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Asthma Care

Image of a woman using an inhaler.

Why Choose UC San Diego Health for Asthma Care?

  • As part of the only academic health system in the region, so our team is at the forefront of new discoveries and groundbreaking research.
  • We're ranked #9 in the nation for the treatment of respiratory disease (pulmonology) by U.S. News & World Report for 2021-22.
  • We are one of the 18 NIH-funded networks (American Lung Association-Airway Center Research Network) involved in leading-edge asthma research and clinical trials across the U.S.
  • Our multidisciplinary team — which includes experts from pulmonology, sleep medicine, head and neck surgery, and allergy and immunology — collaborates regularly to ensure comprehensive, targeted care.
  • We have a complete pulmonary function laboratory capable of basic and advanced lung function assessment (e.g., exercise-induced asthma testing, methacholine challenge test). See our Pulmonary Function and Exercise Lab.
  • In our multidisciplinary Airway Clinic, pulmonologists partner with respiratory therapists to provide training on inhaler technique, general asthma education and assessment testing, and help customize an action plan for your asthma care.

Asthma Diagnosis

In order to make a proper diagnosis, your doctor will:

  1. Review your exposure to pollutants, family asthma history, smoking history, history of seasonal and/or food allergies.
  2. Conduct a physical exam. This usually involves listening to your lungs and an examination of your skin, ears, eyes, oral cavity, nose and chest.
  3. Conduct spirometry (if necessary). Spirometry is a lung function test that measures how fast you can move air in and out of your lungs. A bronchodilator test should be performed following spirometry to look for hyperreactivity of the airway.

If the results of your spirometry test are negative, additional testing may be needed.
Other diagnostic tests that may help in the initial evaluation:

  • Methacholine challenge: Mild constriction in the airways is deliberately triggered and the reaction of the lungs is assessed.
  • Chest X-ray: Looks for abnormalities in the lungs. Sometimes a CT scan following a chest X-ray is necessary to rule out other important medical conditions such as emphysema or bronchiectasis.
  • Exercise bronchoprovocation test: This test helps diagnose exercise-induced asthma by purposely triggering constriction in the airways.
  • Allergy testing: Recommended in the initial evaluation to identify potential allergens (e.g., skin dander or certain pollens). A skin test (prick test) or a blood test (RAST) can help assess the body's response to allergens that may cause or contribute to the presence of asthma.

We provide thorough, state-of-the-art exercise and lung function testing in our Pulmonary Function and Exercise Lab. In addition to diagnosing lung disease, our testing laboratory also determines oxygen needs to help you manage breathing problems.

Asthma Management

Asthma is a disease that usually can be well controlled by taking medications and avoiding irritants, pollutants and allergens that may be making your asthma worse.

What does it mean to have well-controlled asthma?

You have well-controlled asthma if you:

  • Have asthma symptoms twice a week or less
  • Use quick-relief medicine twice a week or less
  • Do not have symptoms at night or upon waking
  • Do not have limitations during physical activity
  • Have a peak flow reading that is normal or your personal best

Your Asthma Control Plan

Our lung specialists follow current asthma guidelines to create a personalized asthma control plan.

A personalized asthma treatment plan can help:

  • Reduce airway inflammation and bronchoconstriction
  • Reduce the number of daytime and nighttime symptoms
  • Put you in control of your asthma management by equipping you with the tools, medication and information to help reduce symptoms
  • Prevent reduced lung growth (in children)
  • Prevent flare-ups, or exacerbations
  • Reduce the impact of asthma on your daily activities and improve your quality of life
  • Minimize the need for emergency care

Your personalized asthma control plan is based on the severity of your asthma symptoms. As you gain better control of your asthma (e.g., rate of flare-ups has reduced), your plan will be revised accordingly.

To ensure your therapy is aligned with your current asthma care needs, regular doctor visits are recommended.

Monitoring Asthma at Home

Continual monitoring of asthma symptoms is important to maintaining control.

A peak flow meter is a simple, portable device that measures airway flow. Knowing when and how to use your peak flow meter can be helpful in managing symptoms and identifying early signs of an asthma attack.

Even after asthma is well controlled, it is important that you continue to monitor on a regular basis.

Picture of a woman using a peak flow meter.

Asthma Medicines

Understanding the differences in your medications and knowing how to take them correctly is an important part of managing asthma symptoms.

An asthma treatment plan typically consists of one quick-relief medicine and one or more long-term control medicines.

Medications used to treat asthma fall into two groups: quick relief and long-term control.

Quick Relief Medicines

Also known as “rescue” medications, quick relief medications act quickly to widen the bronchial air passages (bronchodilation) to allow increased airflow in and out of the lungs. They are used during acute asthma attacks and to prevent exercise-induced asthma. The effect of quick-relief medications is immediate and can last up to four to six hours.

In cases of well-controlled asthma, quick-relief medications may be the only medication needed.

The most common quick-relief drug for treating asthma symptoms is short-acting beta-agonists (SABAs).

Long-Term Control Medicines

Long-term control medicines may be necessary to lessen severity of asthma symptoms and/or reduce the odds of having asthma attacks. Long-term control medicines are taken daily, even when you do not have symptoms. While you may not notice immediate relief, long-term control medicines reduce airway inflammation and keep air passages open.

The most effective control medicine is inhaled corticosteroids (ICSs), as they deliver drugs directly to the airways.

NOTE: You should only use oral corticosteroids under the guidance of a physician. Long-term use of steroids should be avoided if possible because of drug-related side effects (e.g., high blood pressure, thinning bones).

People who have allergic asthma (especially children) may benefit from leukotriene modifiers, anti-IgE therapy, and allergen and pollutant avoidance.

A good treatment plan is one that helps you achieve the best level of control possible. If you’re unable to manage asthma symptoms with your current medications, your asthma control plan should be reviewed and adjusted if needed.

Asthma Medicines Just Not Working?

Despite current guidelines, a customized asthma control plan, and the range of available treatments, over half of patients with asthma continue to suffer from poor asthma control. This has a significant impact on their quality of life.

Several new, promising therapies may play a significant role as add-on therapy in people who have moderate to severe asthma. These may be a good option for individuals who are not responsive to existing medications like leukotriene modifiers or inhaled steroids.

Lifestyle Changes for Better Asthma Control

People looking for natural remedies for asthma control may benefit from a healthy lifestyle.

Lifestyle modifications that may help with symptoms include:

  • Eating a well balanced diet
  • Quitting smoking and/or avoiding smoke exposure
  • Avoiding pollutants
  • Regularly practicing stress reducing techniques