DEAR DR. DONOHUE: What gives? When I was a kid, I had asthma. Then it went away completely. Now, at age 37, it’s come back. As a child, I took only one medicine, and did well. Now I have a number of medicines and inhalers, and I’m confused. Will you simplify asthma for me? It isn’t the same as it used to be. Do you think I have developed allergies that brought it back? — H.F.

ANSWER: In the more developed countries of the world, around 15 percent of children and 12 percent of adults suffer from asthma. Asthma resolves for many children as they reach adolescence, but it can come back. Adults also can develop asthma for the first time. It’s not strictly a childhood problem.

Cough, wheezing and shortness of breath are the signs of an asthma attack. Asthma comes in attacks separated by periods when the asthmatic is well. The goal of treatment is to extend the well periods and shorten any attacks, something that wasn’t all that possible when you had only one medicine as a child.

The basis of an attack is constriction of the breathing tubes, the airways, the bronchi. Along with narrowed airways, inflammation strikes them, and they fill with thick mucus. The combination makes it difficult to get air into and out of the lungs. Exhaling is particularly difficult.

Triggers for asthma attacks include cold air, exercise, viral infections like the common cold and allergens. If your doctor believes that allergens are leading to your asthma attacks, then testing for them is worthwhile. For many, allergy doesn’t lead to bouts of asthma.

Exercise as a trigger needs some clarification. Everyone gets short of breath when exercising, but recovery is quick, within five minutes. Breathlessness brought on by an exercise-induced asthma attack lasts much longer, 30 to 60 minutes.

An attack of asthma often can be stopped in its tracks with an inhaler medicine like albuterol (Ventolin and Proventil). For longer control, cortisone inhalers or inhalers containing cortisone and a long-acting drug that expands airways keeps a person attack-free. Advair is an example.

The booklet on asthma has a more detailed explanation of the common illness and its treatments. To obtain a copy, write: Dr. Donohue — No. 602, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Does heartburn cause asthma attacks? It sounds weird to me, but my doctor thinks that’s what causing my breathing problems. He has me on medicines for heartburn. I can’t believe they’ll help. — J.R.

ANSWER: Your doctor isn’t coming from out of left field. Heartburn can be an asthma trigger. Heartburn is officially called gastroesophageal reflux — an upward shooting of stomach acid and digestive juices into the esophagus, the swallowing tube.

The juices can rise so far up that they leak out of the esophagus and trickle into the bronchi, the airways. That’s what sets off an asthma attack.

DEAR DR. DONOHUE: Several bouts of stomach pain brought me to the doctor. The pain is located in my upper right side. The doctor was certain I was having gallbladder attacks due to stones. She sent me for an ultrasound test of my gallbladder.

I don’t have stones. I have something called a liver hemangioma. My doctor says I don’t need any treatment. I never heard of this and wonder what your thoughts are. — P.K.

ANSWER: A hemangioma is a small, ball-shaped mass of blood vessels. If 100 people had a liver scan, seven would be found to have a hemangioma. Women develop them more often than men do. They do not become cancers. They’re rarely a source of constant pain, unless they grow quite large and press on adjacent tissue. They don’t cause attacks of pain. Have you found out what causes your pain?

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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