Asthma is a lung condition that makes the primary airways—known as the bronchi—in the lungs swollen and inflamed all of the time. People who have Asthma are more sensitive than other people to things inhaled from the environment, known as triggers.

These triggers make the muscles in an asthma sufferer’s lungs tighten, constricting the air passages and making breathing difficult. In addition, cells in the lungs produce more mucus in response to a trigger. The mucus can clog the bronchial tubes, which contributes to breathing problems. The airways also swell and become inflamed with white blood cells.

When the lungs react to a trigger, what’s known as an “asthma attack” can occur. Wheezing, coughing and/or tightness in the chest and shortness of breath are all hallmark symptoms of a classic asthma attack. Asthma can be controlled with the proper diagnosis and treatment. The National Center for Health Statistics (a division of the U.S. Centers for Disease Control and Prevention, or CDC) reported that 18.9 million American adults and 7.1 million children suffered from asthma in 2011. The condition is becoming more common and more severe across all age, sex and racial groups.

Asthma typically develops during childhood. But many people develop the condition in adulthood, after age 20—known as adult onset asthma. Some individuals have their first asthma attack after age 50.

Who’s at Risk?

Obesity significantly increases a person’s risk of developing the condition. Heredity is also thought to play a role. Children of parents with asthma are at greater risk for developing the condition.

Pollution, poor air quality in urban environments, poverty and lack of patient education are also factors contributing to rising asthma and asthma-related complication rates. People who have allergies are at an increased risk of developing asthma, and those raised in environments where they were exposed to cigarette smoke also have a much higher incidence of the condition.

Women and Asthma

Women may first develop asthma during or after pregnancy, though the condition may also improve during pregnancy. There is some evidence that asthma may be affected by hormonal changes during a woman’s cycle and can be triggered prior to or during the menstrual period. Women are also more likely than men to die from asthma.

Researchers aren’t sure why some people’s airways are more sensitive to things in the environment. Asthma sufferers may have allergies to certain proteins, known as allergens, which are usually airborne and can trigger an attack. But not all asthma sufferers have defined allergies. An estimated 70 percent of people with asthma have airborne allergies.

Common Asthma Triggers

Common allergens include: dust mites, mold, pollen, cockroaches, animal dander and certain foods or chemicals commonly used in food processing. Contrary to popular belief, dog and cat fur don’t cause allergies. Rather, a protein found in the pet’s saliva, dander and urine causes allergies in some individuals. Other things can irritate the already-sensitive air passages of asthma or allergy sufferers. Common irritants include cigarette smoke, cold air and pollution. Exercise and stress also can trigger an asthma attack.

Controlling asthma includes short-term relief of symptoms and long-term strategies to prevent attacks from occurring. Medications and behavioral approaches, such as avoiding asthma triggers, for example, are both important to managing asthma successfully. Another critical part of asthma management is education and close consultation with your health care team. Newer medications are available, and older methods are being improved or have been withdrawn from the market.

Asthma symptoms that recur frequently, even when medication is taken regularly, can be a sign that a reassessment with a health care professional is necessary.

While primary care providers can diagnose and treat asthma, consultation with a specialist, such as an allergist or pulmonary or lung specialist, may be necessary. Asthma symptoms are sometimes mistaken for a bacterial infection. Antibiotics are not usually effective in controlling asthma. Pulmonary or lung function testing is essential to making the proper diagnosis.

Moderate and mild asthma attacks are common for asthma sufferers. During these attacks an asthma sufferer may feel restless, feel her chest tighten, wheeze and/or cough up mucus. Severe attacks interrupt breathing, causing breathlessness, difficulty talking and eventually loss of consciousness, if not treated immediately. Asthma symptoms and their severity can vary greatly, but they should always be taken seriously.

Common symptoms of asthma include:

• dry cough, especially at night or as a response to certain “triggers” or allergens, such as dust or pets
• a feeling of tightness or pressure in your chest
• difficulty breathing
• wheezing—which sounds like a whistling sound—when you exhale
• shortness of breath after exercise
• colds that migrate to your chest or don’t go away for 10 days or more
• waking up at night with shortness of breath

Common asthma triggers include the following:

• dust mites
• pollens
• molds
• pet dander (protein in pet fur, saliva and urine)
• cockroaches
• viral respiratory infections
• certain medications, such as aspirin and other nonsteroidal anti-inflammatories, and beta blockers
• exercise
• stress
• menstrual cycles in some women
• irritants (tobacco smoke and some scented products and chemicals)
• food allergies

If you are experiencing one or more of the symptoms associated with asthma and have never received treatment or medication for it, it is very important that you make an appointment with a health care professional soon. To accurately diagnose your condition, your health care professional will ask you questions about your symptoms, perform a physical exam and conduct lung function tests.

Asthma symptoms are often associated with other illnesses in older adults, such as chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD) and sinusitis. COPD is a persistent blockage of the air passages caused by emphysema or chronic bronchitis. Emphysema occurs when the walls of the alveoli—or tiny air sacs—in the lungs are damaged. This damage makes the aveoli less elastic and, therefore, less effective at passing oxygen into the blood and removing carbon dioxide from the blood, leading to shortness of breath. It is most common among people who have smoked the equivalent of one pack of cigarettes per day or more for 10 years.

Chronic bronchitis, which produces a persistent cough not related to a cold or other medical condition, causes inflammation of the airways, which produces mucus and causes muscle spasms.

It is estimated that more than 75 percent of people with asthma also experience GERD, which causes the stomach’s digestive juices to back up or “reflux” into the esophagus—the passageway for food from the mouth to the stomach. Over time, the esophagus becomes inflamed or permanently damaged. Chronic heartburn, cough, snoring, wheezing and hoarseness are some symptoms of GERD.

Asthma and sinusitis frequently coexist, and many patients with asthma won’t improve unless their sinusitis is treated. Additionally, many only get asthma when their sinusitis worsens. Thus, a complete assessment of asthma always requires a review of the upper airway, including the sinuses.

Tests that measure your airflow are a primary tool in the diagnosis of asthma. Specialists and some primary health care professionals will use a spirometer, which is a machine that measures how much air you blow out each second. Another test employs a peak flow meter to measure how much air you can breathe out in a fast blast. These tests are simple and painless, but offer revealing information about your airflow. Your health care professional might also measure your airflow before and after treatment with a bronchodilator, a medicine that relaxes tight muscles in the airways, to judge reversibility or improvement with a bronchodilator, the hallmark of asthma.

Other tests may be administered to assess your sensitivity to specific allergens that may be triggering your asthma. Often skin tests are used to determine which allergens you are allergic to. Diluted extracts from allergens such as particular foods, pollens, dust mites and molds are injected under your skin or into a tiny scratch or puncture on your arm or back. If you have a positive reaction (meaning you are allergic), a small, raised, reddened area with a surrounding flush will appear at the test site, indicating antibodies to that specific allergen are present in the skin. These reactions can be modest or very large depending on how allergic you are.

Your health care professional might also conduct a blood test, which is not as sensitive as a skin test, to look for allergies. Using a sample of your blood, the test looks for levels of antibodies to particular allergens present in the home and outdoors in various parts of the United States.

 Treatment

There is no way to prevent asthma from developing. You can learn to identify your asthma or allergy triggers and possibly avoid them. Developing an asthma management plan with your health care team can help you determine which medication works best for you and what other strategies you can use to improve your condition. Here are a few suggestions for avoiding triggers:

• Track your symptoms to identify what triggers your asthma attacks; once identified try to avoid them.
• Always be prepared to manage your attacks.
• Prevent symptoms before they occur, if possible.
• If you’re allergic to cat or dog dander, use your asthma medications before visiting someone with these pets, and be sure and have a reliever type medication with you, such as albuterol.
• If necessary, find a new home for your pet or keep it out of your sleeping area.
• If you smoke, quit, and turn your home into a smoke-free zone.
• When pollen counts or ozone levels are high in the summer, try to stay indoors and in air conditioning; use air filters on your furnace and air conditioner.
• If cold air is a trigger for you, wear a scarf to cover your mouth and nose when you are outside in the winter.
• Wash all your bedding, including pillow cases, clothes and stuffed animal toys, once a week or more often in hot water (greater than 130° F) and dry at high heat to kill dust mites.
• Use a dehumidifier in damp areas such as bathrooms and basements to reduce mold build-up.
• Avoid close contact with anyone who has a cold or the flu, and wash your hands regularly.
• Get a flu shot in the fall.
• Work with your health care professional to come up with a medication regimen that will still allow you to exercise.
• Use your asthma medications before exercising in cold air.

1. Asthma is a chronic lung condition caused by heightened sensitivity to various things in the environment, such as pollen, dust and smoke. Exposure to these “triggers” causes the air passages to become swollen and inflamed, causing the hallmark symptoms of an asthma “attack”: increased mucous production, wheezing, coughing, chest tightness and difficulty breathing.
2. Asthma can’t be cured, but it can be controlled with a variety of medications. If not well controlled, asthma can be life threatening. Lifelong management is usually necessary.
3. The rate of asthma is higher in children than in adults (8.2 percent of adults have asthma, compared to 9.5 percent of children).
4. The National Center for Health Statistics (a division of the CDC) reported that 18.9 million American adults and 7.1 million children suffered from asthma in 2011. Asthma cases have been increasing in number and severity since the early 1980s, spanning people of all ages, sex and racial groups.
5. According to the Asthma and Allergy Foundation of America, African Americans are three times as likely as Caucasians to be hospitalized from asthma and three times as likely to die from the disease. Racial differences in asthma prevalence and mortality are believed to be related to poverty, urban air quality, indoor allergens, lack of patient education and inadequate medical care. Women are more likely than men to die from asthma attacks.
6. About half of all adults with asthma have allergies that may trigger asthma symptoms. Identifying, avoiding or controlling triggers is an important part of asthma management.
7. Obesity is a major risk factor for developing asthma.
8. Asthma is believed to have a genetic component. Children of a parent or parents with asthma are at greater risk of developing the condition.
9. Three main groups of asthma medications are available: quick-relief medications, long-term controller medications and medications for allergy-induced asthma.
10. Exercise can trigger an asthma attack; treatment with an inhaled bronchodilator before exercising can prevent exercise-induced asthma.