Asthma is an inflammatory disease of the lungs that often makes breathing difficult and causes attacks of coughing, wheezing, tightness in the chest and shortness of breath. Airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. This makes the airways swollen and very sensitive. They tend to react strongly to certain substances that are breathed in.

When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows to your lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your airways. This chain reaction can result in asthma symptoms.

Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times, symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. It's important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma attack.

Asthma can't be cured. Even when you feel fine, you still have the disease and it can flare up at any time. But with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma.

For successful, comprehensive, and ongoing treatment, take an active role in managing your disease. Build strong partnerships with your doctor and other health providers, such as a RedBrick Health Coach.

What is asthma?

Asthma is an inflammatory disease of the lungs that often makes breathing difficult and causes attacks of coughing, wheezing, tightness in the chest and shortness of breath. Asthma symptoms occur when the lining of the air passages swell and the muscles surrounding the airways tighten. Mucus fills the airways, further reducing the amount of air that can pass through them and causing an asthma attack.

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Why does asthma matter?

It's important to treat asthma symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe attack. Severe asthma attacks may require emergency care, and they can cause death.

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What are the types of asthma?

Asthma is sometimes referred to as bronchial asthma because it involves the narrowing of the bronchial airways. The distinction is often made between childhood asthma and adult-onset asthma, when symptoms don’t appear until at least the age of 20. Other types of asthma include:

Allergic Asthma (Extrinsic Asthma). Allergic asthma is triggered by allergens, such as pet dander, food preservatives, mold, or pollen. Allergic asthma is more likely to be seasonal because it often goes hand-in-hand with allergies that are also seasonal.  

Non-Allergic Asthma (Intrinsic Asthma). This type of asthma is triggered by irritants in the air that are not related to allergies – including wood or cigarette smoke, air pollution, room deodorants, household cleaning products and perfumes. 

Cough-Variant Asthma (CVA). Cough-variant asthma does not have the classic symptoms of asthma – such as wheezing and shortness of breath. Instead, CVA is characterized by one symptom, a persistent dry cough. Cough-variant asthma can lead to full-blown asthma that shows other asthma symptoms.

Exercise-Induced Asthma (EIA). Exercise-induced asthma affects people during or after physical activity. EIA can occur in people who are not sensitive to classic asthma triggers such as dust, pollen, or pet dander.

Occupational Asthma. Occupational asthma is induced by triggers that exist in a person’s workplace. Irritants and allergens include dusts, dyes, gases, fumes, animal proteins, and rubber latex that are common in a wide range of industries—including manufacturing, textiles, farming, and woodworking.

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What causes/triggers asthma?

Asthma is a chronic disease of the air passages in the lungs. Actual causes of asthma are not known. However, asthma experts believe that a combination of genetic and environmental factors (such as family history, childhood viral infections and early allergen exposure), can cause asthma or at least make a person sensitive to asthma triggers.

Allergies often are associated with asthma. But not all people with allergies suffer from asthma. While asthma causes are not known, doctors have identified two main causes of asthma symptoms:

Inflammation

If you have asthma, the lining – or inside walls – of the airways are inflamed (or swollen). This inflammation makes the air passages particularly sensitive to irritants and asthma triggers. The swelling narrows the air passages, making it difficult for air (and oxygen) to pass through the airways and making it hard to breathe in and out.

Airway Constriction

To further complicate things, when the airways come into contact with certain asthma triggers, the muscles around the airways tighten. This causes the air passages to become even narrower and gives you a tight feeling in the chest, like a rope is being tightened around it. Mucus can get lodged in the narrowed airways, causing more breathing difficulties.

Asthma Triggers

The triggers that cause the inflammation and airway constriction can vary in different people. What is known is that when the airway comes in contact with one of many asthma triggers, it becomes inflamed, constricts and fills with mucus. The lining of the airway swells, causing the airway to narrow.

Asthma triggers include:

• Pollen
• Dust mites, cockroaches
• Mold
• Pet hair or dander
• Changes in weather (especially cold air)
• Respiratory infections (such as the common cold)
• Tobacco smoke
• Stress and strong emotions
• Exercise and physical activity
• Allergic reaction to food or sulfites (food preservatives)
• Heartburn/acid reflux
• Certain medications (aspirin, beta blockers)

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Am I at Risk?

The number of people diagnosed with asthma is growing each year, but no one really knows why some people are affected while others are not. There are a number of asthma risk factors that are thought to increase a person’s chance of developing asthma.

 Ask yourself these questions:

• Does one of my parents have asthma?
• Am I sensitive to allergens—such as dust, pet dander, mold, and toxic chemicals?
• Do I smoke?
• Did my mother smoke while pregnant with me and/or was I exposed to second-hand smoke as a child?
• Did I grow up in or currently live in a high smog area?
• Am I overweight/obese?
• Did I have a viral respiratory infection as a child?

The more frequently you answer “yes” to these questions, the greater your odds of developing asthma.  Discuss these answers with your doctor or a RedBrick Health Coach at 866.261.7144.

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What are the symptoms?

Asthma symptoms are caused when the airways become inflamed and constricted. Symptoms vary from one person to the next and could worsen by a respiratory condition, such as the flu or a cold. Asthma symptoms can also vary from one attack to another in the same person. You could go long periods of time without any symptoms, and then have periodic asthma attacks. Or you might have asthma symptoms every day, only at night or only after exercise.
 

 Common symptoms include:

• Coughing
• Wheezing
• Difficulty breathing
• Chest tightening

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Emergency Symptoms of Asthma

Asthma symptoms can disrupt your daily life and keep you from living an active lifestyle, but most of the time they are more of an annoyance than a threat to your life. However, asthma symptoms, if severe enough, can certainly cause a life-threatening emergency and should be taken seriously.

An adult or child experiencing an asthma attack should go to the emergency room if quick-relief medication is not working after 10-15 minutes, or if he or she is experiencing the following asthma symptoms:

• Discolored (blue or gray) lips, face, or nails
• Extreme difficulty breathing, causing neck and chest to be “sucked in” with each breath
• Difficulty talking or walking
• Mental confusion
• Extreme anxiety caused by breathing difficulty
• Fever of 100 degrees or higher
• Chest pain
• Rapid pulse

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How is asthma diagnosed?

Diagnosing asthma in an individual patient is challenging for a number of reasons. Because asthma attacks occur suddenly and for a short period of time, patients often go see a doctor without showing any symptoms at all.

Furthermore, most of the symptoms are nonspecific to asthma, meaning they are also symptoms for other conditions, such as emphysema, bronchitis, or pneumonia. This makes an asthma diagnosis tricky, especially when symptoms vary from person to person and even differ from one attack to another in the same person.

As asthma is most often diagnosed in children, you will likely visit your child’s pediatrician for asthma screening. The doctor will use several factors to make an asthma diagnosis. He or she will ask you several questions about your child’s medical history and the nature of his or her symptoms and perform a routine physical examination. Finally, your doctor will likely run one or more asthma tests—such as a spirometry—for further evaluation and could refer you to a specialist who focuses on lung function and breathing disorders.

Asthma tests

There is no single test for asthma. To properly diagnose asthma, your doctor will ask you or your child several questions about symptoms, medical history and risk factors and perform a physical exam to rule out any other possible conditions. A number of diagnostic tests are available to help diagnose asthma:

• Spirometry
• Bronchial Challenge Test
• Nitric Oxide Test
• Chest X-Ray

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How is asthma treated?

There is no cure for asthma. The goal of asthma treatment is to control the disease by following the asthma action plan you create with your doctor, such as:

• Taking asthma medicines as prescribed
• Learning what things make your asthma worse and taking steps to avoid exposure to them
• Tracking your level of asthma control
• Responding quickly to worsening symptoms

 asthma triggers is the most important step in reducing asthma symptoms. However, complete avoidance of triggers is unlikely, therefore other treatment options are needed:

• Asthma drugs fall into two categories:  Long-term control drugs are taken daily to prevent symptoms and quick-relief medications are used to provide rapid relief when symptoms flare up.
  
• Asthma inhaler is a small, handheld device that holds a canister of asthma medication. The asthma inhaler is usually pumped to release a spray mist that is breathed into the lungs. There are different types of asthma inhalers for adults and children.
  
• Asthma nebulizer is a breathing machine that delivers asthma medication directly into the lungs. Asthma nebulizers are often used by people who have trouble using asthma inhalers, especially infants, small children, or the elderly. Some nebulizers are portable and battery powered. Others are designed to be used at home.
  
• Bronchial Thermoplastyis a treatment option for severe asthma that doesn’t respond to medications. This treatment, administered on an outpatient basis in three sessions, is used to limit how much the airway can constrict. A small flexible tube, called a bronchoscope, is inserted into the lungs, via the nose or mouth, where it uses heat to singe and thin the smooth muscle in the airways. During an asthma flare-up, the thinner muscles can’t narrow as much when triggered.

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Take Charge!

What can I do to prevent/manage my asthma?

There's no cure for asthma. Asthma is a long-term disease that requires long-term care. Successful asthma treatment requires you to take an active role in your care. Learn how to manage your asthma, get ongoing care and watch for signs that your asthma is getting worse.

• Avoid triggers and allergens.  Most of the time, asthma attacks are caused by inhaling an allergen that triggers airway inflammation, bronchoconstriction and wheezing. Therefore, the best thing you can do to prevent asthma attacks is to identify and avoid these triggers as best you can.
• Use a high-quality air-filter. Air filters can help rid your home of common asthma triggers, including most mold, pollen, dust mites and other allergens. The best systems, which use high-efficiency particulate air (HEPA) filters, can clear the air of up to 99.9% of pollutants.
• Use a humidifier. Humidifiers increase moisture level in the air by producing water vapor. If cleaned and maintained properly, humidifiers can help ease asthma symptoms.
• Immunotherapy. Immunotherapy injections (allergy shots) are designed to enhance or suppress the immune system. If asthma triggers are unavoidable, immunotherapy is an option for managing asthma symptoms. The goal is to reduce sensitivity to allergens over time. For the first few months, injections are usually administered once a week. After which they might be given once a month for several years until desired results are achieved.
• Using preventative medication. Recognizing the onset of asthma attacks and treating them immediately is important in preventing severe symptoms. An effective way to do this is with medication. Most asthma medications are used on a regular basis to prevent attacks and are taken via an inhaler, although some may be administered orally or by injection.

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Resources and tools

If diagnosed with asthma or to learn more about the condition, call a RedBrick Health Coach to participate in the “Asthma” telephone coaching program at: 866.261.7144.

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Where to turn

Centers for Disease Control and Prevention (CDC)

WebMD

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