Asthma is a lung condition that causes irritation and swelling (inflammation) of the lining of the airways in your lungs. The inflammation causes wheezing, coughing, and shortness of breath. Asthma can be a chronic problem, which means you may have it the rest of your life.
You may start coughing or wheezing when you breathe in irritants or something you are allergic to.
A cold or the flu might also bring on an asthma attack.
Some people have coughing or wheezing only when they are being physically active. This is called exercise-induced asthma.
Asthma may be mild, moderate, or severe. An asthma attack may last a few minutes or a few days. Attacks can happen anywhere and at any time. Severe asthma attacks can be life threatening. It is very important to get prompt treatment for asthma attacks and to learn to manage your asthma so you can live a healthy, active life.
Many Americans have asthma, and the number of people who have asthma is increasing worldwide.
If you have asthma, the airways in your lungs are always somewhat inflamed, even when you do not have any symptoms. When your airways are exposed to irritants or allergens, the airways become more swollen and make more mucus. The tiny muscles in the walls of the airways contract. These reactions cause the airway openings to get smaller. When the airways are smaller, it is harder for air to move in and out. Wheezing is the sound of air moving through the narrowed air passages. The extra mucus in the airways causes coughing.
Some of the factors that may increase the risk that you will have asthma are:
Symptoms can be occasional or daily and include:
You may find that there are things you used to do that you can no longer do because it is harder to breathe.
A single attack of wheezing does not mean you have asthma. Some infections and chemicals can cause wheezing that lasts for a brief time or a few days and then does not happen again.
Your healthcare provider will ask about your history of breathing problems. You will have a physical exam. You may have breathing tests called pulmonary function tests or spirometry. You may be tested before and after taking medicine to see how your symptoms respond to medicine.
The goal of treatment is to allow you to live a normal, active life. With proper treatment, your asthma should be less of a problem day to day. It will also be less likely that you will have a bad asthma attack or more problems in the future. Treatment will probably include prescribed medicines. You may also need to remove allergy-causing substances or irritants from your home.
Three types of medicines are used to control asthma:
Quick-relief medicines (also called reliever, rescue, or quick-acting medicines)
Albuterol is the generic name of the most widely used quick-relief medicine. It is a type of medicine called a bronchodilator. Bronchodilators relax the muscles in the airways. When the muscles are relaxed, the airways become larger. This means that there is more space for air to move in and out.
You inhale the medicine by breathing it into your lungs as you spray it into your mouth. You use this medicine when you start to have an asthma attack. In some cases your provider may recommend that you use it on a regular daily schedule.
You should always carry a bronchodilator with you to use when you start to cough or wheeze. If you have exercise-induced asthma, you should use the medicine before exercise to prevent wheezing.
Steroid medicines for attacks that last several days
Steroids are another type of medicine that may be used to control asthma attacks. They are a type of anti-inflammatory medicine. The steroid medicine usually used for asthma is prednisone. You may need to take steroid tablets or use a steroid inhaler for several days with your other medicines to get your asthma back under control.
Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.
Long-term control medicines (also called controller medicines)
Long-term control medicines are used to prevent asthma attacks and to keep you breathing as normally as possibly every day. Several types of medicines help prevent asthma attacks. They help reduce the inflammation in your airways. They are taken 1 or more times every day whether or not you are having symptoms. You may need only 1 of these medicines or you may need a combination. These medicines are now considered the best and safest way to have long-term control of asthma.
Long-term control medicine should be used all the time for year-round asthma. If you have asthma during just certain seasons of the year, your healthcare provider may instruct you to take the medicine just during the months when you usually have asthma symptoms. The medicine does not work well if you start and stop it frequently, for example, every week or two.
Long-term control medicines cannot stop attacks of wheezing after you have started wheezing. You must use a quick-relief medicine, such as albuterol, when you are wheezing.
The goals of long-term control medicines are to:
The medicines used most often for long-term control of asthma are:
Some of these medicines are available as combinations. For example, salmeterol is always used in combination with another type of controller medicine, usually an inhaled steroid.
One other, less often used controller medicine is theophylline. It is a pill usually taken at bedtime to prevent nighttime wheezing.
If you have severe persistent asthma and your asthma cannot be controlled with inhaled steroids, your healthcare provider may prescribe low-dose steroid tablets for long-term control of the asthma. However, steroid tablets have more long-term side effects than inhaled steroids. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.
You need to work closely with your healthcare provider to find the treatment right for you. Make sure you understand how to use each of your medicines. Some are quick-acting and meant to be used when you have an asthma attack. Others are slow acting and help prevent attacks, but they do not help when you are having an attack.
Inhalers
Make sure you know how to use your inhaler correctly. Some inhalers work best if you hold them 2 inches in front of your mouth when you spray. This helps the medicine get to your lungs rather than getting stuck in your mouth. However, some inhalers need to be put in your mouth.
If you have an inhaler that should be used a couple of inches in front of your mouth and it is hard for you to hold the inhaler in the right position, ask your healthcare provider for a spacer tube. You can put one end of the spacer in your mouth and attach the inhaler to the other end. The spacer can help you inhale more of the asthma medicine.
Be sure you ask your healthcare provider or pharmacist the best way to use your inhalers. Read the directions that come with the inhalers. Also ask your pharmacist how you can know when your inhaler is empty so you can avoid getting caught without medicine.
Peak flow meter
Your breathing ability can change from day to day. For example, illness or seasonal allergies may make your airways more inflamed than usual. Your healthcare provider may prescribe a peak flow meter to measure how well air is moving out of your lungs. The peak flow meter can help you and your healthcare provider know if your asthma is in good control, if you need to take medicine to prevent an attack of wheezing, or if you need to get help right away.
Your peak flow measurement will often go down before you start having symptoms of asthma. When your peak flow reading is getting low it may mean that you’re about to have an asthma attack or that you need to adjust your medicines.
Ask your healthcare provider at what peak flow level you should call the office.
Pregnancy
Uncontrolled or poorly controlled asthma increases the risk of problems during your pregnancy because not enough oxygen will get to your baby. Examples of problems that might happen are high blood pressure (preeclampsia), early delivery of your baby, or a small baby. By carefully following your healthcare provider’s recommended treatment, you should be able to avoid the pregnancy problems that can be caused by asthma.
See your asthma provider as soon as you know you are pregnant in case any changes need to be made to your medicines. Be sure to keep taking your asthma medicines as recommended by your asthma provider and have regular asthma checkups during your pregnancy. You may need changes in your asthma medicines to keep your lungs working well enough so that the baby gets the oxygen that it needs. Make sure that you talk to your healthcare provider about how you should treat an asthma attack while you are pregnant. Take only medicines that have been prescribed by your healthcare provider. If you have concerns about your medicines, talk with your provider about which medicines are safe for you and your baby.
Asthma is a chronic condition, even though you might not have any symptoms for decades. It is more common in children than adults. People who had asthma as children often have no symptoms once they become adults. However, the symptoms may come back later in life. Asthma that develops for the first time in mid- or late life usually keeps being a problem for the rest of your life.
Learn about asthma and its treatment.
You should also:
If you often have problems with acid indigestion—a condition called gastroesophageal reflux disease, or GERD—you may have more asthma symptoms, especially at night. When you have GERD, stomach acid flows backward into the throat. The stomach acid irritates the upper airway and causes heartburn. If you have heartburn often, talk to your healthcare provider about it. Your provider may prescribe a medicine that reduces the acid in your stomach. This can help relieve GERD and asthma symptoms. You can also prevent or relieve symptoms of GERD by:
Asthma can be a life-threatening condition.
In most cases asthma is a controllable disease and you can live an active life. But it requires understanding your medicines, using them as directed, and working with your healthcare provider to find the best treatment plan for you. This plan may change as you get older, move to a different location, or start having other health problems.
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