What is Asthma?

Asthma is a chronic respiratory condition that causes inflammation and narrowing of the airways. It affects more than 25 million people in the United States alone and can have a significant impact on daily activities. Although asthma cannot be cured, it can be effectively managed through various treatments. The key to managing asthma is to identify triggers that can cause asthma symptoms to flare up and work with your doctor to develop a plan to avoid and manage them.

Asthma Explained

Asthma is a respiratory disease that affects the airways in the lungs. This chronic condition causes inflammation in the bronchial tubes, which leads to symptoms such as chest tightness, shortness of breath, wheezing, and coughing. While the cause of asthma isn’t fully understood, it is known that several factors can contribute to its development, including genetics, environmental factors, and respiratory infections. Certain triggers such as dust, pollen, exercise, and cold air can also cause asthma symptoms. A doctor can diagnose asthma through various tests, including a physical exam, lung function tests, and medical history review. If left untreated, asthma can lead to complications such as respiratory failure and even death. Individuals with a history of asthma, allergies, or a family history of respiratory diseases are at higher risk of developing asthma, but the condition can affect anyone. While there is no cure for asthma, treatment options such as rescue inhalers and long-term control medications can help manage symptoms and prevent asthma flare-ups. Proper management and prevention of asthma attacks are essential for living an active life with this chronic condition.

Symptoms

Asthma symptoms can range from mild to severe, with varying degrees of intensity depending on the individual. Common symptoms include chest tightness, shortness of breath, wheezing, and coughing. However, not everyone with asthma experiences these symptoms, and some may have other lesser-known signs.

Less common symptoms of asthma include difficulty exercising, fatigue, trouble sleeping due to coughing or wheezing, and rapid breathing. The severity of asthma symptoms can vary greatly from person to person. Some individuals may have mild symptoms and only experience occasional asthma episodes, while others may have severe, life-threatening asthma attacks.

Respiratory infections, allergies, and exposure to environmental triggers such as secondhand smoke, dust mites, and pollution can exacerbate asthma symptoms. When left unmanaged, these triggers can lead to an asthma flare-up, which can cause a rapid and severe worsening of asthma symptoms.

Potential exacerbating factors of asthma to look out for include an increase in coughing or wheezing, difficulty breathing, chest tightness, and shortness of breath, particularly during times of physical activity. It’s important to know the warning signs of a potential asthma attack so that medical assistance can be sought if needed. Some individuals may not experience any noticeable symptoms until they have a severe asthma attack. Therefore, it’s crucial for individuals with a history of asthma to be vigilant about monitoring their symptoms and seeking medical attention if any changes or unusual symptoms arise.

Causes

The exact cause of asthma is still unknown, but it’s believed that both genetic and environmental factors are contributing factors. While some individuals may inherit genes that make them more susceptible to developing asthma, others may develop it due to exposure to environmental factors that irritate the airways. Exposure to irritants like smoke, air pollution, and chemicals can also cause or worsen asthma symptoms.

Having allergies or a family history of asthma or allergic diseases can increase the risk of developing the condition. If one or both parents have asthma, their child is more likely to develop it. Similarly, individuals who have other allergic conditions such as eczema or hay fever are also at an increased risk of developing asthma.

Triggers

With continued patient education and awareness of asthma triggers, patients can take proactive steps to minimize the likelihood of an asthma attack. Asthma triggers are defined as any factors that can cause asthma symptoms, and they vary from person to person. The triggers for asthma can be broadly classified into different categories–pollutants, allergens, respiratory infections, physical and mental stress, and climate.

Air pollutants, such as exhaust fumes, smoke, and smog, can irritate the lungs and trigger asthma symptoms. These irritants can irritate the airways and trigger inflammation, leading to coughing, wheezing, and shortness of breath. Similarly, exposure to allergens such as dust mites, pet dander, mold, and pollen can also trigger asthma. These allergens can cause an allergic reaction in the airways, leading to inflammation and tightness in the chest.

Respiratory infections caused by viruses or bacteria can also trigger asthma symptoms. When an individual with asthma contracts a respiratory infection, the infection exacerbates preexisting asthma symptoms, leading to difficulty breathing, wheezing, and coughing. Physical and mental stress can also trigger asthmatic reactions in certain individuals. Exercise-induced asthma, for instance, is triggered by increased physical activity. Similarly, individuals with asthma may experience symptoms triggered by emotional stress.

Climate can also impact asthma symptoms. Dry, cold air can irritate the airways and trigger tightness in the chest. Hot and humid weather can exacerbate symptoms such as wheezing and shortness of breath.

Diagnosis

Diagnosing asthma can be challenging as it shares similar symptoms with other respiratory diseases. Doctors rely on a combination of factors to diagnose asthma accurately, including symptoms, medical history, potential triggers, and test results. All these factors are used to reach a conclusive diagnosis.

When diagnosing asthma, your doctor will typically begin by reviewing your medical history, including a family history of allergies and asthma. Your doctor will also ask about symptoms you may be experiencing. To assist your doctor in making an accurate diagnosis, it’s helpful to keep a log of symptoms, frequency, and potential triggers. This information is valuable in developing an appropriate treatment plan.

Your doctor may also perform tests to help diagnose asthma. These tests may include cough tests, lung function tests, spirometry, and fractional exhaled nitric oxide tests. Lung function tests measure how well the lungs are working, while spirometry measures how much air an individual can breathe in and out. Fractional exhaled nitric oxide tests measure the amount of nitric oxide in the breath, which is a marker for inflammation in the airways.

Asthma can be misdiagnosed as other respiratory diseases. Differential diagnosis is a process used by healthcare providers to distinguish asthma from other conditions with similar symptoms. It’s important to differentiate life-threatening asthma attacks from anaphylactic reactions, which share similar symptoms, including shortness of breath, chest tightness, and wheezing.

Complications

When left untreated or poorly managed, asthma can lead to a variety of potential complications that can significantly impact your quality of life. One of the main short-term complications of asthma is interference with daily activities. Asthma can cause chest tightness, coughing, wheezing, and shortness of breath, making it difficult to perform routine tasks like exercising or even walking up the stairs. It can also lead to work absenteeism during flare-ups.

If asthma is left untreated or improperly managed, it can cause long-term effects, including the permanent narrowing of bronchial tubes. Known as airway remodeling, this condition can make it even more challenging for air to pass through the bronchial tubes, leading to breathing difficulties and ultimately decreased lung function.

Complications from asthma can be severe and may require emergency care. In some cases, uncontrolled asthma can lead to serious respiratory complications that require hospitalization, specifically for severe asthma attacks. In severe cases where long-term medication use is necessary to manage asthma symptoms, prolonged use of medication can cause side effects, including headaches, an upset stomach, and trembling. Managing asthma with the help of healthcare providers is essential to minimize complications.

Risk factors

Although anyone can develop asthma, certain factors increase the chances of developing this respiratory disease. Knowing these risk factors can be helpful in understanding who is most at risk. Preventative measures can then be taken to manage or reduce the risk of asthma.

One major risk factor for asthma is smoking and exposure to secondhand smoke. Cigarette smoke contains hundreds of harmful chemicals that irritate the airways and lungs, making them more susceptible to respiratory problems. Exposure to secondhand smoke can be just as damaging, particularly for young children whose lungs are still developing.

Being overweight is another potential risk factor for asthma. Studies have found a correlation between obesity and an increased risk of respiratory conditions like asthma. This correlation may be due to the fact that excess weight places additional pressure on the lungs and airways, making them more prone to inflammation and respiratory distress.

Exposure to pollution or occupational triggers can also be a risk factor for asthma. Poor air quality, whether due to traffic emissions or industrial pollution, can irritate the airways and lead to respiratory disease. Additionally, individuals working in certain jobs that involve exposure to chemicals or dust may also be at higher risk.

Furthermore, a family’s history of asthma or having another allergic condition like atopic dermatitis or hay fever can also put one at risk. Genes can play a role in the development of asthma, so having a family member with the condition can increase your chances of developing it. Conditions like atopic dermatitis and hay fever are also often linked to asthma and can increase the likelihood of developing this respiratory disease.

Treatment and Management

While there is currently no cure for asthma, various treatment and management options are available to help control and prevent symptoms. It’s important for asthma sufferers to understand that asthma management is an active process that requires ongoing effort and commitment.

Treatment. One of the main types of medication prescribed by healthcare providers for asthma is inhaled corticosteroids. These medications are used as a preventative measure and work to reduce inflammation in the airways, which can help prevent asthma attacks. Other types of medication for asthma include rescue inhalers like albuterol, which can be used during an asthma attack to quickly relieve symptoms.

In addition to medication, conservative measures can be taken to manage asthma attacks and prevent disease progression. These measures include environmental control, such as reducing exposure to triggers like dust mites or pet dander, and weight reduction for those who are overweight or obese.

Management. The management of chronic asthma typically involves a five-step approach. The first step involves the use of an inhaled corticosteroid as a controller medication, with the addition of a rescue inhaler as needed. If symptoms persist, step two involves increasing the dose of the controller medication or adding a long-acting bronchodilator.

If symptoms continue to persist, steps three and four may involve the use of additional medication, such as biologics or leukotriene modifiers, and referral to a specialist for further treatment options. Step five involves the use of oral corticosteroids, which have the potential for more serious side effects and are typically used as a last resort.

In some cases, asthma attacks can be severe enough to require admission to the hospital. Indications for hospital admission may include severe symptoms that are not responding to medication, a significant drop in lung function, or a history of near-fatal asthma attacks. Treatment options in the hospital may include oxygen therapy, intravenous medications, and mechanical ventilation in cases of life-threatening or near-fatal asthma attacks.

How Asthma Affects Your Body

Asthma can affect people of all ages. It causes inflammation and narrowing of the airways, which can make it difficult to breathe. As a chronic respiratory disease, asthma can lead to asthma flare-ups and airway remodeling. By understanding how asthma affects the body, individuals with asthma can better manage their symptoms and prevent disease progression.

Asthma Flare-Ups

One of the biggest challenges for people with asthma is managing asthma flare-ups. These can happen suddenly and can be very scary, but there are steps that can be taken to recognize and manage them to prevent future attacks.

Signs of an Asthma Flare-Up. Also known as an asthma attack, an asthma flare-up can cause a range of symptoms from mild to severe. The most common symptoms include chest tightness, shortness of breath, wheezing, and coughing. It’s important to be aware of these symptoms and take action if they start to worsen.

Managing Asthma Flare-Ups. If you experience an asthma flare-up, use your quick-relief medication, also known as a rescue inhaler. This medication can help to quickly open up your airways and make it easier to breathe. Be sure to follow the instructions that come with your medication and don’t exceed the recommended dose.

In addition to using medication, it’s important to avoid triggers and monitor your symptoms. By identifying what triggers your asthma flare-ups, such as allergens, respiratory infections, physical activity, cold air, and air pollutants, you can take steps to avoid them. You can also use a peak flow meter to monitor your breathing and identify changes in your lung function. This tool can help you to track your symptoms and recognize when you need to take action.

Treatment Changes. If you experience frequent asthma flare-ups, it may be time to talk to your healthcare provider about a change in treatment. Changes may include adjusting your medication, adding new medications, or exploring other treatment options such as bronchial thermoplasty. By working closely with your healthcare provider, you can develop an asthma action plan tailored to your specific needs and manage your symptoms more effectively.

Airway Remodeling

Airway remodeling refers to the long-term changes that occur in the airways of individuals with chronic asthma. Over time, the continuous inflammation and damage to the airways can cause structural changes such as thickening of the airway walls, narrowing of the air passages, and lung scarring. These changes can negatively impact lung function, making it more difficult to breathe and increasing the risk of severe asthma attacks.

The causes of airway remodeling are not entirely understood, but it is known that prolonged and uncontrolled inflammation contributes significantly to this condition. The best way to prevent airway remodeling is to control your allergy symptoms. The fewer asthma symptoms you experience the less likely airway remodeling will occur. According to allergy specialists at Asthma Canada, some remodeled airways have been found to return to their normal structure when proper treatment is followed.

It all comes down to controlling your asthma and keeping it in check.

What is Asthma Control?

Asthma control refers to the degree to which asthma symptoms are successfully prevented or managed through appropriate medical treatment and self-management. The goal is to achieve a minimal need for quick-relief medication and to maintain normal daily activities, including exercise, without experiencing asthma symptoms.

Monitoring asthma symptoms is an essential part of managing asthma control. It involves tracking and recording asthma symptoms, peak flow readings, and medication use to help identify patterns and triggers that may provoke asthma flare-ups. By monitoring asthma symptoms regularly, individuals with asthma can work with their healthcare provider to adjust their medication and treatment plan accordingly to achieve optimal asthma control.

Why is My Asthma Worse at Night?

While asthma symptoms can occur at any time of the day, many people experience more severe symptoms at night. Several potential triggers can occur in the bedroom that may worsen asthma symptoms at night. Common triggers can include dust mites, pet hair, and mold. Keep the bedroom as clean and allergen-free as possible to reduce the risk of symptoms. Additionally, controlling asthma symptoms during the day can help minimize nighttime symptoms. Staying on top of your medication regimen and monitoring your asthma symptoms can help prevent flare-ups and reduce nighttime symptoms.

Sleeping positions can also affect breathing and worsen asthma symptoms. Lying flat on your back can make it more difficult to breathe. Sleeping on your side or with your upper body elevated can help reduce symptoms.

Some medications used to manage asthma symptoms can also have side effects that may disrupt sleep. For example, inhaled corticosteroids can cause hoarseness or a sore throat, while bronchodilators may cause jitteriness or tremors. Consult with your allergist about the timing of your medication and the best way to manage any side effects that may disrupt your sleep.

Preventive measures can be taken to manage nighttime asthma symptoms. Using allergen-proof bedding can help reduce exposure to dust mites. Keeping pets out of the bedroom or grooming them frequently can also help reduce exposure to pet hair and dander. Maintaining indoor humidity levels between 30 – 50 percent can help prevent mold growth.

Can Asthma be Cured?

Asthma cannot be cured but it can be effectively managed through various treatments. The key to managing asthma is to work with an allergist to identify triggers that can cause asthma symptoms to flare up and develop a plan to avoid and manage them.