What is asthma?

Asthma is a chronic health condition that affects the airways of the lungs (bronchioles) making it difficult to breathe. The bronchioles are affected in three ways:

  • The bronchioles become irritated and swollen restricting the flow of air.
  • The bronchioles become narrower.
  • Excessive secretions. The bronchioles produce more sticky mucus.

When these things happen, it’s called an asthma attack and can be triggered by a variety of things. An asthma attack can get worse very quickly and needs immediate treatment. Signs of an asthma attack include:

  • severe wheezing (noisy breathing) and rapid breathing
  • severe cough
  • difficulty talking
  • pallor (pale skin) and sweating
  • panic and anxiety
  • blue lips and fingernails
  • chest pain

Asthma usually starts in childhood and may go away on its own or continue into adulthood.

It is a common condition that affects around 25 million Americans and leads to almost 1.6 million ER admissions every year. Asthma, however, is a treatable condition and many people with asthma live normal healthy lives.

Types of asthma

Asthma broadly falls into two types.

Allergic asthma is triggered by allergens in the environment such as pollen, pet dander, and mold.

Non-allergic asthma is triggered by other factors like exercise, stress, illness, or cold air.

What are the symptoms of asthma?

Asthma symptoms range from very mild to life-threatening.

Symptoms can vary a lot from person to person, but common symptoms include:

  • wheezing, (noisy breathing with a whistling/ rattling sound)
  • coughing, particularly at night
  • pain or pressure in the chest
  • difficulty breathing and shortness of breath
  • feeling tired or weak when exercising
  • signs of allergy such as runny nose, sneezing, itchy eyes, headache, blocked nose, and sore throat

What causes asthma?

The exact causes of asthma are not known, but certain factors are thought to increase the risk of developing asthma. They include:

  • environmental factors like second-hand smoke, pollutants, and exposure to viruses in infancy
  • people with allergies such as atopic dermatitis (a skin condition) and hay fever are more likely to develop asthma
  • some respiratory infections (infections that affect the lungs) can damage a baby`s developing lungs and increase the likelihood of developing asthma
  • genetic factors. Asthma often runs in families
  • lifestyle factors like smoking and being overweight

Asthma triggers

Although the causes of asthma are not clear, it is known that asthma is triggered by a number of things. Common triggers include:

  • allergens like pollen, mold, pet dander, and dust mites
  • respiratory infections like colds and flu
  • breathing cold, dry air
  • stress and strong emotions
  • certain foods and medications
  • cigarette smoke
  • some chemicals like perfume, strong adhesives, and cleaning products

How is asthma treated?

There are two main types of asthma treatment; those that prevent asthma attacks from happening and those to take if you have an asthma attack. Your doctor will devise a treatment plan for you depending on the type of asthma you have, how severe it is, and how you respond to other treatments. It is also important that you learn to recognize the symptoms of an asthma attack and know when to call for emergency assistance.

Medications used to treat asthma

Asthma medications fall into two types. Long-term preventative medications and fast-acting “rescue” treatments. They are taken as an inhaler, a nebulizer, or in tablet or liquid form.

Preventive treatments need to be taken every day to prevent asthma attacks. They work by reducing inflammation and mucus production and relaxing smooth muscle in the airways making it less likely that you will react to triggers. They include:

  • inhaled corticosteroids like beclomethasone, budesonide, ciclesonide, fluticasone, and mometasone work by reducing inflammation in the airways. If inhaled corticosteroids are not effective, corticosteroids may be prescribed in tablet or liquid form.
  • inhaled long-acting beta antagonists like formoterol, salmeterol, and vilanterol open the airways by relaxing smooth muscle
  • Biologics work by targeting cells to reduce inflammation and are given as an injection or infusion every few weeks. They include benralizumab, dupilumab, mepolizumab, omalizumab, and reslizumab.
  • Leukotriene modifiers like montelukast, zafirlukast, and zileuton come in pill or liquid form and work by relaxing smooth muscle
  • Cromolyn is an inhaler that prevents your airways from reacting to triggers
  • Theophylline also works by relaxing smooth muscle
  • Long-acting bronchodilators like tiotropium work by opening the airways and can be used in addition to corticosteroids if needed.

Short-term treatments are used to treat symptoms of an asthma attack. They should only be used when needed. If you find yourself using short-term treatments every day, or more often than normal, you should talk to your doctor. Short term treatments include:

  • Beta-agonists like albuterol, epinephrine, and levalbuterol are given as an inhaler and work by relaxing the smooth muscle in the airways
  • Anticholinergics like ipratropium work by reducing the production of mucus in the airways
  • Oral corticosteroids like prednisone reduce inflammation in the airways
  • Combination treatments reduce inflammation, relax smooth muscle, and reduce mucus production

Treatment for allergy-induced asthma

If your asthma is triggered by allergies, you may be given medication to increase your tolerance to allergens and reduce allergic reactions. Examples of these treatments Omalizumab and Immunotherapy

 Alternative treatments

In addition to taking medication, some complementary treatments have been found to be beneficial in people with asthma. It is important that you discuss any additional treatments with your doctor before you start taking them, and always continue taking your regular medication as prescribed. Some things that may help are:

  • avoiding triggers. Where possible, try to avoid things that are known to trigger your asthma
  • breathing exercises. Recent studies have shown that breathing exercises when combined with taking prescribed medications, can reduce symptoms of asthma
  • herbal remedies such as turmeric, ginseng, garlic, some Chinese herbs, black seed, and honey have shown some beneficial effects
  • caffeine has been shown to reduce symptoms in some people with asthma but be sure to stick to a safe amount

Can asthma be cured?

Asthma is a chronic (long-term) condition that cannot be cured, however with effective treatment it can be controlled, and its effects minimized allowing people with asthma to live normal, healthy lives.

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