Asthma is a chronic lung disease that causes inflammation and mucus in the airways, the tubes that move air in and out of the body. Inflammation causes the airways to become narrow, referred to as a bronchospasm, trapping air and preventing it from moving in and out. With less room for air to enter, it becomes harder to breathe, and less oxygen gets to the body. There is no cure for asthma, but it is treatable.
What causes asthma?
Asthma can have an allergic or non-allergic cause. An allergic cause is when the airway is sensitive to something in the environment, provoking a sudden or “acute” episode of difficulty breathing. A non-allergic response is exercise, illness, or weather. When the airway is triggered, it becomes inflamed and plugged with mucus. Breathing becomes more challenging and many times results in wheezing.
Triggers can vary and what bothers one person may not bother another. One person may react to only a few triggers, while others react to many. Patients need to become familiar with what triggers them and do their best to avoid triggers as much as possible to prevent episodes. It is also essential to be aware that exposures may not cause immediate attacks. Delayed episodes can occur if patients have a lower sensitivity.
Common triggers can include:
- Pet dander
2. Irritants (Airborne):
- Cigarette smoke
- Air pollution
- Wood smoke
- Charcoal smoke
- Fumes: paint, gasoline, perfumes, etc.
- Powders or airborne particles: dust, flour, etc.
3. Exercise 4. Health Problems:
- Lung diseases: Sleep apnea, COPD
- Food allergies
- Gastroesophageal reflux
5. Respiratory infections: Pneumonia, sinus infections, flu, common cold
6. Weather: Cold or dry air
7. Certain medications in those with severe asthma
Who’s at risk?
There is no singular cause for asthma. It can start at any age but often begins in childhood. Some people outgrow the disease while others do not. People prone to allergies have a higher incidence of the illness, as well as those exposed to cigarette smoke, either through secondhand (directly breathing smoke put out by cigarettes) or thirdhand (being exposed to clothing or surfaces with smoke residue).
Research shows that females often have asthma more than males, and it is more common for Black people than for other races. Family members can also pass asthma down. People exposed to irritants or respiratory infections may also develop lung damage resulting in asthma.
Symptoms of asthma include:
- Wheezing: A whistling sound when you breathe out
- Chest tightness or pain
- Shortness of breath
These symptoms are standard, though patients may not have all of them with every episode, and symptoms may come and go. Some triggers may cause certain symptoms but not others and vice versa. Patients may find that symptoms worsen at night or in the early morning.
An “asthma attack,” as it is commonly referred to, is when the swelling and narrowing occur and the patient has a hard time breathing. Depending on the asthma type, symptoms may be mild or severe. It can be a frightening situation.
Asthma is one of two types depending on the cause and how bad the symptoms are when they occur.
- Intermittent: Symptoms come and go, but the patient feels normal between episodes.
- Persistent: The patient has symptoms most of the time.
Your healthcare provider will complete your medical history, asking questions about symptoms you experience and a physical examination to determine if you have asthma. They will order tests to assess your lungs.
- Spirometry is a pulmonary function test that measures the amount of air breathed out. It determines severity, monitors the disease, and effectiveness of treatment.
- Peak flow monitoring measures the speed at which someone can blow air out of their lungs and monitors the control of the disease.
- Pulse oximetry measures the oxygen percentage in the blood with a small probe over the fingernail. It is occasionally measured during exercise to see if oxygen levels drop.
Providers may also conduct chest X-rays, blood tests, and allergy testing. Allergy testing may determine triggers that you can avoid to minimize symptoms.
Treating and controlling symptoms
Some asthma patients can use medications to treat symptoms when needed. Others need medications daily to prevent symptoms from occurring altogether. Your healthcare provider will determine which is best suited for your needs based on the severity of your symptoms. There are two types of medicines used to treat asthma, fast-acting and long-acting. It is important to understand the difference.
Fasting-acting medications: Used for sudden symptoms or “asthma attacks," these medicines relieve mild or occasional symptoms.
- Inhaled bronchodilators: A short-acting medicine, referred to as a “rescue” medicine, it is used to relieve symptoms by opening airways quickly. This medicine is for occasional use. Your healthcare provider should address more frequent use. Examples include Albuterol, levalbuterol, and albuterol & ipratropium.
Long-acting medications: Requiring daily use to prevent and control symptoms, these include:
- Corticosteroids: Reduces swelling and mucus in the airways.
- Anticholinergics: It prevents the muscles of the airways from tightening. An example is ipratropium bromide.
- Biologic medicines: Used for poorly controlled symptoms and given by injection or IV.
- Leukotrienes modifiers: Decreases swelling in the airways.
- Long-acting bronchodilators: Also inhaled, these are used daily to keep airways open. Examples include salmeterol, budesonide, and other combinations.
- Allergy shots: Must be administered by an allergist.
Ways to control or avoid symptoms
Eliminate exposure to known triggers. If allergens cause symptoms, remove them from your environment and do your best to avoid them.
Take your medications as directed. Discuss uses of the medications with your healthcare provider. Make sure you understand how and when to use them effectively.
Know when to contact your healthcare provider or seek emergency treatment. Call your provider if your symptoms increase in severity or frequency, or if you are not getting control of your medications.
- Asthma is a chronic lung disease that causes inflammation and mucus in the airways.
- It is not curable, but is manageable.
- Asthma is necessary to take the prescribed medications as directed and avoid triggers as much as possible.
- Work closely with your healthcare providers to handle your asthma and understand your symptoms and medication.
Asthma and Allergy Foundation of America. Asthma
Cleveland Clinic. Asthma
John Hopkins Medicine. Asthma
National Heart, Lung, and Blood Institute. What is Asthma?
The American Thoracic Society. What is Asthma?