Asthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness of breath, chest tightness, and coughing.
Normal versus asthmatic bronchiole
During an asthma attack smooth muscles located in the bronchioles of the lung constrict and decrease the flow of air in the airways. The amount of air flow can further be decreased by inflammation or excess mucus secretion.
Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway.
Asthma - Animation
Breathing is something we do without even thinking about it. But some people have a hard time breathing easily. They wheeze, cough, and just can't get enough air into their lungs. Let's talk about asthma. Normally when you breathe, oxygen-rich air enters your nose and mouth and travels to the airways in your lungs. But when you have an asthma attack, the muscles in your airways tighten. Your airways swell up and get narrower. It's like pressing on a straw when you're trying to drink through it. The more you press, the less of your drink can squeeze up through the straw. In the same way, less air can squeeze through tight airways into your lungs. So, what causes asthma? People with asthma have different triggers. Some people are sensitive to pet hair or dander. Others find that dust, pollen, smoke, or chemicals make them wheeze. You may have trouble breathing when you're under stress or working out at the gym. Often people with asthma have allergies that trigger their attacks. Others have a parent or other relative who has allergies. You may ask, how can you know for sure that you have asthma? During an asthma attack, you'll have trouble breathing. You may cough or wheeze as you try to draw air into your lungs. If you're having a severe attack, your lips and face may turn blue and you'll have a hard time getting any air. That's when it's time to call for emergency help. Your doctor will listen to your lungs with a stethoscope, and may do other tests to check your blood and lung function. To find out what's triggering your asthma, you may need to be tested for allergies to mold, pollen, pet dander, or other substances. To measure the strength of air flowing out of your lungs, you'll blow into a device called a peak flow meter. You can also use a peak flow meter to make sure you're keeping your asthma under control. Different medicines are used to prevent and treat asthma. Control drugs help you avoid asthma attacks, but you need to take them every day for them to work. You breathe in control drugs like Flovent, Singulair, and Pulmicort through an inhaler. If you're having an asthma attack, you can take a quick-relief drug to control your wheezing. Examples of quick-relief drugs include short-acting inhaled drugs and steroid medicines that you take by mouth. When you have asthma, you need to be prepared. Know your asthma triggers and try to avoid them. Carry an inhaler with you in case you have an asthma attack. If you ever have an attack that's so severe you can't breathe, call 911 or get emergency medical help.
Asthma symptoms can be caused by breathing in substances called allergens or triggers, or by other causes.
An allergen is a substance that can cause an allergic reaction. In some people, the immune system recognizes allergens as foreign or dangerous. As ...Read Article Now Book Mark Article
Common asthma triggers
Many of the same substances that trigger allergies can also trigger asthma. Common allergens include pollen, dust mites, mold and pet dander. Other asthma triggers include irritants like smoke, pollution, fumes, cleaning chemicals, and sprays. Asthma symptoms can be substantially reduced by avoiding exposure to known allergens and respiratory irritants.
Common asthma triggers include:
- Animals (pet hair or dander)
- Dust mites
- Certain medicines (aspirin and other NSAIDS)
- Changes in weather (most often cold weather)
- Chemicals in the air or in food
- Physical activity
- Respiratory infections, such as the common cold
- Strong emotions (stress)
- Tobacco smoke
Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.
Occupational asthma is a lung disorder in which substances found in the workplace cause the airways of the lungs to swell and narrow. This leads to ...Read Article Now Book Mark Article
An allergy is an immune response or reaction to substances that are usually not harmful.Read Article Now Book Mark Article
Allergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. These symptoms occur when you breathe in something you are ...Read Article Now Book Mark Article
Asthma Treatment Quiz
Which of the following is not a goal of asthma treatment?Correct AnswerThe correct answer is to cure asthma. Unfortunately, there's no way to cure asthma. However, by working closely with your doctor, you can learn to manage it.
The main types of medicine for asthma are:Correct AnswerThe correct answer is both A and B. The goals of asthma treatment are controlling airway swelling and avoiding what triggers your symptoms.
This device, used with an inhaler, helps get more medicine into the airways.Correct AnswerThe correct answer is spacer. The spacer connects to the mouthpiece. The inhaled medicine goes into the spacer tube first. Then you take two deep breaths to get the medicine into your lungs. Using a spacer wastes less medicine than spraying the medicine into your mouth.
Sometimes younger children use a nebulizer to take their medicine. What does this machine do?Correct AnswerThe correct answer is it turns asthma medicine into a mist children can breathe in. This device makes it easy and pleasant to breathe in the medicine. Small children may need to use a mask to help them inhale all the mist. Talk with your doctor if you have questions about your child's treatment.
You can stop taking your control medicine when you start to feel better.Correct AnswerThe correct answer is false. Control drugs must be taken every day to be effective. Take your medicine even when you feel OK. You may need to take these medicines for at least a month before you start to feel better. Your doctor will work with you to find asthma medicines that are right for you.
Why should you use a peak flow meter to check how quickly you can move air out of your lungs?Correct AnswerThe correct answer is all of the above. Peak flow measurements can help show when you need medicine or other action to treat your asthma. Peak flow values of 50 - 80% of your best results signal a moderate asthma attack, while values below 50% mean a severe attack.
If you use quick-relief drugs twice a week or more to control your asthma symptoms, you should:Correct AnswerThe correct answer is tell your doctor. If you need to use quick-relief drugs more than twice a week your asthma may not be under control. Your doctor may need to change your dose of daily control drugs.
Getting rid of tobacco smoke at home is the most important thing a family can do to help a child with asthma.Correct AnswerThe correct answer is true. Don't smoke inside or outside the home. Family members and visitors who smoke outside can carry the smoke inside on their clothes and hair. Helping children avoid asthma triggers is the first step toward helping them feel better.
Exercise can bring on asthma symptoms in some people, but you can still participate in the activities you love. Do this ahead of time:Correct AnswerThe correct answer is use your quick-relief drugs just before exercising. Swimming is a good sport for people with exercise-induced asthma. The warm, moist air helps keep asthma symptoms away. Football, baseball, and other sports with breaks in the action are less likely to trigger asthma symptoms.
Asthma action plans should include:Correct AnswerThe correct answer is all of the above. An asthma action plan is an important part of treatment for anyone with asthma. If you don't already have one, talk with your doctor about creating a personal asthma action plan.
Which of these asthma symptoms is an emergency?Correct AnswerThe correct answer is all of the above. Asthma attacks can be dangerous if a person's airways become severely blocked. If you notice any of these symptoms, call 9-1-1. This might include oxygen, breathing assistance, and medicines given through a vein (IV).
People with asthma can lead normal, active lives.Correct AnswerThe correct answer is true. Asthma can be scary, but it doesn't have to control you. By getting the right medical treatment, working closely with your doctor, and avoiding your asthma triggers, you can manage your condition and enjoy a full life.
Asthma symptoms vary from person to person. For example, you may have symptoms all the time or mostly during physical activity.
Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Wheezing or a cough may be the main symptom.
What causes wheezing? - Animation
Wheezing can be a normal healthy response to an unhealthy environment. Or, wheezing can be a sign of asthma. I'm Dr. Alan Greene and I want to talk with you for a moment about how to tell the difference, what causes wheezing anyway, and when is it healthy and when is it not. Well to understand that, first let's all take a deep breath together (inhales). When you breathe in, the air comes through your nose or mouth, through the big windpipe and breaks into 2 big bronchi, one into each lung. And from there they break into a whole bunch of little, smaller bronchioles. It's almost like a tree's branches branching out. And those bronchioles are where the wheezing happens. Let's look at a bronchiole. Here's one of those small airways. Now if you happen to walk into a cloud of something that's toxic, your body is going to respond instantly to try to protect you. The first thing that will happen is the muscles around the bronchioles will tighten, will constrict down almost like a boa constrictor, and you get the tight airways. If that toxic cloud is still there, to protect your delicate tissues deep in your lungs, swelling of the lining will happen. Inflammatory stuff to help protect you from those toxins. And if it's still there, still irritating, mucus will begin to be secreted to be able again to capture and protect you from those toxins. That's wheezing. Asthma happens when your airways are hyper-responsive. When they're twitchy. When they're hyper-alert and they respond to something that's not truly dangerous. The problem with that is when your bronchioles are constricted and swollen and has mucus in them, that narrow little opening is hard to breathe through. You have to work to breathe, especially to breath out. And that hard breathing through a narrow passageway is what creates the sound we know as wheezing.
Asthma attacks can last for minutes to days. An asthma attack may start suddenly or develop slowly over several hours or days. It may become dangerous if airflow is severely blocked.
Symptoms of asthma include:
- Cough with or without sputum (phlegm) production
- Pulling in of the skin between the ribs when breathing (intercostal retractions)
- Shortness of breath that gets worse with exercise or activity
- Whistling sound or wheezing as you breathe
- Pain or tightness in the chest
- Difficulty sleeping
- Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)
Emergency symptoms that need prompt medical help include:
Exams and Tests
The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. The provider will take your medical history and ask about your symptoms.
Tests that may be ordered include:
- Allergy testing -- skin test or a blood test to see if a person with asthma is allergic to certain substances
Allergy skin tests are used to find out which substances cause a person to have an allergic reaction.Read Article Now Book Mark Article
- Arterial blood gas -- often done in people who are having a severe asthma attack
- Chest x-ray -- to rule out other conditions
- Lung function tests, including peak flow measurements
The goals of treatment are:
- Control airway swelling
- Limit exposure to substances that may trigger your symptoms
- Help you to be able to do normal activities without having asthma symptoms
You and your provider should work as a team to manage your asthma symptoms. Follow your provider's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.
MEDICINES FOR ASTHMA
There are two kinds of medicines for treating asthma:
- Control medicines to help prevent attacks
- Quick-relief (rescue) medicines for use during attacks
Control medicines for asthma are drugs you take to control your asthma symptoms. You must use these medicines every day for them to work well. You ...Read Article Now Book Mark Article
These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK.
Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your provider will prescribe the right medicine for you.
Asthma quick-relief medicines work fast to control asthma symptoms. You take them when you are coughing, wheezing, having trouble breathing, or havi...Read Article Now Book Mark Article
These are also called rescue medicines. They are taken:
- For coughing, wheezing, trouble breathing, or during an asthma attack
- Just before physical activity to help prevent asthma symptoms
Tell your provider if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control. Your provider may change the dose or your daily asthma control medicine.
Quick-relief medicines include:
- Short-acting inhaled bronchodilators
- Oral corticosteroids for a severe asthma attack
A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).
ASTHMA CARE AT HOME
You can take steps to decrease the possibility of asthma attacks:
- Know the asthma symptoms to watch for.
- Know how to take your peak flow reading and what it means.
- Know which triggers make your asthma worse and what to do when it happens.
- Know how to care for your asthma before and during physical activity or exercise.
Asthma action plans are written documents for managing asthma. An asthma action plan should include:
- Instructions for taking asthma medicines when your condition is stable
- A list of asthma triggers and how to avoid them
- How to recognize when your asthma is getting worse, and when to call your provider
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
Peak flow meter
Checking your peak flow is one of the best ways to control your asthma and to keep it from getting worse. Asthma attacks do not usually come on witho...Read Article Now Book Mark Article
- It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action.
- Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack.
There is no cure for asthma, although symptoms sometimes improve over time. With proper self-care and medical treatment, most people with asthma can lead a normal life.
The complications of asthma can be severe, and may include:
- Decreased ability to exercise and take part in other activities
- Lack of sleep due to nighttime symptoms
- Permanent changes in the function of the lungs
- Persistent cough
- Trouble breathing that requires breathing assistance (ventilator)
When to Contact a Medical Professional
Contact your provider for an appointment if asthma symptoms develop.
Contact your provider right away if:
- An asthma attack requires more medicine than recommended
- Symptoms get worse or do not improve with treatment
- You have shortness of breath while talking
- Your peak flow measurement is 50% to 80% of your personal best
Go to the emergency room right away if these symptoms occur:
- Drowsiness or confusion
- Severe shortness of breath at rest
- A peak flow measurement of less than 50% of your personal best
- Severe chest pain
- Bluish color to the lips and face
- Extreme difficulty breathing
- Rapid pulse
- Severe anxiety due to shortness of breath
You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.
- Cover bedding with allergy-proof casings to reduce exposure to dust mites.
- Remove carpets from bedrooms and vacuum regularly.
- Use only unscented detergents and cleaning materials in the home.
- Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold.
- Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people.
- If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating/air conditioning outlets in your home to trap animal dander. Change the filter in furnaces and air conditioners often.
- Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit.
- Avoid air pollution, industrial dust, and irritating fumes as much as possible.
Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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