Asthma

Overview

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This topic provides information about asthma in teens and adults. If you are looking for information about asthma in children age 12 and younger, see the topic Asthma in Children.

What is asthma?

Asthma makes it difficult for you to breathe. This can happen only every now and then, or in more severe cases, every day. Asthma may also last throughout your life (a chronic disease), but you can control it through treatment with medications.

Asthma makes it difficult to breathe because it can cause inflammation in your bronchial tubes, which carry air to the lungs. The inflammation usually starts slowly, but over time it can make the muscles that line the bronchial tubes get tight (bronchospasm) . This can cause a blocking or narrowing of your airways, making it difficult to breathe. This is known as an acute asthma episode (also called an attack, flare-up, or exacerbation) .

Acute asthma episodes can happen rarely or often and be mild or severe. Most often, you can take care of symptoms at home by using an asthma action plan, which is a written plan that tells you which medicines you need to use and when you should call a health professional. If you have a severe acute episode, you may need urgent care. These acute asthma episodes can even cause death, but that is rare.

Even if you have few acute asthma episodes, you still have inflammation in your airways that needs treatment. If the inflammation is not controlled, asthma could lead to permanent changes in the bronchial tubes and harm your lungs.

Although there is no cure for asthma, with treatment you can control your symptoms and prevent further damage to your lungs.

What causes asthma?

We don't know what causes asthma. But here are some of the things that can cause the inflammation in your airways that can lead to asthma and acute asthma episodes:

• Asthma may run in families (inherited).
• In some people, immune system cells release chemicals that cause inflammation in response to certain substances (allergens) that cause allergic reactions. Studies show that exposure to allergens such as dust mites, cockroaches, and animal dander may influence asthma’s development. 1 Asthma is much more common in people with allergies, though not all those with allergies get asthma.
• Some experts believe that there are more cases of asthma because of pollution and less exposure to certain types of bacteria or infections. 2 As a result, children's immune systems may develop in a way that makes it more likely they will also develop allergies and asthma.

What are the symptoms?

Symptoms of asthma can be mild or severe. You may have no symptoms; severe, daily symptoms; or something in between. How often you have symptoms can also change. Symptoms of asthma may include:

• Wheezing, which is a loud or soft whistling noise that occurs when the airways narrow.
• Coughing.
• Chest tightness.
• Shortness of breath, which is rapid, shallow breathing or having a hard time breathing.
• Trouble sleeping.
• Tiring quickly during exercise.

Many people have symptoms that become worse at night (nocturnal asthma).

How is asthma diagnosed?

No one test can diagnose asthma. Your health professional will diagnose asthma using spirometry, as well as your medical history, a physical exam, and lab tests.

Spirometry measures how quickly you can move air in and out of your lungs and how much air you move. The test can help your health professional decide whether asthma is causing your airflow to decrease and by how much. The test can also show how well your lungs work when you're not having asthma symptoms and measure how well your lungs respond to treatment with medication.

While taking your medical history, your health professional will ask about your symptoms and when they occur. A physical exam will not find signs of asthma unless you are having symptoms. Your health professional will listen to your chest for signs of reduced airflow in the bronchial tubes and will look for signs of sinus problems or allergies.

A chest X-ray may be done to see whether another disease is causing your symptoms. Blood tests may show that you have allergies that could cause asthma episodes. If your health professional thinks you may have asthma related to allergies, skin testing may be done to identify them.

You will need routine checkups with your health professional to keep track of your asthma and decide on treatment.

How is it treated?

You can treat asthma with medications, especially inhaled corticosteroids, which prevent or control airway inflammation, and beta 2 -agonists, which make the airways larger (dilate). You usually work with your health professional to form a daily treatment plan and an asthma action plan. These plans help you to:

• Control airway inflammation and prevent asthma episodes.
• Identify and treat early symptoms of episodes.
• Avoid things that make symptoms worse, such as cigarette smoke or allergens (triggers).
• Know when emergency help is needed.