•Asthma

Asthma is a disease affecting the airways that carry air to and from your lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.

The inside walls of an asthmatic's airways are swollen or inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases your susceptibility to an allergic reaction.
As inflammation causes the airways to become narrower, less air can pass through them, both to and from the lungs. Symptoms of the narrowing include wheezing (a hissing sound while breathing), chest tightness, breathing problems, and coughing. Asthmatics usually experience these symptoms most frequently during the night and the early morning.

Causes of Asthma

The cause of asthma is not known, but there is evidence that many factors play a part.

• Genetic factors: asthma tends to run in families, and many people with asthma also have other allergic conditions such as rhinitis (inflammation of the nose lining). "Allergy" is a hypersensitivity to some proteins foreign to the body; a small dose of the "allergen" will produce a violent reaction in the person concerned.
• Environmental factors: in wealthy, hygienic Western countries, most babies are not exposed to bacterial infections that "kick start" the immune system in early life and may be important in directing the immune system away from allergic responses. They also grow up in warm, well-furnished, carpeted homes that don't allow much airflow. This encourages the rapid breeding of large numbers of house dust mites in bedding, carpets and furnishings. Many children, instead of playing outside in fresh air, spend most of their time indoors. This further increases dust mite sensitisation. Exposure to tobacco smoke, whether during the mother's pregnancy or in early childhood, predisposes children to developing asthma. It also makes their symptoms more severe. Children can also become sensitised to animals, pollens moulds and dust in the environment if they are genetically predisposed.
• Dietary changes: changes in diet in Western countries, such as a high proportion of processed foods, a higher salt intake, a lower antioxidant intake and a lack of fresh oily fish (lower intake of omega-3 fatty acids) may contribute to the development of asthma.
• Lack of exercise: spending more time inside in front of the television means that children get far less exercise. Reduced exercise may mean less stretching of the airways, and a greater tendency for the muscle in the airway walls to contract abnormally when exposed to minor irritants.
• Occupational exposure: in adults, asthma can develop in response to irritants in the workplace - chemicals, dusts, gases, moulds and pollens. These can be found in industries such as baking, spray painting of cars, woodworking, chemical production, and farming.

the Signs and Symptoms of Asthma


Common signs and symptoms of asthma include:

• Coughing. Coughing from asthma often is worse at night or early in the morning, making it hard to sleep.
• Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
• Chest tightness. This may feel like something is squeezing or sitting on your chest.
• Shortness of breath. Some people who have asthma say they can't catch their breath or they feel out of breath. You may feel like you can't get air out of your lungs.

Not all people who have asthma have these symptoms. Likewise, having these symptoms doesn't always mean that you have asthma. The best way doctors have to diagnose asthma is to use a lung function test, ask about medical history (including type and frequency of symptoms), and do a physical exam.
The type of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times, they may be troublesome enough to limit your daily routine.
Severe symptoms can be fatal. Thus, treating symptoms when you first notice them is important, so they don’t become severe.
With proper treatment, most people who have asthma can expect to have few, if any, symptoms either during the day or at night.

Many things can trigger or worsen asthma symptoms. Your doctor will help you find out which things (called triggers) may cause your asthma to flare up if you come in contact with them. Triggers can include:

• Allergens from dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers
• Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products, and sprays (such as hairspray)
• Medicines such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
• Sulfites in foods and drinks
• Viral upper respiratory infections, such as colds
• Physical activity, including exercise

Other health conditions can make asthma harder to manage. Examples of these conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. These conditions should be treated as part of an overall asthma care plan.
Asthma is different for each person. Some of the triggers listed above may not affect you. Other triggers that do affect you might not be on the list. Talk with your doctor about the things that seem to make your asthma worse.



Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results.
Your doctor also will figure out the severity of your asthma—that is, whether it's intermittent, mild, moderate, or severe. The treatment your doctor prescribes will depend on the level of severity.
Your doctor may recommend that you see an asthma specialist if:

• You need special tests to help diagnose asthma
• You've had a life-threatening asthma attack
• You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled
• You're thinking about getting allergy treatments

Medical and Family Histories

Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur.
Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night.
Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to "What Are the Signs and Symptoms of Asthma?"
Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea.

Physical Exam

Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema).
Keep in mind that you can still have asthma even if you don't have these signs when your doctor examines you.

Diagnostic Tests

Lung Function Test

Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out.
Your doctor may give you medicine and then retest you to see whether the results have improved.
If your test results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your doctor will likely diagnose you with asthma.

Other Tests

Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include:

• Allergy testing to find out which allergens affect you, if any.
• A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in.
• A test to show whether you have another condition with symptoms similar to asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea.
• A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object in your airways or another disease might be causing your symptoms.

Diagnosing Asthma in Young Children

Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (infants to children 5 years old) can be hard to diagnose.
Sometimes it's hard to tell whether a child has asthma or another childhood condition. The symptoms of asthma are similar to the symptoms of other conditions.
Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma. A child may wheeze because he or she has small airways that become narrow during colds or respiratory infections. The airways grow as the child grows, so wheezing no longer occurs as the child gets older.
A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:

• One or both parents have asthma
• The child has signs of allergies, including the allergic skin condition eczema
• The child has allergic reactions to pollens or other airborne allergens
• The child wheezes even when he or she doesn't have a cold or other infection

The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis.
Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds.

the most effective asthma treatments for short-term relief and long-term control. Understanding asthma treatments will enable you to work with your asthma doctor to confidently manage your asthma symptoms daily. When you do have an asthma attack or asthma symptoms, it’s important to know when to call your doctor or asthma specialist to prevent an asthma emergency. Be sure to read all the in-depth articles that link to topics within each of the following sections. By doing so, you will gain new insight into asthma and how it’s treated.

Asthma Medications

Asthma medications can save your life -- and let you live an active life in spite of your asthma. There are two basic types of drugs used in asthma treatment:
Steroids and Other Anti-Inflammatory Drugs
Anti-inflammatory drugs, particularly inhaled steroids, are the most important treatment for most people with asthma. These lifesaving medications prevent asthma attacks and work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to react to asthma triggers and cause asthma symptoms.
For in-depth information, see WebMD's article on  Asthma, Steroids, and Other Anti-Inflammatory Drugs .
Bronchodilators and Asthma
Bronchodilators relieve the symptoms of asthma by relaxing the muscles that can tighten around the airways. This helps to open up the airways.
Short-acting bronchodilator inhalers are often referred to as rescue inhalers and are used to quickly relieve the cough , wheeze, chest tightness, and shortness of breath caused by asthma. They may also be used prior to exercise for people with exercise-induced asthma. These should not be used daily in the routine treatment of asthma. If you need to use a short-acting bronchodilator as a rescue inhaler more than twice a week, then your asthma is not optimally controlled. Ask your doctor about improving your asthma controller medication.
Long-acting bronchodilators are used in combination with inhaled steroids for control of asthma symptoms or when someone has ongoing asthma symptoms despite treatment with a daily inhaled steroid. Long-acting bronchodilators are never used alone as long-term therapy for asthma. 
For in-depth information, see WebMD's article on Bronchodilators: Airway Openers .

Asthma Inhalers

Asthma inhalers are the most common and effective way to deliver asthma drugs to the lungs . They are available in different types that require different techniques for use. Some inhalers deliver one medication and others contain two different medications. 
For in-depth information, see WebMD's article on Asthma Inhalers .

Asthma Nebulizer

If you’re having difficulty using small inhalers, your doctor may prescribe an asthma nebulizer , also known as a breathing machine. The asthma nebulizer uses a mouthpiece or mask and is typically used for infants, small children, elderly adults, or anyone who has difficulty using inhalers with spacers. The nebulizer changes asthma medications from a liquid to a mist, so that they can be more easily inhaled into the lungs. This takes a few more minutes of time when compared to inhalers.
For in-depth information, see WebMD's article on Asthma Nebulizer (Breathing Machine) .

Prednisone and Asthma Attacks

If you have a serious asthma attack (exacerbation), your doctor may prescribe a short course of oral corticosteroids. When used orally for less than two weeks, the side effects of corticosteroids are only temporary, but when used for many months, these side effects can be serious and permanent. After the severe symptoms of your asthma attack have been successfully treated and controlled, your doctor will work with you to minimize your need for prednisone in the future. Faithfully taking an inhaled corticosteroid every day is the most commonly successful method to do this.
For in-depth information, see WebMD's article on Prednisone and Asthma.

Talk to Your Asthma Specialist

If you have been diagnosed with asthma but your treatment no longer seems to work, then it’s time to check in with your doctor again. Likewise, if you’ve been diagnosed with asthma and you have symptoms that require you to use your rescue inhaler too frequently, go see your asthma doctor. You may need a change to your asthma medication regimen for better control. Your doctor can determine the problem -- and solution -- so you feel better and breathe right.
While asthma is a common disease, it's also very serious breathing problem that demands a proper medical diagnosis and targeted asthma treatment. Get help for asthma. Talk to your doctor for asthma support and find the right asthma drugs that work best for you.