Asthma is a very individual condition and the level of severity differs from person to person. As a result asthma is usually divided into three levels of severity: mild, moderate, and severe. Brittle asthma is used to describe a rare life-threatening form of asthma. Each has its own general set of characteristics, and medical treatment is necessarily customised to the severity of each person's asthma.
Understanding the severity of your current condition is important because it lets you know when to increase treatment to avoid a major attack. Because asthma is such a changeable condition it may become more mild or severe over time, and the severity may vary from attack to attack.
Mild Asthma
Mild asthma is generally spasmodic or seasonal. Breathlessness is usually mild, and attacks are infrequent. Once or twice a month you may find that you wheeze or cough during the night or when exposed to triggers such as exercise or having a cold. Between these episodes, you will probably experience no symptoms at all.
Treatment is almost always with the use of a bronchodilator (reliever medication) which you use to ease the symptoms. However, if you find that you are using these medications more than three or four times a week, inform your doctor. You may have moderate asthma, which calls for a more aggressive treatment program.
Moderate Asthma
Episodes of moderate asthma usually occur once or twice a week. You may experience nocturnal asthma, waking in the night with coughing, and wheezing. Exercise can also trigger moderate symptoms. In some cases, wheezing, coughing, and difficulty in breathing may last for several days at a time. Occasionally, you may require emergency care.
Inhaled steroid medications are prescribed to prevent cases of moderate asthma, while inhaled beta-agonists are used when symptoms occur. This preventer medication is taken daily whether you have asthma symptoms or not. Treating asthma this way is similar to brushing your teeth daily to prevent tooth decay. An occasional short burst of oral steroids may be needed when you are unable to control your condition.
Severe Asthma
Asthma rules the lives of severe asthmatics. Asthma symptoms are continuous, or you experience frequent attacks. Severe asthma can affect your overall level of activity and cause frequent nighttime symptoms. You may require hospitalization or occasional emergency treatment.
Symptoms are made worse by factors such as exercise and cold air. Daily preventive treatment is prescribed and reliever medications are also needed daily. Following severe attacks, steroid tablets (eg prednisone) are given to control the condition. You may require hospitalisation or occasional emergency care.
Brittle Asthma
Brittle asthma is an extremely severe form of the disease that is unpredictable. It is rare, affecting only approximately one in 2000 asthmatics.
Brittle asthmatics experience sudden, very serious and often life threatening attacks. This can occur in spite of being on heavy doses of medication. Many will be on regular maintenance doses of steroid tablets for long periods of time and nebulisers will be used to take bronchodilators.
