Asthma is a chronic disease that affects your
airways. The airways are the tubes that carry air in
and out of your lungs. If you have asthma, the
inside walls of your airways are inflamed (swollen).
The inflammation makes the airways very sensitive,
and they tend to react strongly to things that you
are allergic to or find irritating. When the airways
react, they get narrower, and less air flows through
to your lung tissue. This causes symptoms like
wheezing (a whistling sound when you breathe),
coughing, chest tightness, and trouble breathing,
especially at night and in the early morning.
Obesity may be linked to asthma, as well as other
health problems.
Asthma cannot be cured, but most people with
asthma can control it so that they have few and
infrequent symptoms and can live active lives.
When your asthma symptoms become worse than
usual, it is called an asthma episode or attack.
During an asthma attack, muscles around the airways
tighten up, making the airways narrower so less air
flows through. Inflammation increases, and the
airways become more swollen and even narrower. Cells
in the airways may also make more mucus than usual.
This extra mucus also narrows the airways. These
changes make it harder to breathe.
Asthma attacks are not all the same—some are
worse than others. In a severe asthma attack, the
airways can close so much that not enough oxygen
gets to vital organs. This condition is a medical
emergency. People can die from severe asthma
attacks.
So, if you have asthma, you should see your
doctor regularly. You will need to learn what things
cause your asthma symptoms and how to avoid them.
Your doctor will also prescribe medicines to keep
your asthma under control.
How Is Asthma Diagnosed?
Some things your doctor will ask about include:
-
Periods of coughing, wheezing, shortness of
breath, or chest tightness that come on suddenly,
occur often, or seem to happen during certain
times of the year or season
-
Colds that seem to "go to the chest" or take more
than 10 days to get over
-
Medicines you may have used to help your breathing
-
Your family history of asthma and allergies
-
Things that seem to cause your symptoms or make
them worse
Your doctor will listen to your breathing and
look for signs of asthma or allergies.
Your doctor will probably use a device called a
spirometer to check how your lungs are working. This
test is called spirometry. The test measures how
much air you can blow out of your lungs after taking
a deep breath, and how fast you can do it . The
results will be lower than normal if your airways
are inflamed and narrowed, or if the muscles around
your airways have tightened up.
As part of the test, your doctor may give you a
medicine that helps open narrowed airways to see if
the medicine changes or improves your test results.
Spirometry is also used to check your asthma over
time to see how you are doing.
Spirometry usually cannot be used in children
younger than 5 years. If your child is younger than
5 years, the doctor may decide to try medicine for a
while to see if the child's symptoms get better.
If your spirometry results are normal but you
have asthma symptoms, your doctor will probably want
you to have other tests to see what else could be
causing your symptoms.
Medicines for Asthma
There are two main types of medicines for asthma:
-
Quick-relief medicines—taken at the first signs of
asthma symptoms for immediate relief of these
symptoms. You will feel the effects of these
medicines within minutes.
-
Long-term control medicines—taken every day,
usually over long periods of time, to prevent
symptoms and asthma episodes or attacks. You will
feel the full effects of these medicines after
taking them for a few weeks. People with
persistent asthma need long-term control
medicines.
Quick-relief medicines
Everyone with asthma needs a quick-relief or
"rescue" medicine to stop asthma symptoms before
they get worse. Short-acting inhaled beta-agonists
are the preferred quick-relief medicine. These
medicines are bronchodilators. They act quickly to
relax tightened muscles around your airways so that
the airways can open up and allow more air to flow
through.
You should take your quick-relief medicine when
you first begin to feel asthma symptoms, such as
coughing, wheezing, chest tightness, or shortness of
breath. You should carry your quick-relief inhaler
with you at all times in case of an asthma attack.
Your doctor may recommend that you take your
quick-relief medicines at other times as well—for
example, before exercise.
Long-term control medicines
The most effective, long-term control medicine
for asthma is an inhaled corticosteroid because this
medicine reduces the airway swelling that makes
asthma attacks more likely.
Inhaled corticosteroids (or steroids for short)
are the preferred medicine for controlling mild,
moderate, and severe persistent asthma. They are
generally safe when taken as directed by your
doctor.
In some cases, steroid tablets or liquid are used
for short periods of time to bring asthma under
control. The tablet or liquid form may also be used
to control severe asthma.
Other long-term control medicines include:
-
Inhaled long-acting beta-agonists. These medicines
are bronchodilators, or muscle relaxers, not
anti-inflammatory drugs. They are used to help
control moderate and severe asthma and to prevent
nighttime symptoms. Long-acting beta-agonists are
usually taken together with inhaled corticosteroid
medicines.
-
Leukotriene modifiers (montelukast,
zafirlukast, and
zileuton), which are used either alone to
treat mild persistent asthma or together with
inhaled corticosteroids to treat moderate or
severe asthma.
-
Cromolyn and
nedocromil, which are used to treat mild
persistent asthma.
-
Theophylline, which is used either alone to
treat mild persistent asthma or together with
inhaled corticosteroids to treat moderate
persistent asthma. People who take theophylline
should have their blood levels checked to be sure
the dose is appropriate.
If you stop taking long-term control medicines,
your asthma will likely worsen again.
Many people with asthma need both a short-acting
bronchodilator to use when symptoms worsen and
long-term daily asthma control medicines to treat
the ongoing inflammation.
Over time, your doctor may need to make changes
in your asthma medicine. You may need to increase
your dose, lower your dose, or try a combination of
medicines. Be sure to work with your doctor to find
the best treatment for your asthma. The goal is to
use the least amount of medicine necessary to
control your asthma.
Most asthma medicines are inhaled. They go
directly into your lungs where they are needed.
There are many kinds of inhalers, and many require
different techniques. It is important to know how to
use your inhaler correctly.