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Asthma

Asthma and Lung Fluid

06/05/2007

Question:

My husband has had asthma for about 20 years but in the last 5 years he is now producing fluid in his lungs, it is becoming very difficult to breathe at times, he coughs and spits alot in the morning to clear his lungs, he has alot of medications for his asthma but they are slowly starting to not work. My question is, is it common for people with asthma to produce fluid in their lungs??

Answer:

Increasing cough and phlegm production; along with a reduction in medication effectiveness is concerning.  There are a number of possibilities to cause these symptoms.  I have discussed just a few below.

Asthma may be worsening.  Asthma severity can be assessed with pulmonary function testing.  Spirometry is a quick assessment of lung function that can be done in a few minutes during the office visit.  Spirometry should be performed at least once a year on all asthmatics.  The physician can compare these readings for worsening/improving asthma and for response to asthma medications.  Additionally, there are several screening tools that can be used to assess how often asthmatics are bothered by their symptoms and how many puffs of rescue inhalers are needed per day.  This information combined with the Spirometry can give good information about asthma control.  If asthma is not controlled medication adjustment is necessary. 

Long standing asthma also puts patients at risk for allergic bronchopulmonary aspergillosis (ABPA).  ABPA is an allergic response to aspergillus, a fungus, in the breathing tubes (airways).  The symptoms vary, but can include fever, fatigue, mucous production, chest congestion and wheezing.  There are a number of tests needed to make this diagnosis.

Recurrent respiratory infections and inflammation in the breathing tubes can result in damage called bronchiectasis.  The damage causes phlegm to pool in the breathing tubes (airways) resulting in cough and lots of phlegm production.  This condition can be seen on chest cat scans. 

It is also possible to have underlying emphysema and chronic bronchitis; especially in smokers or ex-smokers.

Other conditions are possible as well.  It is best to discuss your concerns with your physician.  Let your physician know your symptoms, limitations, rescue medication use and general response to asthma medications.

For more information:

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Response by:

Cathy   Benninger, RN, MS, APRN, C-AE Cathy Benninger, RN, MS, APRN, C-AE
Clinical Assistant Professor
Director, OSU Asthma Center Educational Program
College of Medicine
The Ohio State University