An overview of Asthma

Asthma is a chronic lung disease affecting people of all ages. It is caused byinflammation and muscle tightening around the airways, which makes it harder to breathe.Asthma, also called bronchial asthma, is a disease that affects your lungs. It’s a chronic(ongoing) condition, meaning it doesn’t go away and needs ongoing medical management.Asthma affects more than 25 million people in the U.S. currently. This total includes morethan 5 million children. Asthma can be life-threatening if you don’t get treatment.

When you breathe normally, muscles around your airways are relaxed, letting air move easily and quietly.During an asthma attack, three things can happen:

Bronchospasm:The muscles around the airways constrict (tighten). When they tighten, it makes your airways narrow.Air cannot flow freely through constricted airways.

Inflammation:The lining of your airways becomes swollen. Swollen airways don’t let as much air in or out of your lungs.

Mucus production:During the attack, your body creates more mucus. This thick mucus clogs airways.

When your airways get tighter, you make a sound called wheezing when you breathe, a noise your airways makewhen you breathe out. You might also hear an asthma attack called an exacerbation or a flare-up. It’s the term for when your asthma isn’t controlled.

Asthma is broken down into types based on the cause and the severity of symptoms. Healthcare providers identify asthma as:

Intermittent:This type of asthma comes and goes so you can feel normal in between asthma flares.

Persistent:Persistent asthma means you have symptoms much of the time. Symptoms can be mild, moderate or severe.Healthcare providers base asthma severity on how often you have symptoms. They also consider how well you can do things during an attack.

Asthma has multiple causes:

Allergic: Some people’s allergies can cause an asthma attack.Allergens include things like molds, pollens and pet dander.

Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.

Asthma can also be:

Adult-onset:This type of asthma starts after the age of 18.

Pediatric:Also called childhood asthma, this type of asthma often begins before the age of 5,and can occur in infants and toddlers. Children may outgrow asthma. You should make sure that you discuss it with your provider before you decide whether your child needs to have an inhaleravailable in case they have an asthma attack. Your child’s healthcare provider can help you understand the risks.

In addition, there are these types of asthma:

Exercise-induced asthma: This type is triggered by exercise and is also called exercise-induced bronchospasm.

Occupational asthma:This type of asthma happens primarily to people who work around irritating substances.

Asthma-COPD overlap syndrome (ACOS): This type happens when you have both asthma and chronic obstructive pulmonary disease (COPD). Both diseases make it difficult to breathe.

Researchers don’t know why some people have asthma while others don’t. But certain factors present a higher risk:

Allergies: Having allergies can raise your risk of developing asthma.

Environmental factors: People can develop asthma after exposure to things that irritate the airways. These substances include allergens,toxins, fumes and second- or third-hand smoke. These can be especially harmful to infants and young children whose immune systems haven’t finished developing.

Genetics: If your family has a history of asthma or allergic diseases, you have a higher risk of developing the disease.

Respiratory infections: Certain respiratory infections, such as respiratory syncytial virus (RSV), can damage young children’s developing lungs.

People with asthma usually have obvious symptoms. These signs and symptoms resemble many respiratory infections:

Chest tightness, pain or pressure.

Coughing (especially at night).

Shortness of breath.

Wheezing.

With asthma, you may not have all of these symptoms with every flare.You can have different symptoms and signs at different times with chronic asthma. Also, symptoms can change between asthma attacks.

If your healthcare provider says you have asthma, you’ll need to figure out what triggers an attack.Avoiding the triggers can help you avoid an attack. You can’t prevent yourself from getting asthma, though.

Your healthcare provider will review your medical history, including information about your parents and siblings. Your provider will also ask you about your symptoms.Your provider will need to know any history of allergies,(a bumpy rash caused by allergies) and other lung diseases.

Your provider may order spirometry. This test measures airflow through yourlungs and is used to diagnose and monitor your progress with treatment. Your healthcare provider may ordera chest X-ray, blood test or skin test.

You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:

Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen and are used for intermittent and chronic asthma.

Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms of chronic asthma.

Biologic therapies for asthma: These are used for severe asthma when symptoms persist despite proper inhaler therapy.

You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or another type of asthma inhaler. Your healthcare provider may prescribe oral medications that you swallow.

What is asthma control?

The goal of asthma treatment is to control symptoms. Asthma control means you:

Can do the things you want to do at work and home.

Have no (or minimal) asthma symptoms.

Rarely need to use your reliever medicine (rescue inhaler).

Sleep without asthma interrupting your rest.

How do you monitor asthma symptoms?

You should keep track of your asthma symptom. It’s an important piece of managing the disease. Your healthcare provider may ask to use a peak flow (PF) meter.This device measures how fast you can blow air out of your lungs. It can help your provider make adjustments to your medication. It also tells you if your symptoms are getting worse.

What are the different levels of asthma? These guidelines were established by the National Institutes of Health so that physicians can determine the extent of your child’s asthma.

Step 1 – mild intermittent Asthma

Symptoms fewer than two times a week

Does not have problems between flare-ups

Only has short flare-ups from a few hours to a few days

Experiences nighttime symptoms fewer than twice a month

Step 2 – mild persistent Asthma

Symptoms more than two times a week, but no more than once a day

His or her activity levels may be affected by the flare-ups

Experiences nighttime symptoms more than twice a month

Step 3 – moderate persistent Asthma

Symptoms every day

Uses his or her rescue medication every day

Has flare-ups twice a week or more

His or her activity levels may be affected by the flare-ups

Experiences nighttime symptoms more than once a week

Step 4 – severe persistent asthma

Constant symptoms

Has a decrease in physical activity

Has frequent flare-ups

Experiences nighttime symptoms frequently