Description

Asthma is a condition in which your airways narrow and swell and produce more mucus than normal. This can make breathing difficult and trigger coughing, wheezing (whistling sound when breathing) breathing and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a serious problem that interferes with daily activities and may lead to a fatal asthma attack.

Asthma cannot be cured, but its symptoms can be controlled. Because asthma often changes over time, it is important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.

Symptoms

The symptoms of asthma vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times, such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Wheezing when exhaling, which is a common sign of asthma in children
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is likely worsening include:

  • Asthma signs and symptoms are more frequent and annoying
  • The increase of the difficulty of breathing, as measured with a device that is used to check how well your lungs are working (peak flow meter)
  • The need to use a quick-relief inhaler more often

For some people, asthma symptoms, and the symptoms flare up in certain situations:

  • Exercise-induced asthma, which may be worse when the air is cold and dry
  • Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
  • Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by the animals (pet dander)

When to see a doctor

Seek emergency treatment

Severe asthma attacks can be life-threatening. Work with your doctor to decide what to do when signs and symptoms get worse, and when you need emergency treatment. The signs of an asthma emergency include:

  • Rapid worsening of shortness of breath or wheezing
  • Does not improve after using a quick-relief inhaler
  • Shortness of breath when you are doing minimal physical activity

Please contact your doctor

See your doctor:

  • If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse with time.
  • To monitor your asthma after diagnosis. If you know that you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better day to day, and can prevent a life-threatening asthma attack.
  • If your asthma symptoms get worse.Contact your doctor right away if your medication doesn't seem to relieve your symptoms, or if you need to use your quick-relief inhaler more often. Do not take more medication than prescribed without checking with your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.
  • To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.

If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to relieve your symptoms, or if you need to use your quick-relief inhaler more often.

Do not take more medication than prescribed without checking with your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.

Causes

It is not clear why some people get asthma and others don't, but it is probably due to a combination of environmental and inherited (genetic) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

  • Allergens in the air such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
  • Respiratory infections such as the common cold
  • Physical activity
  • The cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, such as beta-blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back into her throat

Risk factors

A number of factors that are thought to increase your chances of developing asthma. They include:

  • Having a blood relative with asthma, as a father or a brother
  • Having another allergic condition, such as atopic dermatitis — which causes red, itchy skin or hay fever, which causes a runny nose, congestion, and itchy eyes
  • Overweight
  • Being a smoker
  • Exposure to second-hand smoke
  • Exposure to exhaust fumes or other types of contamination
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

Complications

Asthma complications include:

  • The signs and symptoms that interfere with sleep, work and other activities
  • In the days of disease from work or school during an outbreak of asthma
  • A permanent narrowing of the tubes that carry air to and from the lungs (bronchi), which affects how well you can breathe
  • Emergency department visits and hospitalizations for severe asthma attacks
  • Side effects of long-term use of some medications that are used to stabilize severe asthma

The right treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Prevention

While there is no way to prevent asthma, you and your doctor can design a step-by-step to live with her condition and prevent asthma attacks.

  • Follow your asthma action plan.With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then, be sure to follow your plan. Asthma is a disease that requires regular monitoring and treatment. Take control of your treatment can make you feel more in control of your life.
  • Get vaccinated against the flu and pneumonia. Keep up to date with vaccines can prevent the flu and pneumonia since the start of an outbreak of asthma.
  • Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take measures to avoid the triggers.
  • Control your breathing.You can learn to recognize the warning signs of an impending attack, such as slight coughing, wheezing or difficulty breathing. But because your lung function can decrease before you notice any signs or symptoms, they regularly measure and record your peak flow of air with a peak flow meter. A peak flow meter measures how hard you can breathe. Your doctor can show you how to check your peak flow at home.
  • Identify and treat attacks early.If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control their symptoms. When the peak flow measurement of decrease and alert of an imminent attack by taking your medicine as directed. Also, immediately stop any activity that may have triggered the attack. If your symptoms do not improve, get medical help as outlined in your action plan.
  • Take your medicines as prescribed. Do not change your medications without first talking to your doctor, even if your asthma seems to be getting better. It is a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you are using your medications correctly and taking the correct dose.
  • Pay attention to the increasing quick-relief inhaler use. If you trust in your quick-relief inhaler, such as albuterol, your asthma is not under control. Talk to your doctor about adjusting your treatment.

Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then, be sure to follow your plan.

Asthma is a disease that requires regular monitoring and treatment. Take control of your treatment can make you feel more in control of your life.

Control your breathing. You can learn to recognize the warning signs of an impending attack, such as slight coughing, wheezing or difficulty breathing.

But because your lung function can decrease before you notice any signs or symptoms, they regularly measure and record your peak flow of air with a peak flow meter. A peak flow meter measures how hard you can breathe. Your doctor can show you how to check your peak flow at home.

Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control their symptoms.

When the peak flow measurement of decrease and alert of an imminent attack by taking your medicine as directed. Also, immediately stop any activity that may have triggered the attack. If your symptoms do not improve, get medical help as outlined in your action plan.

Diagnosis

Physical examination

Your doctor will perform a physical exam to rule out other conditions, such as a respiratory infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions about your signs and symptoms and any other health problem.

Tests to measure lung function

You may be given pulmonary function tests to determine the amount of air that enters and leaves to breathe. These tests may include:

  • Spirometry. This test estimates the narrowing of the bronchial tubes by checking the amount of air you can exhale after a deep breath and how fast you can breathe.
  • The maximum flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than normal peak flow readings are a sign that the lungs can't work well and that your asthma worse. Your doctor will give you instructions on how to track and deal with the low peak flow readings.

Pulmonary function tests are often done before and after taking a medication to open the airways that is called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol. If your lung function improves with the use of a bronchodilator, it is very likely that you have asthma.

Additional tests

Other tests to diagnose asthma include:

  • Provocation test with methacholine. Methacholine is a well-known asthma. When inhaled, it will cause your airways to narrow slightly. If you react to methacholine, it is likely that you have asthma. This test can be used even if the first pulmonary function test is normal.
  • Imaging tests. A chest x-ray can help identify any structural abnormalities or diseases (such as infection) that can cause or aggravate respiratory problems.
  • The allergy tests. Allergy tests can be performed by a skin test or a blood test. They say that if you're allergic to pets, dust, mold, or pollen. If the allergy triggers are identified, the doctor may recommend allergy shots.
  • The nitric oxide test. This test measures the amount of nitric oxide gas in the air. When the airways are inflamed — a sign of asthma — you may have higher-than-normal levels of nitric oxide. This test is not widely available.
  • Eosinophils in sputum. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) of the discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye.
  • The provocation testing for exercise and cold-induced asthma. In these tests, the doctor measures the obstruction of the airway before and after vigorous physical activity, or take several breaths of cold air.

How asthma is classified

To classify its severity of asthma, your doctor will take into account the frequency of signs and symptoms and their severity. Your doctor will also take into account the results of your physical examination, and diagnostic tests.

The determination of the severity of asthma, helps your doctor choose the best treatment. The severity of asthma often changes over time, the need of a treatment settings.

Asthma is classified into four general categories:

Treatment

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

Drugs

The appropriate medication for you depends on a number of things, such as age, symptoms, asthma triggers and what works best to keep your asthma under control.

Preventive long-term control medications to reduce swelling (inflammation) of the airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are needed.

Long-term asthma control drugs, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on the day-to-day and make it less likely for you to have an asthma attack. Types of long-term control medications include:

  • Inhaled corticosteroids.These medications include fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex HFA Asmanex Twisthaler) and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days, weeks before they reach their maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids have a relatively low risk of serious side effects.
  • Leukotriene modifiers.These oral medications — including montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) — helping to relieve the symptoms of asthma. Montelukast has been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thoughts. Seek medical advice immediately if you experience any of these reactions.
  • The combination of inhalers. These medications — such as fluticasone-salmeterol (Advair HFA, Airduo Digihaler, others), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera) and fluticasone furoate-vilanterol (Breo Ellipta) — contain a long-acting beta-agonist, together with a corticosteroid.
  • Theophylline. Theophylline (Theo-24, Elixophyllin, Theochron) is a daily pill that helps to keep the airways open by relaxing the muscles that surround the airways. It is not used as often as other medications for asthma and requires regular blood tests.

Inhaled corticosteroids. These medications include fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex HFA Asmanex Twisthaler) and fluticasone furoate (Arnuity Ellipta).

You may need to use these medications for several days, weeks before they reach their maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids have a relatively low risk of serious side effects.

Leukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) — helping to relieve the symptoms of asthma.

Montelukast has been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thoughts. Seek medical advice immediately if you experience any of these reactions.

Quick-relief (rescue) medications are used as needed for rapid, short-term relief of the symptoms during an asthma attack. It can also be used before exercise if your doctor recommends it. Types of quick-relief medications include:

  • Short-acting beta agonists.These inhaled, quick-relief bronchodilators act within minutes to quickly relieve symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex, Xopenex HFA). Short-acting beta agonists can be taken with a portable, hand-held inhaler or nebulizer, a machine that turns medication for asthma to a fine mist. Are inhaled through a mask or mouthpiece.
  • Anticholinergic agents. Like other bronchodilators, ipratropium (Atrovent HFA) and tiotropium (Spiriva, Spiriva Respimat) to act quickly to immediately relax your airways, making it easier to breathe. Most are used for emphysema and chronic bronchitis, but it can be used to treat asthma.
  • Oral and intravenous corticosteroids. These medications include prednisone (Prednisone Intensol, Rays) and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol) — relieve the inflammation of the airways caused by severe asthma. Can cause serious side effects when used long term, so these drugs are used only in a short-term basis for the treatment of severe asthma symptoms.

Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to quickly relieve symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex, Xopenex HFA).

Short-acting beta agonists can be taken with a portable, hand-held inhaler or nebulizer, a machine that turns medication for asthma to a fine mist. Are inhaled through a mask or mouthpiece.

If you have an asthma attack, a quick-relief inhaler can relieve your symptoms. But you do not need to use your quick-relief inhaler very often, if your long-term control medications are working properly.

Keep a record of how many puffs of use each week. If you need to use your quick-relief inhaler more often than your doctor recommends that you consult with your doctor. You will probably need to adjust the long-term control medication.

Allergy medications may help if your asthma is caused or aggravated by allergies. These include:

  • Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system's reaction to specific allergens. In general, you will receive injections once a week for a couple of months, once a month, for a period of three to five years.
  • Biological products. These medications include omalizumab (Xolair), mepolizumab (Nucala), dupilumab (Dupixent), reslizumab (Cinqair), benralizumab (Fasenra), and tezepelumab (Tezspire) — are specifically for people who have severe asthma.

Bronchial thermoplasty

This treatment is used for severe asthma that does not improve with inhaled corticosteroids or other long-term medications for asthma. It is not widely available, nor a right for all.

During bronchial thermoplasty, your doctor heats up the inside of the airways in the lungs, with an electrode. The heat reduces the smooth muscle in the airways. This limits the ability of the airways to constrict, making breathing easier and, possibly, reduce the asthma attacks. The therapy is usually performed through three outpatient visits.

The treatment by gravity for better control: A phased approach

Your treatment should be flexible and based on the changes in their symptoms. Your doctor should ask about your symptoms at each visit. Based on signs and symptoms, your doctor may adjust your treatment accordingly.

For example, if your asthma is well controlled, your doctor may prescribe less medication. If your asthma is not well controlled, or is getting worse, your doctor may increase the medication and recommend more frequent visits.

Asthma action Plan

Work with your doctor to create an asthma action plan that are described in the scripture when you take certain medicines or when to increase or decrease the dosage of medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them.

Your doctor may also recommend you track your asthma symptoms, or the use of a peak flow meter on a regular basis to monitor the effectiveness of your treatment is to control your asthma.

Lifestyle and home remedies

Although many people with asthma rely on medications to prevent and alleviate the symptoms, you can do several things on your own to maintain your health and reduce the chance of asthma attacks.

Avoid the triggers

Take steps to reduce your exposure to asthma triggers is a key part in the control of asthma. To reduce your exposure, you must:

  • Use your air conditioner. Air conditioning reduces the amount of air pollen from trees, grasses and weeds that finds its way into the interior. The air conditioning also reduces the humidity in the interior and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep windows closed during pollen season.
  • Decontaminate your decor. Minimize dust, which may make symptoms worse night for the replacement of certain elements in their bedroom. For example, encase pillows, mattresses and box springs in dust covers. Avoid the use of down-filled pillows and blankets. Throughout the house, remove carpet and install wood or linoleum. Use washable curtains and blinds.
  • To maintain the optimal moisture. If you live in a humid climate, talk with your doctor about the use of a dehumidifier.
  • Avoid mold spores. Clean damp areas in the bath, the kitchen and around the house to keep mold spores from developing. Get rid of mold and mildew on the leaves or the humidity of wood in the yard.
  • Reduce pet dander. If you are allergic to the dander, avoid pets with fur or feathers. Have pets regularly bathed or groomed it also can reduce the amount of dander in your surroundings.
  • Clean regularly. Clean your home at least once a week. If you're going to pick up the dust, wear a mask or have someone else do the cleaning. Wash bedding regularly.
  • Cover your mouth and nose if it's cold. If your asthma is made worse by cold or dry air, use a face mask can help.

Stay healthy

Take care of yourself can help to keep the symptoms under control, including:

  • Get regular exercise.Having asthma does not mean that you have to be less active. Treatment can prevent asthma attacks and control symptoms during the activity. Regular exercise can strengthen the heart and lungs, helping to relieve the symptoms of asthma. If you exercise in cold temperatures, wear a mask to warm the air that you breathe.
  • Maintain a healthy weight. Being overweight can worsen asthma symptoms, and puts you at higher risk of other health problems.
  • The Control of heartburn and gastroesophageal reflux disease (GERD). It is possible that the acid reflux that causes heartburn can damage lung airways and worsen the symptoms of asthma. If you have frequent or constant heartburn, talk with your doctor about treatment options. You may need treatment for GERD before your symptoms improve.

Get regular exercise. Having asthma does not mean that you have to be less active. Treatment can prevent asthma attacks and control symptoms during the activity.

Regular exercise can strengthen the heart and lungs, helping to relieve the symptoms of asthma. If you exercise in cold temperatures, wear a mask to warm the air that you breathe.

Alternative medicine

Certain alternative treatments that can help with the symptoms of asthma. However, keep in mind that these treatments are not a replacement for medical treatment, especially if you have severe asthma. Talk with your doctor before taking any herb or supplement, as some may interact with other medicines that you take.

In most cases, more research is needed to see how well the alternative remedies work, and measure the extent of possible side effects. Alternative asthma treatments include:

  • Breathing exercises. These exercises can reduce the amount of medication you need to keep your symptoms under control.
  • Herbal and natural remedies. A couple of herbs and natural remedies that can help to improve the symptoms of asthma include black seed, caffeine, choline and pycnogenol.

Coping and support

Asthma can be difficult and stressful. Sometimes, you may be frustrated, angry, or depressed because you need to reduce your regular activities to avoid environmental triggers. You can also feel confined or embarrassed by the symptoms of the disease and for complicated management routines.

But asthma doesn't have to be a limiting condition. The best way to overcome anxiety and a feeling of powerlessness is to understand your condition and take control of your treatment. Here are some suggestions that may help:

  • A rhythm. Take breaks between tasks, and avoid activities that worsen symptoms.
  • Make a list of tasks. This can help you avoid feeling overwhelmed. Reward yourself for achieving goals simple.
  • Talk with other people with your condition. Chat rooms and message boards on the internet or support groups in your area, you can connect with people who face similar challenges and to let you know that you're not alone.
  • If your child has asthma, be encouraging. Focus on the things your child can do, not on the things that he or she may not. Involve teachers, school nurses, coaches, friends and family to help your child control asthma.

Preparing for your appointment

It is likely to start by seeing your family doctor or a general practitioner. However, when you call to schedule an appointment, you may be referred to an allergist or pulmonologist.

Because appointments can be brief, and because there is often a lot of ground to cover, it is a good idea to be well prepared. Here's some information to help you prepare for your appointment, as well as what to expect from your doctor.

What you can do

These steps can help you get the most out of your appointment:

  • Write down the symptoms you are experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Note when your symptoms bother you more. For example, write if your symptoms tend to get worse at certain times of the day, during certain seasons of the year, or when they are exposed to cold air, pollen, or other triggers.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking.
  • Have a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their doctor.

Your time with your doctor is limited, so preparing a list of questions will help you to make the most of your time together. A list of questions from most important to least important in case time runs out. For asthma, some basic questions to ask your doctor include:

  • Asthma is the most likely cause of my breathing problems?
  • Other that the most likely cause, what are other possible causes of the symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best treatment?
  • What are the alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • What are your symptoms?
  • When did you first notice your symptoms?
  • How severe are the symptoms?
  • Do you have trouble breathing most of the time or only at certain times or in certain situations?
  • Do you have allergies such as atopic dermatitis or hay fever?
  • What, if anything, appears to worsen your symptoms?
  • What, if anything, seems to improve your symptoms?
  • Do allergies or asthma in your family?
  • Do you have any chronic health problems?
Symptoms and treatment of Asthma