What causes asthma exacerbations?

Regular use of inhaled corticosteroids is the best way to prevent asthma exacerbations.

Asthma exacerbations are acute worsening of asthma control. The are unpredictable and affect the day to day functioning of an individual. The acute exacerbations can be mild, moderate or severe. A moderate exacerbation is an event that leads to an increase in the exisiting asthma therapy not including systemic steroids. A severe exacerbation is one which usually requires hospitalization/emergency room visit or use of systemic steroids for at least 3 days. The mechanisms that cause acute exacerbations are not clearly understood. The following are the common causes of acute exacerbations of asthma

  1. Viral infections – contributes to 65% of adult exacerbations and 80% of childhood exacerbations. Rhino virus is responsible for upto 2/3rd of viral induced exacerbations.
  2. Bacterial and other pathogens
  3. Allergens
  4. Pollutants
  5. Other environmental factors

 The best way to prevent the exacerbations is regular use of inhaled corticosteroids and allergen avoidance. Acute exacerbations predispose the lung to a long term decline in the lung function. By preventing acute exacerbations by the regular use of inhaled corticosteroids, the lung function can be preserved.

If you feel your symptoms are worsening, measure your peak expiratory flow. If there is a mild reduction, try increasing your regular medications. Studies show increasing the inhaled corticosteroids four fold may prevent an acute exacerbations. If the symptoms are severe you need to visit your pulmonologist or emergency room.