Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 20, 2016

Asthma is a long-term condition that narrows the respiratory airways. It can begin in childhood but can impact people of any age throughout most of their life. It can't be cured, but it can be controlled with supervision from the patient as well as health care professionals.


Definition & Facts

Airways work like tubes that carry air in and out of the lungs. People with asthma have inflamed airways that have become restricted. Asthma sufferers can react negatively to inhaled substances since their airways are incredibly sensitive. The muscles around the airways can tighten, which makes the swelling worse and mucus can form.

When these reactions happen, the person can have an asthma attack. Asthma attacks also called flareups can be quite serious. They range from slight wheezing to not getting enough air to full-blown attacks that require hospitalization. While asthma has no cure, there are ways to relieve symptoms and live an active life.

Symptoms & Complaints

The symptoms of asthma vary from person to person. For those with severe asthma, attacks occur frequently, can be life-threatening, and may require seeking a doctor's help. Others have light symptoms and complaints that don't require treatment at a hospital and can be treated at home. People with less severe asthma might only have attacks during certain activities.

Asthma symptoms can include shortness of breath as well as chest tightness. The sufferer can't seem to pull in a good amount of air. It could cause them to become dizzy, and it could cause them to have trouble sleeping because they're coughing or wheezing at night and in the morning. While some patients with asthma have a wheezing or whistling sound, others might only have a breathless cough. Attacks can worsen if the person has a cold. Patients with severe asthma could have these symptoms all the time.


While doctors aren't quite sure what causes asthma to afflict some patients while others do not have a problem, it's thought to be partly environmental and partly hereditary. Doctors may not know why some children have asthma, but they do know what can cause the symptoms to worsen and cause flareups and attacks, which are called triggers.

The triggers that can cause attacks are pollutants found in the air like dust allergens, dog or cat fur, mold or pollens from outdoor plants like flowers or trees. Other triggers in the air are irritants like cigarette smoke and chemicals. Medicines can sometimes trigger an asthma attack. Other ingested triggers might be sulphites in foods and drinks.

There are health conditions that can make it difficult to manage the patient's asthma like having a runny nose, cold and upper respiratory infections. Gastroesophageal reflux disease or acid reflux and sleep apnea can be serious problems for people with asthma too. While those are common causes of asthma flareups and attacks, not every person who suffers from asthma will be triggered by those irritants. Some people are fine unless they exert themselves through some exercises like running.

Diagnosis & Tests

A doctor can diagnose asthma through a thorough medical history that includes family history of allergies and asthma. The doctor will want to know when the patient has symptoms and what seems to trigger the episodes. The doctor will also want to see if there are other related health conditions that might be making flareups happen like sleep apnea or acid reflux.

After taking a medical history and listening to what might have caused flareups, the doctor will perform a physical examination. He or she will listen to the patient's breathing and check nasal passages for swelling. The doctor will also look for skin problems that might indicate an allergy.

Once the physical exam is done, the doctor moves on to a test called a spirometry to check how the lungs are functioning. It measures how much air is inhaled and released from the lungs as well as how fast the patient can blow air out of the lungs. The doctor might test for sleep apnea, vocal cord dysfunction and lung disease. Bronchoprovocation testing could be ordered. This test measures the sensitivity of the person's airways under stress like physical activity, or the introduction of chemicals. The doctor could test to see how much oxygen is reaching the body too.

Treatment & Therapy

Once asthma has been diagnosed, the doctor can discuss the treatment options based on the severity of the patient's level of symptoms. Asthma has no cure, but it can be regulated and controlled with a treatment plan. The treatment plan will help alleviate symptoms like coughing that causes the patient to lose sleep, maintain good lung function throughout the day and prevent attacks that require a visit to the hospital. While parents might have to regulate a child's exposure to triggers as well as manage their asthma, older children should take an active role in the management of their condition.

If there are triggers in the home, they should be removed. Smoking, dust, pets and other triggers will have to be removed from where the asthma sufferer lives. The only thing that can't be avoided is physical activity since that keeps a person healthy.

The doctor will work with the patient to control the asthma through medications. There are two types of medicines available for asthma sufferers; short-term and long-term relief. Long-term medication will help reduce the swelling in the airways and prevent the symptoms. Long-term medications might include inhaled corticosteriods like fluticason or budesonide, long-acting beta agonists like salmeterol or formoterol, theorphylline or a combination of corticosteriods and long-acting beta agonists. Short-term or quick-relief medicines will provide relief for flareups. Quick-relief medications could be albuterol or ipratropium.

Prevention & Prophylaxis

Over time, asthma symptoms can lessen. This can be done through active participation in an asthma plan implemented by a doctor. Removing triggers from the home and avoiding common ones that cause flareups is helpful to reduce hospital visits. The asthma sufferer can learn what will cause a serious flareup and avoid that trigger.

Those people who suffer from asthma due to allergies can see a specialist to receive allergy shots that will lessen the symptoms. If health conditions cause asthma to become worse, specialists can work to manage those conditions. Sleep apnea patients could start using a CPAP machine at night to breathe. The use of long-term asthma controlling medications like inhaled corticosteroids or long-acting beta agonists can help an asthma sufferer gain greater control over their condition along with quick-relief medications for attacks like albuterol or ipratropium.

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