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What is Asthma?

Asthma is a condition in which your airways narrow and swell and produce extra mucus. 

Why You Should Care?

  • In the United States, about 25.7 million people have asthma, including seven million children.
  • Approximately 1.8 million people have an asthma-related emergency department visit each year, and 439,000 people are hospitalized.
  • About 3,400 people die from asthma each year in the United States. The number of asthma deaths has been declining steadily since 2001.
  • Worldwide, there are about 334 million people with asthma.

Symptoms:

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

For some people, asthma signs and symptoms flare up in certain situations:

  • Exercise: triggered when the air is cold and dry
  • Occupational (at a worksite): triggered by workplace irritants such as chemical fumes, gases, or dust
  • Allergy-induced: triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander)

Causes, Triggers and Risk Factors:

Causes:

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.

Triggers:

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

  • Respiratory infections, such as the common cold
  • Physical activity (exercise-induced asthma)
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer, and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Risk factors:

A number of factors are thought to increase your chances of developing asthma:

  • Having a blood relative (such as a parent or sibling) with asthma
  • Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
  • Being overweight
  • Being a smoker
  • Exposure to secondhand smoke
  • Strong emotions and stress
  • Exposure to exhaust fumes or other types of pollution
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing, and manufacturing

Treatment:

Prevention and long-term control are key in stopping asthma attacks before they start. Medications are both for long-term control as well as short term control (in case of an attack).

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. Preventive, long-term control medications reduce the inflammation in your airways that lead to symptoms.

Types of long-term control medications include:

  • Inhaled corticosteroids. These anti-inflammatory drugs include fluticasone (Flonase, Flovent HFA), budesonide (Pulmicort Flexhaler, Rhinocort), flunisolide (Aerospan HFA), ciclesonide (Alvesco, Omnaris, Zetonna), beclomethasone (Qnasl, Qvar), mometasone (Asmanex) and fluticasone furoate (Arnuity Ellipta).
  • TLeukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms for up to 24 hours.
  • Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways.
  • Combination inhalers. These medications — such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) — contain a long-acting beta agonist along with a corticosteroid.
  • Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways.
  • Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma   attack — or before exercise if your doctor recommends it.
  • Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease   symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol   (Xopenex).
  • Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe.
  • Oral and intravenous corticosteroids. These medications — which include prednisone and methylprednisolone — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms.
  • Allergy medications may help if your asthma is triggered or worsened by allergies. These include:
  • Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others) and levalbuterol (Xopenex).
  • Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years.
  • Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system.
  • Bronchial thermoplasty: This treatment — which isn't widely available nor right for everyone — is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications.

Lifestyle Modifications:

Taking steps to reduce your exposure asthma triggers is a key part of asthma control, including:

  • Use your air conditioner
  • Decontaminate your decor
  • Maintain optimal humidity
  • Prevent mold spores
  • Reduce pet dander
  • Clean regularly
  • Cover your nose and mouth if it's cold out 

Other measures:

  • Get regular exercise
  • Decontaminate your decor
  • Maintain a healthy weight
  • Control heartburn and gastroesophageal reflux disease (GERD) 

References:

* CIS does not provide medical advice, diagnosis or treatment. The content is for informational purposes only.