Asthma

Asthma

Asthma is a long-term lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

What causes asthma?

Since asthma has a genetic origin and is a disease you are born with, passed down from generation to generation, the question isn’t really “what causes asthma,” but rather “what causes asthma symptoms to appear?” People with asthma have inflamed airways which are super-sensitive to things which do not bother other people. These things are called “triggers.”

Although asthma triggers vary from person to person based on if you have allergic asthma or non-allergic asthma, some of the most common include:

  • Substances that cause allergies (allergens) such as dust mites, pollens, molds, pet dander, and even cockroach droppings. In many people with asthma, the same substances that cause allergy symptoms can also trigger an asthma episode. These allergens may be things that you inhale, such as pollen or dust, or things that you eat, such as shellfish. It is best to avoid or limit your exposure to known allergens in order to prevent asthma symptoms.
  • Irritants in the air, including smoke from cigarettes, wood fires, or charcoal grills. Also, strong fumes or odors like household sprays, paint, gasoline, perfumes, and scented soaps. Although people are not actually allergic to these particles, they can aggravate inflamed, sensitive airways. Today most people are aware that smoking can lead to cancer and heart disease. What you may not be aware of, though, is that smoking is also a risk factor for asthma in children, and a common trigger of asthma symptoms for all ages. It may seem obvious that people with asthma should not smoke, but they should also avoid the smoke from others’ cigarettes. This “secondhand” smoke, or “passive smoking,” can trigger asthma symptoms in people with the disease. Studies have shown a clear link between secondhand smoke and asthma, especially in young people. Passive smoking worsens asthma in children and teens and may cause up to 26,000 new cases of asthma each year.
  • Respiratory infections such as colds, flu, sore throats, and sinus infections. These are the number one asthma trigger in children.
  • Exercise and other activities that make you breathe harder. Exercise—especially in cold air—is a frequent asthma trigger. A form of asthma called exercise-induced asthma is triggered by physical activity. Symptoms of this kind of asthma may not appear until after several minutes of sustained exercise. (When symptoms appear sooner than this, it usually means that the person needs to adjust his or her treatment.) The kind of physical activities that can bring on asthma symptoms include not only exercise, but also laughing, crying, holding one’s breath, and hyperventilating (rapid, shallow breathing). The symptoms of exercise-induced asthma usually go away within a few hours. With proper treatment, a child with exercise-induced asthma does not need to limit his or her overall physical activity. (See the page on Exercise-Induced Asthma .)
  • Weather such as dry wind, cold air, or sudden changes in weather can sometimes bring on an asthma episode.
  • Expressing strong emotions like anger, fear or excitement. When you experience strong emotions, your breathing changes — even if you don’t have asthma. When a person with asthma laughs, yells, or cries hard, natural airway changes may cause wheezing or other asthma symptoms.
  • Some medications like aspirin can also be related to episodes in adults who are sensitive to aspirin. Irritants in the environment can also bring on an asthma episode. These irritants may include paint fumes, smog, aerosol sprays and even perfume.

People with asthma react in various ways to these factors. Some react to only a few, others to many. Some people get asthma symptoms only when they are exposed to more than one factor or trigger at the same time. Others have more severe episodes in response to multiple factors or triggers. In addition, asthma episodes do not always occur right after a person is exposed to a trigger. Depending on the type of trigger and how sensitive a person is to it, asthma episodes may be delayed.

Each case of asthma is unique. If you have asthma, it is important to keep track of the factors or triggers that you know provoke asthma episodes. Because the symptoms do not always occur right after exposure, this may take a bit of detective work.

How is asthma treated?

Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers and taking steps to avoid them, and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol.

Medications
The right medications for you depend on a number of things, including your age, your symptoms, your asthma triggers and what seems to work best to keep your asthma under control. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you’ll have an asthma attack.

Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it.  so they’re used only on a short-term basis to treat severe asthma symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn’t need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication.