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Asthma

Definition:
Asthma is inflammation and narrowing of the airways (called the bronchial tubes).

Causes:
The cause of asthma is not known. It does seem to run in some families. Possible triggers of an asthma attack in a person with asthma include:

  • Exercise
  • Cold weather
  • Viral illness
  • Sinusitis
  • Gastroesophageal reflux disease (GERD)
  • Sulfites 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
Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.
  • Living in a large urban area
  • Regularly breathing in cigarette smoke (including second-hand smoke)
  • Regularly breathing in industrial or agricultural chemicals
  • A parent who has asthma
  • History of multiple respiratory infections during childhood
  • Low birth weight
  • Being overweight
  • GERD
Symptoms:
Symptoms include:
  • Wheezing
  • Tightness in the chest
  • Trouble breathing
  • Shortness of breath
  • Cough
  • Chest pain
Diagnosis:
The doctor will ask about your symptoms and medical history and perform a physical exam:

Tests may include:

Peak Flow Examination – blowing quickly and forcefully into a special instrument that measures your output of air

Pulmonary Function Tests (PFTs) – breathing into a machine that records information about the function of your lungs

Methacholine Provocation Test – lung function tests performed after taking a small dose of methacholine, which causes narrowing of the airways in susceptible people; helps confirm asthma in unclear cases

Allergy Tests – usually skin or sometimes blood tests to find out if allergies are causing your symptoms

Treatment:
Asthma is treated with medication. Often, you'll need to take more than one type of medication.

Asthma medications include:

Quick-Acting Inhaler (such as albuterol) – relaxes your airways so that they become wider again. These are used to stop an acute episode of asthma, or "asthma attack." (also called a rescue inhaler)

Long-Acting Inhaler (such as salmeterol) – used daily to prevent asthma attacks. This inhaler should not be used to try to stop an asthma attack in progress. A recent study showed that long-acting inhalers, like salmeterol, may increase the risk of a life-threatening asthma attack and asthma-related death if taken for more than three months * If you have any concerns, be sure discuss them with your doctor.

Steroid Inhaler – used daily to reduce inflammation in your airways. These types of inhalers should not be used to try to stop an asthma attack in progress.

Cromolyn Sodium or Nedocromil Sodium Inhaler – used daily to prevent asthma flare-ups. These may also be used just before exercise, if you have exercise-induced asthma. These types of inhalers should not be used to try to stop an asthma attack in progress.

Zafirlukast, Zileuton, and Montelukast – pills taken daily to help prevent asthma attacks

Corticosteroids – pills, injections, or intravenous (IV) medications given to treat an acute flare-up of symptoms. You may also take corticosteroid pills for a longer period of time if you have severe asthma that isn't responding to other treatments.

Theophylline – pills taken daily to help prevent asthma attacks

Epinephrine – a shot given to stop an asthma attack

Prevention:
There are no guidelines for preventing asthma because the cause is not known. However, you can help prevent asthma attacks by avoiding substances that trigger asthma attacks. Some general guidelines include:
  • Keep windows closed.
  • Consider getting HEPA filters for your heating/cooling system and your vacuum cleaner.
  • Keep the humidity down in your house.
  • Avoid strenuous outdoor exercise during days with high air pollution, a high pollen count (if you’re allergic to pollens), or a high ozone level.
  • Get a yearly flu shot.
  • Don't smoke.
  • Avoid breathing in chemicals or second-hand smoke.
  • Don't use a wood-burning stove regularly.
  • Consider getting allergy shots, if allergies trigger your asthma attacks.
  • Talk to your doctor about an appropriate level of exercise for you.
  • Talk to your doctor about how to track your asthma, so you can identify and treat flare-ups immediately.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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