Imagine breathing through a straw. Now imagine you are running or very stressed and trying to breathe through this straw. This is what millions of people with asthma experience when they experience an asthma “attack,” or an asthma attack.
But what exactly is asthma?
Asthma is a chronic condition that affects your airways as they narrow and swell and sometimes fill with mucus. The word “asthma” comes from the Greek word “aazein,” which means “to gasp with one’s mouth open”—a good addition considering how the disease affects breathing.
Asthma symptoms
Asthma symptoms vary from person to person and can also change, sometimes making diagnosis difficult.
Symptoms of asthma can include:
- shortness of breath
- Tightness or pressure in the chest
- Wheezing (whistling sound when exhaling)
- Shortness of breath, coughing or wheezing when falling asleep
- Coughing or wheezing that gets worse with a cold or respiratory virus
Signs that asthma is getting worse include:
- More common symptoms
- Lower readings on a peak flow meter, which measures how much air your lungs can push out
- Requires emergency medication more often
If symptoms progress to the point where you can no longer breathe or speak without gasping for air, it is a medical emergency. Call 911 immediately.
Asthma types and severity
Asthma ranges from mild to life-threatening and can get better or worse over time.
Doctors classify asthma cases based on the frequency and severity of symptoms:
- Mildly intermittent: Symptoms occur no more than two days a week or two nights a month
- Mildly persistent: Symptoms more than twice a week, but not every day
- Moderately persistent: Symptoms occur daily and more than one night per week
- Severe and persistent: Symptoms last most of the day, almost every day and often at night
There are also different types of asthma:
- Allergic: Associated with inhaled allergens such as pollen, dust or animal dander
- Exercise-Induced: Triggered by physical activity
- Cough variant: Cough is the main or only symptom
- Occupational: Caused by triggering substances at work
- Nocturnal: Symptoms occur primarily at night
- Aspirin-induced: Triggered by aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Steroid resistant: Does not respond to standard steroid treatments
Asthma risk factor and triggers
Anyone can get asthma, but it usually occurs more often. You may be at higher risk of having asthma if you:
- Do you have a parent with asthma?
- You have allergies such as allergic rhinitis (also called hay fever) or allergic diseases such as eczema (atopic dermatitis)
- Are exposed to dust, chemical fumes or mold when working
- Do you smoke cigarettes or are exposed to secondhand smoke?
- Live in areas with high air pollution
- Living with overweight or obesity
Triggers for a seizure are anything that triggers a response from your respiratory system. You can be allergic or non-allergic.
The most common allergic triggers include:
- Dust
- Animal hair
- pollen
- Mold
- Food allergies
Common non-allergic triggers include:
- Smoke, smog and air pollution
- Exercise
- Respiratory tract infections
- Cold air
- Changes in weather
- Perfumes, cleaning products and other scented products
- Intense emotions
Although intense emotions can trigger an asthma attack, that doesn’t mean that asthma is “all in the head,” as many people once believed. Laughing, crying, and other emotions can cause the muscles in your body, including the muscles around your airways, to spasm.
Who you are and where you live also influences asthma risk and asthma control. Black, Hispanic and Indigenous populations in the U.S. have higher rates of asthma, more emergency room visits and hospitalizations, and often greater difficulty accessing doctors and medications compared to whites.
People in lower-income neighborhoods may be exposed to more indoor and outdoor pollution, moisture, mold and pests.
Diagnose asthma
To receive an asthma diagnosis, you will undergo a physical exam and answer questions about your symptoms and family history. Your doctor will then carry out some tests.
The most common asthma test is spirometry, which measures how much air you can breathe in and blow out quickly. If your doctor suspects an allergy, you may be given an allergy test. If you experience symptoms while exercising, you may be given an exercise test, such as: B. walking on a treadmill or climbing stairs. Another possible test for exercise-induced asthma is the methacholine challenge test, which involves inhaling medication and repeating spirometry to see how your airways responded to the medication.
Asthma treatment and management
People with mild or well-controlled asthma are usually cared for by their primary care doctor. People with more complex, uncontrolled or severe asthma may be referred to a pulmonologist (lung doctor) and possibly an allergist.
There is no cure for asthma, but most people can control symptoms with medication and lifestyle changes to avoid triggers.
Asthma medications are usually divided into two groups: quick relief (rescue) medications and long-term prevention (control) medications.
Quick relief medications are usually inhalers, which work quickly and relax your airways. They may contain corticosteroids (steroids) to reduce inflammation, bronchodilators to widen the airways, or both. If inhalers do not control your symptoms, you may need oral corticosteroids such as prednisone or, in severe cases, intravenous corticosteroids.
Steroids can be life-saving, but they can also cause serious side effects such as high blood pressure, bone loss (osteoporosis), and a higher risk of infections if used too often or for a long time. To reduce this risk, your doctor may prescribe preventative medications if you suffer from frequent asthma attacks.
Long-term control medications, also called maintenance medications, help reduce the number of asthma attacks. However, they do not work as emergency medications because they take some time to take effect and must be taken regularly, even if no symptoms occur.
Long-term control medications typically include inhaled corticosteroids and long-acting bronchodilators.
Other options include leukotriene modifiers (pills), older drugs like theophylline, and newer biologic drugs. Biologics can be given as injections or infusions and used as adjunctive treatment for some people with moderate to severe asthma whose symptoms remain uncontrolled despite treatment.
Living well with asthma
When well controlled, most people with asthma can lead full lives and work, exercise, and carry out their usual activities.
Key steps to keep your asthma under control include:
- Take preventative medications exactly as directed
- Keep rescue inhalers nearby and use as directed
- If possible, avoid known triggers
- Stay up to date on recommended vaccinations, such as: B. the flu vaccination, up to date
- Regular visits to your doctor
It is important to talk to your doctor if you experience new or worsening symptoms. You may need to adjust your treatment plan.
This educational resource was created with support from Sanofi and Regeneron.
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