Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

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Definition

Asthma is a chronic condition of the airways or tubes of the lungs. It narrows the airways and makes it difficult to breathe.

Inflamed Bronchus in the Lungs

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Causes

The exact cause of asthma is not clear. It may be caused by a combination of factors including environment, genetics, and biology.

Asthma symptoms are caused by an increased sensitivity of the airways to certain triggers. The triggers cause the lining of the airways to swell and produce extra fluid called mucus. At the same time, the muscles around the outside of the airway tighten in response to the irritation. All of these reactions narrow the airways and make it difficult to breathe. This response is often referred to as an asthma attack.

Possible triggers of an asthma attack in a person with asthma include:

Risk Factors

Factors that may increase you risk for asthma include:

  • Regularly breathing in cigarette smoke (including second-hand smoke)
  • Regularly breathing in industrial or agricultural chemicals
  • A family member who has asthma
  • History of multiple respiratory infections during childhood
  • Being overweight
  • History of wheezing or asthma as a child
  • Having allergies
  • Your mother smoked during pregnancy

Symptoms

Symptoms include:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may also do some tests to measure lung functions. They may include:

Your doctor may also do some allergy tests. The test will help determine if allergies are causing symptoms. The test may include skin pricks or blood tests.

Treatment

The treatment strategy for asthma includes:

You and your doctor should also create an asthma action plan. This is a plan you will follow to help control your asthma and handle asthma attacks.

These medications are used to control the chronic swelling. It will help to avoid asthma attacks, but will not treat an existing attack:

  • Inhaled corticosteroid—used daily to reduce inflammation in your airways
  • Long-acting beta agonists—(such as inhaled salmeterol ) used daily to prevent asthma attacks. In most cases, prescribed with an inhaled corticosteroid
    • May increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breath), and hospitalization—If you have any concerns, talk to your doctor.
  • Cromolyn sodium or nedocromil sodium inhaler—used daily to prevent asthma flare-ups or to prevent exercise-induced symptoms
  • Zafirlukast, zileuton, and montelukast—taken daily to help prevent asthma attacks
  • Omalizumab (Xolair)—a monoclonal antibody against immunoglobulin E (IgE), given as an injection under the skin, used along with other medications for patients with harder to control asthma
  • Theophylline—taken daily to help prevent asthma attacks, not as commonly used because of interactions with other drugs

These medications are used to treat an existing asthma attack:

  • Quick-acting beta agonists—(such as inhaled albuterol , xopenex ) relax your airways so that they become wider again, may also be used to avoid exercise-induced asthma attacks
  • Anticholinergic agents—inhaled medications, such as ipratropium , that function as a bronchodilator, typically only used in an emergency setting
  • Corticosteroids—pills, injections, or IV medications given to treat acute flare-up of symptoms
    • Pills may be taken for a longer period of time. They may also be recommended to help control asthma if you have severe asthma that isn't responding to other treatments.

Prevention is an important step in asthma care. Allergy avoidance can be very effective with asthma that is exacerbated by allergens. Some general tips for allergen avoidance include:

  • Avoid outside activities if there are high levels of air pollution, pollen, or mold spores.
  • Keep your windows closed during seasons with high pollen or mold spores. Air conditioning may help filter out allergens during warm seasons.
  • Consider getting a portable HEPA unit air cleaner to use in sleeping areas.
  • Consider getting HEPA filters for your heating/cooling system and your vacuum cleaner.
  • Have someone else vacuum for you. Avoid a room that has been freshly vacuumed. If you do vacuum, use a dust mask.
  • Keep the humidity down in your house. This may help prevent the growth of mold.
  • Treat allergies and sinusitis as recommended.

If allergies trigger your asthma attacks, ask your doctor about allergy shots. If you commonly have stuffy, runny, or itchy nose, these shots may improve your asthma.

In addition, it may be helpful to learn breathing techniques. Ask your doctor for recommendations.

Your asthma plan may need to be adjusted to adapt to changes in your life or health. Staying in contact with your doctor between visits can help you have better control of your asthma. Contact may occur over the phone, through email, or through your doctor's website.

Online programs aimed at helping you manage your own symptoms can improve asthma control and lung function. Some examples of programs include American Lung Association or Asthma and Allergy Foundation of America.

Prevention

There are no guidelines for preventing asthma because the cause is unknown. However, you can help prevent asthma attacks by avoiding things that trigger your attacks. Triggers can vary from person to person but some general guidelines include:

Talk to your doctor about:

  • An appropriate level of exercise for you
  • Ways to track your asthma to help identify and treat flare-ups right away.
  • Your work, hobbies, and home activities to see if any of these may be causing or worsening your asthma.