Asthma Asthma Asthma

Asthma is a lung condition that inflames, narrows, and swells the airways. It also produces extra mucus, making it difficult to breathe. Even if you don’t have symptoms all the time, you may still have asthma if environmental triggers cause you to wheeze and cough. Read on to learn more about asthma, find out how to spot the signs, and explore treatment options for this common condition.

What Is Asthma?

Asthma is a lung condition. People who have asthma don’t necessarily have symptoms all the time, but when something triggers an asthma attack, they wheeze, cough, and struggle to breathe. During an asthma attack, the sides of the body’s airways swell, reducing the flow of air. The body also makes extra mucus that blocks the airways and makes breathing difficult.

These terms can help you understand asthma:

  • Asthma triggers: Things that trigger asthma symptoms, such as air pollution, smoke, pet hair, mold, pollen, and dust.
  • Asthma attack: An increase in asthma symptoms that occurs during or after exposure to an asthma trigger.

Stages and Types of Asthma

There are two main types of asthma.

  • Allergic asthma: Sometimes called extrinsic asthma, allergic asthma is caused by external triggers, such as cigarette smoke, pollen, animal fur, cold air, exhaust fumes, perfume, and certain chemicals.
  • Non-allergic asthma: Sometimes called intrinsic asthma, non-allergic asthma is triggered by bacteria, viruses, and certain medications, including aspirin and ibuprofen. Some people also get non-allergic asthma symptoms from physical exertion or emotional stress.

Both types of asthma have similar symptoms, which are caused by mucus and swelling restricting air flow through the lungs.

Symptoms and Causes of Asthma

These are the main symptoms of asthma:

  • Shortness of breath
  • Breathlessness during exercise
  • Making a wheezing, rattling, or whistling noise when you breathe
  • Chest tightness
  • Coughing, especially at night
  • Tiredness as a result of coughing disturbing sleep

Symptoms often come on suddenly during an asthma attack. Between asthma attacks, you may not have any symptoms at all.

“Asthma is caused by an interaction of inflammatory cells of the immune system (the person’s immune system permanently overreacts), the lining of the airway (epithelium), smooth muscle cells of the airway and the nervous system in response to various types of stimuli,” said Jack Coleman, M.D., the senior medical director for the Lung Institute. “Often asthma is given various names depending on the type of stimulus: allergic asthma, exercise-induced asthma, cold air asthma, and reactive asthma to name the most common.”

Prevention and Risks of Asthma

Doctors and researchers are not sure why some people have asthma and others do not. However, they have identified some risk factors that make a person more likely to develop the condition.

  • Having a family member with asthma
  • Being male
  • Smoking or being exposed to cigarette smoke (passive smoking)
  • Having other allergy-related conditions, such as eczema or hay fever
  • Low birth weight

If you smoke, quitting or avoiding smoking inside your home can help to reduce your child’s risk of developing asthma.

“Boys have a greater risk to develop [the] disease than girls,” said Dr. Coleman. “Below the age of 14 years, it is twice as high in boys. By age 40 years, women develop it more than males.”

Asthma Diagnosis and Tests 

The first step to getting diagnosed with asthma is to schedule an appointment with a doctor. Asthma can begin at any stage of life, although many sufferers start having symptoms and are diagnosed when they are children. Sometimes, these symptoms improve as a child ages.

When you see your doctor about asthma, they will talk to you about your or your child’s symptoms, take a full medical history, and ask questions about lifestyle, such as whether anyone in the household smokes. The doctor will also perform a physical examination to check the lungs and heart.

A lung function test measures how quickly you can blow air out of your lungs. A low result on this test suggests that air flow through your airways is restricted, which is a sign of asthma.

Your doctor may perform allergy tests or refer you to an allergy specialist to identify the triggers that cause you to have asthma symptoms. 

“Allergy skin testing is one of the best ways to determine specific allergies,” said Dr. Coleman. “This allows for accurate desensitization or immunotherapy treatment and can assist patients and family in what to avoid or eliminate from the patient’s environment.”

Treatment, Procedures, and Medication for Asthma

There is no cure for asthma. However, the right treatment can control your symptoms so you can live a healthy life. Doctors prescribe three main types of medications to treat asthma.

“The goals of treatment are to control and minimize symptoms, improve quality of life, decrease exacerbations that result in emergency visits and hospitalizations, decrease inflammation and its long-term effects and return pulmonary function tests to normal levels,” said Dr. Coleman. “It is important to remember that it does not always get worse and can be treated quite effectively.”

​​​​​​Fast-acting medication is also called reliever or rescue medication. You can take one of these medications during an asthma attack to open up your airways and help you breathe. These medicines are taken using an inhaler, which is a device you place in your mouth during an asthma attack. When you press down on the top of the inhaler, it releases medicine that you need to breathe in to stop your asthma attack. 

  • Albuterol
  • Ipratropium
  • Corticosteroids (for severe asthma attacks)

Slow-acting medication is also called controller or preventer medication. If you have frequent asthma attacks, you may need to take one of these medications every day to prevent attacks.

  • Corticosteroid inhalers
  • Leukotriene modifiers
  • Long-acting beta agonists (LABAs)
  • Theophylline

Allergy medications are also often prescribed. If you have allergic asthma, allergy shots and anti-allergy medicines such as omalizumab can reduce your sensitivity to asthma triggers.

Sub-lingual immunotherapy (SLIT) is “one method to treat allergies that has been used for many years in Europe and is now becoming more popular in the United States,” Dr. Coleman said. “This uses drops or a pill that is placed under the tongue to be absorbed. It is very safe and treatment can be done at home. It is also much easier to alter the dosage rapidly in such situations as a particularly heavy pollen season causing symptom breakthrough despite previous control. It is also reported that it is a very safe method for controlling food allergies.”

Healthy Lifestyle Tips for Asthma 

Some healthcare providers recommend using breathing techniques to keep asthma symptoms under control. Regular exercise or playing sports may help to reduce your symptoms over the long term. These alternative treatments usually work best when used in combination with medication.

Dr. Coleman recommends environmental controls to reduce allergen exposures for patients with allergic asthma. Avoiding asthma triggers is an excellent way to reduce the number and severity of your asthma attacks. For example, you could limit the amount of time you spend exercising outdoors on days when pollen or pollution levels are high. If you know that animal fur triggers your symptoms, you could avoid owning or spending time around pets that shed hair. Many people find that quitting smoking or spending less time with people who are smoking helps to reduce their asthma symptoms.

“Fortunately, with proper treatment and precautions, most asthma, especially in children, will get better over time,” said Dr. Coleman. “However, teenagers who become symptom-free may have a recurrence of the disease in their 20s and 30s.” 

Food and Nutrition-Based Approaches to Prevention and Management of Asthma

Most people who have asthma do not need to follow a particular diet. However, some people with asthma are also allergic to certain foods, in which case eating them can cause asthma symptoms. The most common allergies involve these foods:

  • Dairy products
  • Eggs
  • Nuts, especially peanuts
  • Seeds
  • Fish and shellfish
  • Wheat
  • Soy
  • Food additives such as sulfites
  • Salicylates, which are chemicals naturally present in tea, coffee, and certain herbs

Most people with asthma do not need to avoid these foods. If you think eating certain foods affects your asthma symptoms, ask your doctor for a skin prick test to find out whether you have a food allergy. 

Some people with food allergies can suffer severe reactions such as anaphylactic shock. This is most common with peanut and other nut allergies. If you or your child has a severe food allergy you need to carry an epi-pen — it could be life-saving. 

Many researchers have tried to find out whether taking certain vitamins or eating certain foods could help to prevent asthma. While there is no evidence that particular vitamins can prevent asthma, researchers recommend eating a balanced diet that includes plenty of fruits and vegetables.

What Type of Doctors to See

The first doctor that many people consult about asthma symptoms is a primary care physician or pediatrician. These doctors can listen to your breathing and use your symptoms and medical history to determine whether you are likely to have asthma or another condition.

Some people choose to see an asthma specialist for help managing their asthma, such as an allergist, pulmonologist, immunologist or otolaryngologist (ENT specialist). These doctors have had extra training in dealing with asthma, which may mean they can help you manage your condition more effectively. If you have allergic asthma, a specialist may be able to help you identify your asthma triggers and reduce your sensitivity to them.

Conclusion

Although there is no cure for asthma, there are many medications and lifestyle changes that can help you control your symptoms. The first step is to visit a doctor to find out whether you have asthma and learn what you can do to manage it. 

Expert Contributor: 

Jack Coleman, MD,  is the Senior Medical Director of the Lung Institute, a division of Regenerative Medicine Solutions (RMS). Based at the Nashville, TN clinic, he brings extensive medical and surgical expertise to his role and robust experience in cellular medicine and developing new methods for treating lung disease.

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