Overview
Asthma is a chronic lung disease in which the airways become inflamed and narrowed. This causes shortness of breath, wheezing, and coughing attacks. It affects 5-7% of adults and up to 10% of children.
Asthma attacks can range from mild to severe; with proper treatment, the condition can be controlled. Most patients can lead a normal life.
Symptoms
- Shortness of breath (especially with exertion)
- Wheezing (especially when exhaling)
- Chest tightness or pressure
- Dry, persistent cough (especially at night and early morning)
- Difficulty speaking due to breathlessness
- Easy fatigue during activity
Symptoms of an asthma attack:
- Severe shortness of breath
- Rapid breathing
- Speaking word by word
- Bluish lips and nails
- Confusion
Causes
The exact cause is unknown, but a combination of genetic predisposition and environmental factors plays a role. The airways are hypersensitive to certain triggers.
Triggers
- Allergens: Pollen, dust mites, mold, animal dander
- Respiratory infections: Cold, flu
- Physical activity (exercise-induced asthma)
- Cold air
- Air pollution, cigarette smoke
- Strong odors and perfumes
- Some medications (aspirin, beta blockers)
- Stress and strong emotions
- Some food additives
- Gastroesophageal reflux (GERD)
Risk Factors
- Family history
- History of allergy and eczema
- Frequent respiratory infections in childhood
- Secondhand smoke exposure
- Air pollution
- Some occupational exposures (paint, chemicals)
- Excess weight
Complications
- Disruption of sleep and daily activities
- School/work absenteeism
- Permanent airway narrowing
- Life-threatening asthma attack
- Side effects of long-term medication use
When to See a Doctor
Emergency situations:
- Inability to speak due to shortness of breath
- Bluish lips/nails
- Shortness of breath not responding to rescue inhaler
- Severe wheezing
Routine visits:
- New cough, wheezing, or shortness of breath
- Symptoms not controlled with treatment
- Frequent attacks (more than weekly)
- Symptoms waking you at night
Diagnosis and Treatment
Diagnosis:
- Pulmonary function test (spirometry)
- Bronchial provocation test
- Allergy tests
- Chest X-ray
Treatment is divided into two groups:
1. Controller medications (daily):
- Inhaled corticosteroids (budesonide, fluticasone)
- Long-acting bronchodilators
- Leukotriene receptor antagonists (montelukast)
- Biological agents (omalizumab)
2. Rescue medications (during attacks):
- Short-acting bronchodilators (salbutamol)
- Systemic steroids during attacks
Proper inhaler use is critical.
Prevention
- Identify and avoid your triggers
- Keep your home free of dust, mold, and pet dander
- Do not smoke; avoid secondhand smoke
- Get flu and pneumonia vaccines
- Manage seasonal allergies
- Do not skip preventive medications
- Maintain lung capacity with regular exercise
- Avoid excess weight