, rather than the concept of a 'complete cure.' About half of the patients whose symptoms were not severe at the time of initial diagnosis reach a state of remission with almost no symptoms if they undergo steady treatment for more than 2 to 3 years. The ultimate goal of asthma treatment is to maintain a state without limitations in daily life through treatment.