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Everything You Need to Know about Asthma

Asthma is a common respiratory problem that makes it hard to breathe.

If you have asthma, you are not alone. More than 25 million people in the United States have this breathing condition, according to the National Institutes of Health, and about 7 million of those who have asthma are children.

If you have asthma, your airways (the tubes that carry air in and out of your lungs) are prone to become inflamed. This is usually a consequence of a trigger such as inhaling smoke, exposure to dust or other allergens, or exercising in the cold air or after a respiratory illness. Severe inflammation develops and causes an asthma attack. Symptoms of an asthma attack, also known as a flare-up or exacerbation, can be mild and go away on their own – or they can worsen into a life-threatening medical emergency.

During an asthma attack, you may experience tightness in your chest, shortness of breath, and coughing. Your cough may be worse early in the morning and at night. Asthma usually causes periods of wheezing, which is a whistling sound when you breathe, but some patients only experience a cough.  This is known as “variant asthma.”  Either way, these symptoms are the result of the inflammation causing narrowing of your airways.

When your airways become inflamed, muscles around your airways tighten. This narrows your bronchial tubes and prevents air from flowing into and out of your lungs easily. Additionally, during an attack, your airways produce more mucus, which is a thick and sticky liquid that can further narrow your airways. The tightening of the airway and buildup of mucus causes the symptoms of asthma.

Treatment and Management of Asthma

Asthma is a chronic disease, and while there is currently no cure for asthma, it tends to improve with age and many children with asthma will outgrow the disease altogether.

In the meantime, you can control symptoms through effective management and treatment which include avoiding asthma triggers and taking asthma medications as directed. Your doctor will prescribe medication to manage symptoms, and teach you how to use your medications properly.

Asthma Treatment

Treatment of Asthma usually involves 2 types of medication and avoidance of triggers.  The Two types of medications are:  1) long-term control medications and 2) quick-relief drugs.

Long-term control medicines are usually taken daily and help reduce airway inflammation to decrease the risk of an asthma attack. Inhaled corticosteroids are the preferred medication for long-term control of asthma and are usually quite effective. However, your doctor may need to increase the dosage of your long-term control medicine, or add other types of long-term control medications, if the usual steroids do a poor job of controlling the number and severity of your asthma attacks.

Quick-relief drugs, also known as rescue medications, reduce swelling and mucus production associated with asthma attacks. Allergists often prescribe inhaled short-acting beta2-agonists for quick relief from asthma symptoms. These rescue drugs relax tight muscles and open up your airways during flare-ups.

Sometimes, all that is needed is avoidance of triggers.  Triggers are environmental exposures that increase inflammation and symptoms.  Some triggers that can be avoided include indoor and outdoor allergens, pets, smoke, chemical fumes, exercise (especially in cold air) and even strong odors.

When to See a Doctor

If you have symptoms consistent with asthma but have not been diagnosed, see your doctor.

If you have already been diagnosed with asthma, call your doctor if your rescue medications do not stop an asthma attack or you feel your attacks are too frequent or severe.

Severe attacks should not wait for a routine visit to your doctor but should be seen and treated right away.  Some situations that should lead you to seek emergency care are:

  • Severe difficulty breathing or if you have trouble walking and talking because you cannot breathe.
  • The need to use your rescue inhaler more than once every 2 hours
  • A fever of above 100.5 F during an attack
  • Production of bloody mucus from a cough
  • Any chest pain
  • Persistent, or recurrent symptoms after finishing an oral steroid such as prednisone
  • If you have ever required admission to the hospital due to a severe attack or make frequent visits to the ER due to severe attacks