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Health Issues - Asthma

Overview and Facts

Asthma occurs when the airways in your lungs (bronchial tubes) become inflamed and constricted. The muscles of the bronchial walls tighten, and your airways produce extra mucus that blocks your airways. Signs and symptoms of asthma range from minor wheezing to life-threatening asthma attacks.

Asthma can't be cured, but its symptoms can be controlled. Management includes avoiding asthma triggers and tracking your symptoms. You may need to regularly take long-term control medications to prevent flare-ups and short-term "rescue" medications to control symptoms once they start. Asthma that isn't under control can cause missed school and work or reduced productivity due to symptoms. Because in most people asthma changes over time, you'll need to work closely with your doctor to track your signs and symptoms and adjust your treatment as needed.

Asthma is common, affecting millions of adults and children. A growing number of people are diagnosed with the condition each year, but it isn't clear why. A number of factors are thought to increase the chances of developing asthma. These include:

  • A family history of asthma
  • Frequent respiratory infections as a child
  • Exposure to secondhand smoke
  • Living in an urban area, especially if there's a lot of air pollution
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
  • Low birth weight 
  •  Being overweight

This interactive asthma animation provides a comprehensive overview of asthma as a critical starting point for individuals and/or their loved ones. All information has been reviewed for medical accuracy by an MD. Click here to watch the video.

Symptoms and Facts

Asthma signs and symptoms range from minor to severe, and vary from person to person. You may have mild symptoms such as infrequent wheezing, with occasional asthma attacks. Between episodes you may feel normal and have no trouble breathing. Or, you may have signs and symptoms such as coughing and wheezing all the time or have symptoms primarily at night or only during exercise.

Asthma signs and symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • An audible whistling or wheezing sound when exhaling
  • Bouts of coughing or wheezing that are worsened by a respiratory virus such as a cold or the flu

Signs that your asthma is probably getting worse include:

  • An increase in the severity and frequency of asthma signs and symptoms
  • A fall in peak flow rates as measured by a peak flow meter, a simple device used to check how well your lungs are working
  • An increased need to use bronchodilators — medications that open up airways by relaxing the surrounding muscles

Work with your doctor to determine when you need to increase your medications or take other steps to treat symptoms of worsening asthma and get your asthma back under control. If your asthma keeps getting worse, you may need a trip to the emergency room. Your doctor can help you learn to recognize emergency signs and symptoms so you'll know when to get help.

Diagnosis

Diagnosing asthma can be difficult. Signs and symptoms can range from mild to severe and are often similar to those of other conditions, including emphysema, early congestive heart failure or vocal cord problems. In children, it can be hard to differentiate asthma from wheezy bronchitis, pneumonia or reactive airway disease.

In order to rule out other possible conditions, your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe.

Tests to Measure Lung Function

Spirometry. This test measures the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath, and how fast you can breathe out.

Peak flow. A peak flow meter is a simple device that can be used at home to help detect subtle changes before you notice symptoms. If the readings are lower than usual, it's a sign your asthma may be about to flare up. Your doctor will give you instructions on how to track and deal with low readings.

Lung function tests often are done before and after taking a bronchodilator to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma.

Treatment and Care

If you or a loved one has asthma, it’s important that you know about the most effective asthma treatments for short-term relief and long-term control. Understanding asthma treatments will enable you to work with your asthma doctor to confidently manage your asthma symptoms daily. When you do have an asthma attack or asthma symptoms, it’s important to know when to call your doctor or asthma specialist to prevent an asthma emergency. Be sure to read all the in-depth articles that link to topics within each of the following sections. By doing so, you will gain new insight into asthma and how it’s treated.

Asthma Medications

Asthma medications can save your life -- and let you live an active life in spite of your asthma. There are two basic types of drugs used in asthma treatment:

Steroids and Other Anti-Inflammatory Drugs

Anti-inflammatory drugs, particularly inhaled steroids, are the most important treatment for most people with asthma. These lifesaving medications prevent asthma attacks and work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to react to asthma triggers and cause asthma symptoms.

Bronchodilators and Asthma

Bronchodilators relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways.  

Asthma Inhalers

Asthma inhalers are the most common and effective way to deliver asthma drugs to the lungs. There are some combination asthma inhalers, which contain two different medications: an inhaled steroid and a long-acting bronchodilator. These combination asthma inhalers are popular due to their convenience, and the medications last for at least 12 hours.

For in-depth information, see WebMD's article on Asthma Inhalers.


Asthma Nebulizer

If you’re having difficulty using small inhalers, your doctor may prescribe an asthma nebulizer, also known as a breathing machine. The asthma nebulizer with a mask is typically used for infants, small children, elderly adults, or anyone who has difficulty using inhalers with spacers. The nebulizer changes asthma medications from a liquid to a mist, so that they can be more easily inhaled into the lungs. This takes a few more minutes of time when compared to inhalers.

Prednisone and Asthma Attacks

If you have a serious asthma attack (exacerbation), your doctor may prescribe prednisone pills for five to 14 days. Prednisone (or prednisolone) is the most effective asthma medication available, but does cause side effects. When used for less than two weeks, these side effects are only temporary, but when used for many months, these side effects can be serious and permanent. After the severe symptoms of your asthma attack have been successfully treated, your doctor will work with you to minimize your need for prednisone in the future. Faithfully taking an inhaled corticosteroid every day is the most commonly successful method to do this.

Talk to Your Asthma Specialist

If you have been diagnosed with asthma but your treatment no longer seems to work, then it’s time to check in with your doctor again. There are many new asthma treatments. Finding a new medication or new method of delivery will help you breathe better and allow you to be active again. Likewise, if you’ve been diagnosed with asthma and you have symptoms that require you to use your asthma rescue inhaler too frequently, go see your asthma doctor. You may need a different asthma medication to decrease inflammation. Your doctor can determine the problem -- and solution -- so you feel better and breathe right.

While asthma is a common disease, it's also very serious breathing problem that demands a proper medical diagnosis and targeted asthma treatment. Get help for asthma. Talk to your doctor for asthma support and find the right asthma drugs that work best for you.