Asthma
What is Asthma?
Asthma is a chronic disease in which the lungs (bronchi and bronchioles) become inflamed and swollen and produce extra mucus. Episodes of asthma (known as attacks) occur when the airways narrow, making it difficult to breathe. Factors in the environment (indoors and outdoors) called triggers can make asthma symptoms worse. BACK TO TOP
Symptoms
There are a lot of unknowns about asthma, such as what exactly causes it, and why some people have it and others don't. Asthma cannot be cured, but asthma symptoms can be controlled. You can prevent symptoms from happening or keep symptoms from getting worse once they occur by regularly taking your prescribed medications and closely following your prescribed management plan.
You may have all of these symptoms, some of them, or just one. Asthma symptoms are recurrent and can be mild or severe.
- Wheezing (a whistling or hissing sound as you breathe)
- Shortness of breath
- Feelings of tightness in the chest (like someone is squeezing your chest)
- Coughing
Triggers of Asthma
Some of the most common triggers that can make asthma symptoms worse include the following:
Allergens, such as pollen, mold, animal dander (fine scales from the skin or feathers of pets and other animals), dust mites, or cockroaches. Viral infections of the respiratory tract Irritants, such as strong odors or sprays, chemicals, air pollutants, or changing weather conditions Tobacco smoke or wood. BACK TO TOP
Treatment and Prevention
The factors that can cause asthma symptoms can be different for each person with asthma. It is best to work with your doctor to come up with an individualized asthma management plan that tells you what medications to take and when to take them. Following your prescribed management plan at all times is important to prevent or reverse asthma symptoms. It may take some time working with your doctor to figure out what triggers your asthma symptoms, how to avoid the triggers, and what medications work best for you. See your doctor regularly to check your asthma and review your treatment. BACK TO TOP
Understand Your Condition
- If you have asthma, you may experience wheezing, shortness of breath, a feeling of tightness in your chest or a persistent cough, especially at night or early in the morning.
- These breathing problems are caused by conditions in the airways of your lungs.
- Inflamed or swollen lining that produces a thick mucus that may clog the airways.
- Muscle spasms that constrict and narrow the airways.
- Sensitivity to common allergens like pollen, dust mites, mold, mildew, animal dander or irritant triggers such as tobacco smoke and pollution in the air.
- Irritation of the airways by asthma triggers such as colds, sinus infections, cold air and even heavy breathing during exercise.
- During an asthma attack, inflamed airways become increasingly constricted, making it difficult, sometimes impossible, to breathe. The information in this brochure can help you breathe easier and live a fuller, more symptom-free life by showing you how to control your asthma and the inflammation of your airways.
Early Diagnosis, Proper Treatment, Ongoing Monitoring and Self-Management
Many of the 14 million to 15 million Americans who suffer from asthma make unnecessary lifestyle compromises to accommodate their disease. Asthma also can be deadly: an estimated 5,000 people die each year. Underdiagnosis and improper treatment are major contributors to these alarming statistics.
While there is yet no cure for asthma, it can be controlled with an accurate diagnosis, the right treatment and ongoing monitoring by you and your physician.
Early diagnosis. Your asthma may be diagnosed by your personal or family physician, or by an asthma specialist such as an allergist. The important thing is that the symptoms of asthma be recognized early and dealt with effectively. The longer you wait, the more permanent may be the damage to your lungs.
Because symptoms vary widely from patient to patient, it is essential that your doctor determine the severity of your asthma to develop the best plan to treat it. The new guidelines classify asthma into four categories: mild intermittent, mild persistent, moderate persistent and severe persistent. BACK TO TOP
How severe are your asthma symptoms?
The frequency and intensity of your asthma attacks and symptoms will help your doctor determine the severity of your asthma. Describe your asthma as it would be without treatment or medications by answering these questions. BACK TO TOP
Mild Intermittent. Do You...
- Experience symptoms twice a week or less, and nighttime symptoms twice a month or less?
- Have attacks which are brief, lasting from a few hours to a few days with the intensity of the attack varying?
- Experience no symptoms between attacks?
Mild Persistent. Do You...
- Experience symptoms more than twice a week but less than once a day, and nighttime symptoms more than twice a month?
- Have attacks which sometimes affect your activity?
Moderate persistent. Do You...
- Experience symptoms daily, and nighttime symptoms more than once a week?
- Use an inhaled short-acting beta2-agonist daily?
- Change your daily activity because of your asthma?
- Have attacks which occur twice a week or more and may last days?
Severe Persistent. Do You...
- Experience frequent attacks?
- Have continual daytime symptoms and frequent nighttime symptoms?
- Have attacks which cause you to limit your activity?
Proper Treatment
Once asthma is diagnosed, aggressive treatment is recommended to gain quick control of your asthma. Regardless of the severity of your condition, the goals of asthma treatment are the same: control of your symptoms and a normal lifestyle. You and your doctor will work together to develop a treatment plan that:
- Ends the coughing, wheezing and breathlessness, especially at night and in the morning.
- Enables you to participate in all normal activities including exercise.
- Avoids emergency room visits or hospitalizations.
- Avoids the possible side effects of asthma medication.
- Meets your goals for a good quality of life.
Often the most effective and fastest way to bring asthma under control is to reduce your exposure to whatever is triggering the asthma. Avoidance and environmental control should be the first consideration in an overall treatment plan.
When allergy triggers cannot be avoided, immunotherapy or allergy desensitization shots may be considered. Immunotherapy is especially helpful when symptoms occur year-round or during a majority of the year, or when it is difficult to control symptoms with medication.
Asthma medications also play an important role in asthma therapy. No matter how severe your asthma, a quick-relief medication such as a short-acting rapid-onset inhaled beta2-agonist bronchodilator must be readily available for treatment of acute attacks. If your asthma is more than mild and intermittent, a preventive anti-inflammatory medication should be used on a regular basis.
Ongoing monitoring. Regular visits with your doctor to monitor your condition will help you meet your treatment goals. During your visits, the doctor will review your asthma symptoms, activities and medications. Between visits, you'll likely be using a peak flow meter to monitor the health of your lungs. Close monitoring of your condition will help you and your doctor determine if any changes in your treatment are necessary.
Education and self management. Research has shown that the more you learn and know about your asthma and medications to treat it, the better you'll be able to work with your doctor to control your asthma. BACK TO TOP
Understand How Medication Controls and Prevents Your Symptoms
Today, effective medications are available for the treatment of asthma. The new guidelines recommend a stepwise approach to using these medications with the type and amount determined by the severity of your condition. When your asthma is worse, you increase or step up your medication, and when your asthma is under control, you often can decrease or step down your medication. Always consult your doctor before making any change in prescribed medications. BACK TO TOP
There Are Two Types of Asthma Medications: Long-Term Control and Quick-Relief Medications.
Long-term control medications are preventive, taken daily and can achieve and maintain control of asthma symptoms. Examples include inhaled or systemic corticosteroids, cromolyn sodium and nedocromil, long-acting beta2-agonist bronchodilators, methylxanthines and leukotriene modifiers.
Quick relief medications are used to treat asthma attacks. They relieve symptoms rapidly and are taken on an as-needed basis. Quick-relief medications include short-acting, rapid-onset inhaled beta2-agonist bronchodilators, anticholinergics and systemic corticosteroids.
Since inflammation of the lungs and airways plays a critical role in asthma, the most effective medications for long-term control have anti-inflammatory effects. Inhaled corticosteroids are the most potent and effect anti-inflammatory medications for mild, moderate or severe persistent asthma. Taken early and as directed by your doctor, these well-tolerated and safe medications can improve asthma control, normalize lung functions, and possibly prevent irreversible injury to your lung airways. BACK TO TOP
When to See an Asthma Specialist
- An allergist can help you to learn more about your asthma and help you develop a treatment plan to prevent your symptoms.
- The new asthma guidelines recommend that you see an asthma specialist such as an allergist if you have difficulty achieving or maintaining control of your asthma. You should seek specialist care if:
- You have had a life-threatening asthma attack.
- You are not meeting the goals of your asthma therapy after three to six months of treatment, or your doctor believes you are not responding to current therapy.
- Your symptoms are unusual or difficult to diagnose.
- You have other conditions such as severe hay fever or sinusitis that complicate your asthma or your diagnosis.
- You need additional diagnostic tests to determine the severity of your asthma and what causes your asthma symptoms.
- You require additional education or guidance on the complications of therapy, adhering to your treatment plan or avoiding asthma triggers.
- You are a candidate for immunotherapy.
- You have severe persistent asthma.
- You require continuous oral corticosteroid therapy or high-dose inhaled corticosteroids, or have taken more than two bursts of oral corticosteroids in one year.
- Children under 3 with moderate or severe asthma, or children who are beginning daily long-term therapy, also should see an asthma specialist.
Partner With Your Doctor to Manage Your Asthma
People who participate in managing their own health tend to be healthier. This is especially true for people with asthma.
The best partnership of patients and physicians have open and frequent communication for review and adjustment of treatment plans to fit your needs according to your individual goals and expected outcomes. The treatment plan may involve your family, employer or school, as appropriate. BACK TO TOP
Remember
- Seek early and accurate diagnosis.
- Work with your family physician or allergist to develop a written, daily action plan for managing asthma attacks.
- Control your environment.
- Avoid your known asthma triggers.
- Adhere to the medication plan prescribed by your physician.
- Communicate with your physician or allergist.
- Monitor your response to treament.