Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.
See also:
Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.
In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).
Common asthma triggers include:
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.
Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.
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. Either wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.
Symptoms include:
Emergency symptoms:
Other symptoms that may occur with this disease:
Allergy testing may be helpful to identify allergens in people with persistent asthma. Common allergens include:
Common respiratory irritants include:
The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.
Tests may include:
The goal of treatment is to avoid the substances that trigger your symptoms and control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.
For information on treating asthma in children, see: Pediatric asthma
There are two basic kinds of medication for treating asthma:
Control drugs for asthma control your symptoms if you don't have mild asthma. You must take them every day for them to work. Take them even when you feel okay.
The most common control drugs are:
Other control drugs that may be used are:
Quick-relief drugs work fast to control asthma symptoms:
Quick-relief drugs include:
A severe asthma attack requires a check-up by a doctor. You may also need a hospital stay, oxygen, breathing assistance, and medications given through a vein (IV).
ASTHMA CARE AT HOME
Asthma action plans are written documents for anyone with asthma. An asthma action plan should include:
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
You can often ease the stress caused by illness by joining a support group, where members share common experiences and problems.
See: Asthma and allergy - support group
There is no cure for asthma, although symptoms sometimes improve over time. With proper self management and medical treatment, most people with asthma can lead normal lives.
The complications of asthma can be severe. Some include:
Call for an appointment with your health care provider if asthma symptoms develop.
Call your health care provider or go to the emergency room if:
Go to the emergency room if the following symptoms occur:
You can reduce asthma symptoms by avoiding known triggers and substances that irritate the airways.
Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes as much as possible.
Bronchial asthma; Exercise-induced asthma
Lugogo N, Que LG, Fertel D, Kraft M. Asthma. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 38.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.
National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publication 08-4051.
Wechsler ME. Managing asthma in primary care: putting new guideline recommendations into context. Mayo Clin Proc. 2009;84:707-717.
Fanta CH. Asthma. N Engl J Med. 2009;360:1002-1014.
Reviewed by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA.
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