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Asthma

Asthma is a chronic disease that interferes with a person's ability to breathe. Asthma affects the airway tubes that bring air to the lungs.

Asthma causes three changes in the lungs:

  • Inflammation or swelling of the airways.
  • Increased mucous production in the airways.
  • Tightening of muscles in the airways.

Often asthma has no known cause.

Sometimes it is due to an allergy to airborne dust, pet dander, or mold. Cockroaches can also be a factor. There is also a tendency for asthma to run in families. The National Institute of Health (NIH) has determined that most—but not all—asthma cases can be linked to allergies.

People with asthma breathe normally most of the time. Occasionally, they have attacks or flare-ups when breathing is more difficult. These episodes are often caused by exposure to triggers that cause the airways to react.

Triggers can include:

  • Cigarette smoke.
  • Pollen.
  • Pet dander.
  • GERD (gastroesophageal reflux disease).
  • Dust mites.
  • Viruses: viral infections may be the most common cause of asthma flare-ups.

The most common ways to prevent asthma attacks are to take preventive medications.

These medications are called long-term-control medications. You should also try avoid the triggers that cause attacks for you whenever possible.

Symptoms

Symptoms of asthma are:

  • Trouble breathing.
  • Wheezing.
  • Feeling of tightness in the chest.
  • Coughing, particularly coughing at night.

There is a system that your doctor will use to classify the severity of your asthma. This system will help your doctor to decide how to treat and manage your asthma. Regardless of the severity of your asthma, it needs to be managed with planned use of medications as prescribed by your doctor. Your doctor may also recommend the use of peak flow meters and a detailed action plan.

The four levels used to classify people with asthma who are five years of age and older are as follows:

Intermittent: Daytime symptoms two or less times per week, or nighttime symptoms one or two nights per month. A sudden flare-up of symptoms (wheezing, shortness of breath, or cough) occurs once or less per year.
Persistent, mild: Daytime symptoms more than two times per week, but not every day, or nighttime symptoms three or four nights per month.
Persistent, moderate: Daytime symptoms every day or nighttime symptoms more than one night per week, but not every night.
Persistent, severe: Continual daytime symptoms or frequent nighttime symptoms (often every night).

With all levels of Persistent asthma, sudden flare-ups of symptoms may occur, usually two or more times per year.

For very young children (four years of age or younger), asthma classifications differ. The four levels of asthma for very young children are as follows:

Intermittent: Daytime symptoms two or less days per week with no nighttime symptoms. A sudden flare-up of symptoms (wheezing, shortness of breath, or cough) occurs once or less per year.
Persistent, mild: Daytime symptoms more than two times per week, but not every day, or nighttime symptoms one to two nights per month.
Persistent, moderate: Daytime symptoms every day or nighttime symptoms three to four times per month, but not every night.
Persistent, severe: Continual daytime symptoms or nighttime symptoms more than one time a week.

With all levels of Persistent asthma for very young children, sudden flare-ups of symptoms may occur, usually two or more times in six months. There can also be wheezing episodes that last for more than one day and may occur four or more times per year.

National Guidelines

For you and your doctor to follow when treating asthma:

  • Every person with asthma should see their doctor every 1–6 months to have their asthma evaluated. At each visit the doctor is assessing the asthma and adjusting the medications. The doctor should be asking how often asthma symptoms are occurring. The medication dosages are adjusted to keep the symptoms and level of irritation inside the lungs at a minimum. Even if asthma is under control, persons with asthma should still be seeing their doctor every 6 months to have their therapies evaluated.
  • Every person with asthma should receive their influenza shot every year. This is because a person with asthma has weak lungs and cannot fight off influenza as well. They often can develop fluid in the lung, called pneumonia, and die.
  • Every person with asthma should have their lungs measured by a machine called a spirometer. This should be done at diagnosis, and at least every 1–2 years thereafter.
  • Every person with asthma should have a written asthma action plan. The best medications to treat asthma are those that treat the swelling and irritation inside the airway. According to The National Guidelines, the preferred medications for all severities of asthma are inhaled corticosteroids. These include: PULMICORT, QVAR, FLOVENT, ALVESCO, ASMANEX, AEROBID

Helpful Documents

View and print these helpful asthma handouts

Asthma: Action Plan
Asthma: in Children
Asthma: Tips For Reducing Indoor Pollutants
Asthma: Helping Your Child
Asthma: Lung Function Test
Asthma: Symptoms of Difficulty Breathing
Asthma: Triggers
Asthma: Exercise Induced
Asthma: Taking Charge Of Your Asthma
Asthma: When To Call A Doctor
Asthma: Treatment of in Children

Compiled from the following sources: National Heart, Lung, and Blood Institute.