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
pallor (pale skin) and sweating
panic and anxiety
blue lips and fingernails
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
Although the causes of asthma are not clear, it is known that asthma is triggered by several factors. 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
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 the smooth muscles 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 are Omalizumab and Immunotherapy
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.