About Asthma

What Is It?

Asthma is a potentially deadly, commonly chronic lung disease that affects approximately 1 in 11 children and 1 in 12 adults in the U.S. Asthma can have a significant impact on health and quality of life.

One of the main characteristics of asthma is inflammation and narrowing of the airways. Airways are tubes that help carry air in and out of your lungs. When inflammation and narrowing occurs, less air is able to flow in and out.

During asthma symptoms, it is common for the airways to produce more mucus than usual. This extra mucus can further limit the airflow within the airways.

It is predicted that the number of people with asthma will grow to 400 million worldwide by 2025. -- American Academy of Allergy Asthma & Immunology.

Asthma Symptoms

While asthma can affect people at any age, it is common for symptoms to start during childhood or as a young adult.

Common signs of asthma:

  • Wheezing or whistling sound when exhaling
  • Chest tightness
  • Cough (most common at night)
  • Colds that don’t seem to go away (ten days or longer)
  • Shortness of breath (dyspnea)
  • Runny nose and/or itchy eyes
  • Coughing after exercise or after being exposed to cold or dry air

If you are experiencing one or several of these symptoms, you should schedule a pulmonary evaluation with your doctor.

Asthma Attack

An asthma attack is an acute episode of wheezing, coughing and/or chest tightness.

Difficulty breathing is usually associated with an asthma attack.

Asthma attacks can range from mild to severe. Since severe cases can lead to death, knowing about the disease and how to handle an acute attack is very important.

Our experts can work with you to create a customized asthma control plan that can help minimize asthma attacks.

Illustration of airways before and during an asthma attack. 

If you have diagnosed asthma and your short-acting inhaler such as albuterol (e.g., 4-6 puffs) does not improve symptoms, you should contact 9-1-1 or go to the emergency room (ER).

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.

Causes & Risk Factors

If you have a family history of asthma, you have an increased risk of having the disease.

Although there are some recognized factors that trigger asthma symptoms, many cases have no known triggers.

Common triggers and conditions associated with asthma:

  • Seasonal allergies
  • Acid reflux
  • Obesity
  • Obstructive sleep apnea (OSA)
  • Nasal polyps
  • Drugs (e.g., aspirin)

Tobacco Smoke

Tobacco smoke is a common trigger for asthma attacks.

People who are exposed to second-hand smoke during childhood are more likely to develop asthma. Furthermore, people who smoke do not respond as well to inhaled asthma treatments as non-smokers.

bulletNeed help quitting? ​See our smoking cessation program.

Our physician-scientists are currently researching the connection between COPD and asthma caused by tobacco exposure. Learn more about this study.

Allergies

Asthma that is triggered by an allergic reaction is very common. About 70 percent of people who have asthma may also have allergies to some degree – this is known as allergic asthma.

People with non-allergic (intrinsic) and allergic asthma (extrinsic) have similar symptoms. Allergy testing (e.g., prick test and RAST) can help determine if allergies are present and if they potentially contribute to your asthma.

Some of the known allergens that can trigger asthma symptoms include:

  • Dust mites
  • Mold
  • Pet dander
  • Some grasses, trees and plants

Exercise

Any form of exercise can trigger asthma.

If you are diagnosed with exercise-induced asthma, using a short-term bronchodilator (e.g., albuterol) 20 to 30 minutes prior to exercise may prevent symptoms.

NOTE: While swimming can be a good exercise option for those with exercise-induced asthma, exposure to chlorine in pools may exacerbate symptoms or cause asthma symptoms to develop.

Emotional Stress

Intense emotions of happiness and sadness can trigger wheezing and shortness of breath. Our respiratory therapists can show you behavioral techniques that can help reduce stress levels for better asthma control.

Respiratory Infections

Common colds and inflammation of the sinuses (sinusitis) are the most common causes of asthma exacerbations, especially during the winter season. Staying current on vaccinations is important in disease prevention (e.g., flu or pneumonia vaccines).

Early Intervention is Key
If you have a lung infection in the upper or lower airway and you are experiencing respiratory symptoms such as shortness of breath or coughing, seek treatment immediately.

Acid Reflux

Several studies have been done over the last few decades to confirm a relationship between gastroesophageal reflux disease and asthma. The results are mixed: While some studies support a connection between the two, other studies do not. 

If you have symptoms of heartburn, let your doctor know to see if it may be contributing to your asthma symptoms.