Asthma Overview

Asthma can not be cured.

Asthma CAN BE MANAGED so people can lead healthy, active and comfortable lives.

The main keys to managing asthma are to:

avoid your triggers and

take the right medications for your asthma symptoms.

What is asthma?

Asthma is a disease that affects the airways. A person with asthma has a very sensitive airway that becomes swollen when exposed to irritants. The airways fill up with mucous and the muscles surrounding the airways tighten up. This is called an asthma episode.

During an episode the person experiences coughing, wheezing, chest tightness and/or difficulty breathing. Fortunately, there are steps to take to avoid airway irritation. Medications are available that can prevent asthma episodes as well as medications that can relieve asthma symptoms.

Signs & Symptoms

Signs and symptoms of asthma include cough, wheeze, tightness of the chest, increased breathing rate and difficulty breathing. The cough of asthma is often dry and persistent. Commonly an asthma cough occurs during the night, with exercise and with exposure to irritants.

A wheeze is a high pitched whistle sound that can be heard when you breathe out. As an episode becomes worse the whistle will get louder and will be heard when you breathe in as well.

Some people will feel tightness of the chest. This can best be described as feeling as though your chest is being held inside really tight clothing, or like something heavy is sitting on your chest.

An asthma episode will cause most people to breathe faster. Increased breathing rate is often the first asthma symptom in infants. As an asthma episode gets worse, it becomes difficult to breathe. The chest and neck can be seen pulling in with breathing and the shoulders will hunch forward.

Triggers

Irritants that cause an asthma episode are known as triggers. Each person has his or her own triggers. Some of the more common triggers include: pet dander, dust, mold, pollens, tobacco smoke, allergies, exercise, weather extremes, strong odors, viral respiratory infections and emotions.

Once the individual’s triggers are identified, steps can be taken to avoid those triggers and avoid asthma episodes.

Diagnosis

A detailed health history is the starting point for the diagnosis of asthma. The Health Care Provider will need to know about the symptoms of cough, wheeze, shortness of breath and/or chest tightness.

Is there a history of colds that “go to the chest”? Or a history of colds that lasts longer that 10 days? Is there a family history of asthma or allergies? Are there things that make the symptoms worse, such as exercise or cold air? Has there been a medication used in the past to help breathing?

The next step will be a physical examination. Careful observation of the nose, mouth, throat and skin as well as listening to breathing with a stethoscope will be done.

Very often a test called spirometry will be done on anyone over the age of five years. This simply involves breathing into a machine for as hard and long as possible. The patient may be asked to exercise and then do a repeat spirometry. Or, the patient may be exposed to an irritant followed by a repeat spirometry.

The patient may be taught to do peak flow monitoring and then be asked to do a peak flow test daily for two weeks. Peak Flow monitoring is done by breathing into a peak flow meter with as much force as possible, much like blowing a pinwheel.

It will also be necessary to rule out other health problems that might be causing the symptoms or be contributing to the symptoms. This may include a chest x-ray, a sinus x-ray, an evaluation for gastric reflux disorder (GERD), or allergy testing. See diagnostic tests for further information.

Treatment

The treatment of asthma involves avoiding triggers and taking the appropriate medicines. It is also important to carefully monitor asthma symptoms to be sure that the individual management plan is working to control asthma symptoms.

It is essential to identify all of the triggers that cause symptoms for each person. Avoiding those triggers as well as avoiding things that can irritate airways such as tobacco smoke, strong chemical odors and strong perfumed odors can lower the possibility of an asthma episode.

Long-term medications are taken daily to prevent asthma episodes and symptoms. These medications keep the airway from swelling and filling up with mucous. Quick-relief medications are used when an asthma episode occurs. The medicine relaxes the muscles surrounding the airway and makes it easier to breath right away. Quick-relief medications are also used before exercise when asthma symptoms are caused by exercise.