Intrinsic vs. Extrinsic Asthma
Extrinsic asthma is caused by an allergic reaction to something in your environment that your immune system views as “foreign” to your body. Intrinsic asthma is any type of asthma that isn’t caused by an allergy.
During an asthma attack, inflammation causes your airways to swell and clog with mucous. Muscles around your airways also contract, called bronchospasm. This makes it difficult for your lungs to move air into and out of your body.
Symptoms of Intrinsic Asthma
Symptoms of an asthma attack are similar, regardless of the type of asthma you have. These can include:
Coughing Shortness of breath Wheezing when breathing out (squeaking/whistling) Tight chest Difficulty breathing Increased speed of breathing
Asthma attacks can be life-threatening. Symptoms of a serious asthma attack, called respiratory distress, can include:
Use of accessory muscles (neck and shoulders) for breathingSweatingDecreased alertnessDifficulty speaking due to breathlessnessBlue-tinted lipsVery fast breathingFast heart rate
Seek immediate medical attention if you suspect you are in respiratory distress.
Causes
While the exact cause of intrinsic asthma is not known, several conditions are associated with it, including:
Sinus infectionBronchitisCommon coldNasal polypsSinusitisTooth or gum infectionsThroat infectionGastrointestinal issuesKidney failureHeart failure
Intrinsic asthma affects more adults than children, and is more likely to be a long-term problem than extrinsic asthma.
Cigarette smokeWood smokeCharcoal grillsPerfumesScented hygiene productsAir pollutionDustChemicals that are airborneDry windCold airDrastic changes in weather conditionsVigorous exercise (called exercise-induced asthma)Strong emotions (crying, shouting, laughing, excitement, anger, fear)Drugs (aspirin and nonsteroidal anti-inflammatory drugs)
Diagnosis
Your primary doctor will likely send you to a specialist called an allergist for diagnosis of your non-allergic asthma. There is no specific test for intrinsic asthma. In addition to your overall medical history, the doctor will ask questions about your symptoms and when they occur to help figure out the underlying cause.
Age of onset can also be a clue—while extrinsic or allergic asthma typically develops in childhood or young adulthood, intrinsic asthma most often occurs in middle age and beyond.
Treatment
A variety of asthma treatments are available, depending on the severity of your symptoms.
Short-acting medications (commonly called rescue medications) treat an asthma attack that is actively occurring. Longer-acting medications (called maintenance or control medications) are taken daily to help manage swelling in your airways and excess mucous production.
These medications include bronchodilators, which work by relaxing the muscles around your airway and decreasing mucous production. Bronchodilators can be short- or long-acting and include short-acting beta agonists (SABA), short-acting muscarinic antagonists (SAMA), long-acting beta agonists (LABA), long-acting muscarinic antagonists (LAMA), and theophylline.
In some cases, your doctor might prescribe more than one type of medication.
Another group of medications called biologics are sometimes used to treat severe cases of allergic asthma. The effectiveness of biologics for intrinsic/non-allergic asthma is still being researched. These medications target specific proteins or cells that cause inflammation in the airways.
Corticosteroids can also be used to reduce inflammation in your airways. Other medications called leukotriene modifiers directly target chemicals that cause your asthma symptoms.
Prognosis and Coping
The severity of your asthma symptoms depends on a lot of factors. If you’re able to identify your triggers, and avoid them, you might be able to prevent asthma attacks from occurring. However, this is not very common—and triggers can change over time.
Inhalers (sometimes called puffers): These devices deliver medication into your mouth that you immediately inhale. Nebulizers: Asthma medication used in nebulizer machines comes in liquid form. The machine turns the liquid into a mist that you breathe in through your mouth or a mask that covers both your mouth and nose. Biologics: These medications are given through a shot or an IV infusion. Steroidal anti-inflammatories: These medications can be inhaled or taken orally.
Most people with asthma have to take medication very frequently, or even every day. However, you can take steps to improve your overall quality of life if you have asthma.
Follow your doctor’s instructions: Take your medication as prescribed. Keep your lungs healthy: Exercise regularly and avoid smoking. Avoid your triggers (if you know them): Even if you don’t know your specific triggers, avoid common airborne irritants (strong fragrances, wood smoke, cigarette smoke, etc. ).
A Word From Verywell
While living with chronic illness such as asthma can be stressful, focusing on your overall wellness can help. Incorporate physical activity and stress management techniques, such as yoga, meditation, or guided imagery into your routine and get plenty of sleep. Asthma is a highly treatable condition that can be managed with the right treatment and lifestyle changes.
