Overview

Definition

Asthma is a chronic disease. It is a change in how the lining of the airways of the lungs work. Asthma makes the airways narrow and makes it hard to breathe.

Some people may have mild asthma with rare flare-ups. Others may have a severe, constant asthma.

Inflamed Bronchus in the Lungs
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

The exact causes of asthma are unknown. Genetics do play a role.

The airways become very sensitive to triggers in people with asthma. The reaction causes a flare up of symptoms called an asthma attack. It includes swelling of airway and increase in mucus. At the same time, muscles around the airway tighten. These reactions all make it hard to breathe.

Risk Factors

Factors that may increase your chance of asthma include:

  • Regular exposure to cigarette smoke , including second-hand smoke
  • Regular exposure to industrial or agricultural chemicals
  • A family member who has asthma
  • History of bronchiolitis
  • Multiple respiratory infections during childhood, especially before the age of 1
  • Being overweight
  • History of wheezing or asthma as a child
  • Having allergies
  • Premature birth
  • Having a mother who smoked during pregnancy

SymptomsandDiagnosis

Symptoms

An asthma attack can cause:

  • Cough
  • Wheezing
  • Tightness in the chest
  • Trouble breathing
  • Shortness of breath
  • Chest pain
  • Limited exercise tolerance

They can range from mild to very severe.

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. The doctor may suspect asthma based on your symptoms.

Some tests may be done to see how well your lungs are working. Lung tests may include:

  • Peak flow assessment
  • Pulmonary function tests (PFTs)
  • Reversibility testing
  • Bronchoprovocation tests

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.

Treatments

Treatment

The goal of treatment is to prevent asthma attacks when possible. A second goal is to manage attacks and ease breathing.

You and your doctor will create an asthma action plan. This is a plan you will follow to help control your asthma and handle asthma attacks. Tools can also be used at home to test your breathing. Keep in touch with your care team. Your plan made need to change over time.

Medicine

Medicine to Control Asthma

Some medicine is taken on a regular basis. It may help to stop asthma tacks from starting. They can not treat an existing attack. Medicine may include one or more of the following:

  • Inhaled corticosteroids—to prevent airway swelling and inflammation
  • Inhaled long-acting beta agonists—to keep airways relaxed
  • Oral leukotriene modifiers—to prevent airway inflammation and swelling, decrease mucus in the lungs, and open the airways
  • Inhaled cromolyn or nedocromil—to prevent airways from swelling after contact with a trigger
  • Biologic agents—if asthma is not controlled by other medicine

Medicine Used to Treat an Asthma Attack

Other medicine can be used to treat an asthma attack. It will help to open the airways and ease breathing. Options include:

  • Inhaled quick-acting beta agonists and anticholinergic agents—to open the airways
  • Corticosteroids pills—to reduce severe airway inflammation

Procedure

Bronchial thermoplasty may be done for severe asthma. A tool is used to clear out excess muscle around the airway. This will help keep airway more open during an attack.

Avoiding Attacks

Prevention can be an important part of asthma care. Finding triggers is the first step. Possible triggers of an asthma attack in a person with asthma include:

  • Viral illness
  • Exercise
  • Cold weather or changes in the weather
  • Sinusitis
  • Gastroesophageal reflux disease (GERD)
  • Sulfites, preservatives used in dried fruits and wine
  • Medications, such as aspirin, ibuprofen, and beta-blockers
  • Exposure to irritants or allergens, including:
    • Cigarette smoke
    • Smoke from a wood-burning stove
    • Pet dander
    • Dust
    • Chemicals
    • Mold and mildew
    • Pollen
    • Smog or air pollution
    • Perfumed products

If possible triggers should be avoided. Others like medicine or exercise may only need some adjustments. Work with your care team to make your plan to avoid asthma attacks.

Prevention

Asthma cannot be prevented. However, you can help prevent some asthma attacks by avoiding triggers. Triggers can vary from person to person but some general guidelines include:

  • Avoid strong chemicals or odors like perfume.
  • Avoid strenuous outdoor exercise during days with high air pollution, a high pollen count, or a high ozone level.
  • Get a yearly flu shot . Colds and flus can increase risk of asthma attacks.
  • Don't smoke.
  • Avoid secondhand smoke. Do not allow anyone to smoke in your home.
  • Don't use a wood-burning stove or fireplace. This includes unvented gas fireplaces.
  • Avoid strenuous activity in cold weather. If you must, use a scarf or mask. It will help to warm the air before it reaches your lungs.

Talk to your doctor about:

  • Right level of exercise
  • Ways to track your asthma
  • Work, hobbies, and home activities

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

American Academy of Allergy, Asthma, and Immunology http://www.aaaai.org 

Asthma and Allergy Foundation of America http://www.aafa.org 

CANADIAN RESOURCES

Allergy Asthma Information Association http://aaia.ca 

The Lung Association http://www.lung.ca 

References

Asthma in adults and adolescents. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  . Updated May 25, 2018. Accessed September 21, 2018.

Asthma exacerbation in adults and adolescents. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114076/Asthma-exacerbation-in-adults-and-adolescents  . Updated May 26, 2018. Accessed September 21, 2018.

Asthma stepwise management in adults and adolescents. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T474361/Asthma-stepwise-management-in-adults-and-adolescents  . Updated May 25, 2018. Accessed September 21, 2018.

Asthma overview. Asthma and Allergy Foundation of America website. Available at: http://www.aafa.org/display.cfm?id=8. Accessed August 28, 2017.

Flu and people with asthma. Center for Disease Control and Prevention website. Available at: http://www.cdc.gov/flu/asthma. Updated September 25, 2013. Accessed August 28, 2017.

Global Initiative for Asthma (GINA) global strategy for asthma management and prevention. (GINA 2018)

National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol. 2007 Nov;120(5 Suppl):S94-138 or at National Heart, Lung, and Blood Institute (NHLBI) PDF, correction can be found in J Allergy Clin Immunol 2008 Jun;121(6):1330

1/6/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Levenson M. Long-acting beta-agonists and adverse asthma events meta-analysis. Joint Meeting of the Pulmonary-Allergy Drugs Advisory Committee, Drug Safety and Risk Management Advisory Committee and Pediatric Advisory Committee. December 10-11, 2008.

2/17/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Bailey EJ, Cates CJ, Kruske S, et al. Culture-specific programs for children and adults from minority groups who have asthma. Cochrane Database Syst Rev. 2009;(1):CD006580.

7/6/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Thomas M, McKinley RK, Mellor S, et al. Breathing exercises for asthma: a randomised controlled trial. Thorax. 2009;64(1):55-61.

9/2/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Van der Meer V, Bakker MJ, van den Hout WB, et al. Internet based self-management plus education compared with usual care in asthma: a randomized trial. Ann Intern Med. 2009;151(2):110-120.

10/8/2010 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Ducharme F, Chroinin M, Greenstone I, et al. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database Syst Rev. 2010;(5):CD005535.

1/4/2011 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : McLean S, Chandler D, Nurmatov U, et al. Telehealthcare for asthma. Cochrane Database Syst Rev. 2010;(10):CD007717.

11/12/2013 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Freitas DA, Holloway EA, Bruno SS, et al. Breathing exercises for adults with asthma.Cochrane Database Syst Rev. 2013 Oct 1;10:CD001277.

11/2/2015 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T114449/Asthma-in-adults-and-adolescents  : Normansell R, Kew KM, et al. Sublingual immunotherapy for asthma. Cochrane Database Syst Rev. 2015 Aug 28;8:CD011293.