Types of Asthma

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Bronchial Asthma is classified into :

I. Atopic or Extrinsic Asthma (Early onset Asthma)

  • Usually begins in childhood
  • It generally occurs in atopic (hereditary predisposition toward developing certain hypersensitivity reactions) individuals i.e.individuals who are prone to allergy like cold, sneezing, skin rashes.
  • External factors (like smoke, dust, pollen) are responsible for causing the asthmatic attacks. Hence also called as extrinsic asthma.
  • The patients having atopic asthma can be identified by skin hypersensitivity tests which produce positive reactions to a wide range of common allergens.

Atopic asthma may be associated with other allergic disorders like :

  • Allergic Rhinitis : It is commonly seen that the patient first presents with sneezing, running nose, and after sometimes develop the symptoms of asthma.
  • Inflammation of the Larynx, Trachea, Bronchi (Laryngo-tracheo-bronchitis) : In this case, the asthmatic attack is preceded by hoarseness of voice, cough (with or without phlegm), difficulty in breathing and pain in chest.
  • Dermato-respiratory syndrome : Asthma may be associated with some skin problems such as
    • Asthma after suppression of skin complaints : According to Dr. Hahnemann’s observation (as mentioned above), whenever skin complaints are suppressed by local applications the disease comes back in some other form (asthma in many patients). This may occur especially in those cases where there is a past history of suppressed eczema or when there is a family history of asthma.
    • Asthma with skin complaints : In many cases, asthma is seen along with some skin disease. For e.g. a person having skin allergy to an allergen may at the same time have bronchial allergy to the same allergen and therefore present with skin rashes and asthma at the same time.
    • Asthma alternating with skin complaints : In certain cases, asthma may alternate with skin diseases like urticaria, eczema etc.
  • Gastro-respiratory syndrome : This is when asthma attack is accompanied with stomach allergies. Some foods or medicines when ingested cause allergies in the digestive system. These are called Trophallergens. For e.g. on eating strawberries a person may develop pain in the stomach with diarrhea which may cause an attack of asthma.

II. Non-Atopic or Intrinsic Asthma (Late onset Asthma)

  • Often begins in adult life.
  • History of allergy usually absent.
  • Family history of allergies or asthma is usually absent.
  • As there is no involvement of external allergens in causing this type of asthma it is known as Intrinsic Asthma.
  • The hypersensitivity skin test would give a normal reaction.

Non-Atopic asthma can be divided into two groups:

  • Asthma from mechanical obstruction : This can result in symptoms resembling an asthmatic attack. This obstruction can be due to:
    • some foreign body which may get accidentally lodged in the airway.
    • inhalation of smoke, small carbon particles and soot lodges in smaller bronchi and this alerts the army force (White Blood Cells) in our body. If the bronchi is very small even an excessive mucus secretion may block it producing asthmatic symptoms.
    • Millar’s Asthma, which occurs as a result of spasm of glottis (closure of glottis). This is common in children especially below two years of age. The attack is usually provoked by crying, laughing, drinking or by fright. During an attack, the child has to strain all chief and accessory muscles of respiration to draw the air in through the glottis, which is in spasm (closed). Hence, the inspiration is whistling, crowing or snoring type. Attacks are very exhaustive, and the number of attacks are variable.
  • Asthma associated with infection : In this case the causative factor is usually infection. According to Besacon (Master of Homeopathy), there is a relation between a bacillary factor and repetition of asthmatic attack. Patients may present with a history of repeated upper respiratory tract infection.

III. Occupational asthma

Certain occupations can be harmful for people with an allergic background for e.g. bakers, farmers, and poultry-men are exposed to large amounts of fungus. Farmers and gardeners are exposed to pollens, mattress renovators to house dust, beauticians and barbers to dyes and animal dander (skin scales or fur of animals).