Asthma (AZ-muh) is a chronic disease that affects your airways, which 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 (IN-fla-MAY-shun) makes the airways very sensitive, and they tend to react strongly to things to which you are allergic or find irritating. When the airways react, they get narrower and less air flows through to your lung tissues. This causes symptoms like wheezing (a whistling sound when you breathe), coughing, chest tightness, and trouble breathing.
Asthma cannot be cured, but for most patients it can be controlled so that you have only minimal and infrequent symptoms and you can live an active life. So, if you have asthma, taking care of it is an important part of your life. Controlling your asthma means staying away from things that bother your airways and taking medicines as directed by your doctor. By controlling your asthma every day, you can prevent serious symptoms and take part in all activities. If your asthma is not well controlled, you are likely to have symptoms that can make you miss school or work and keep you from doing things you enjoy. Asthma is one of the leading causes of children missing school.
When you experience a worsening of your asthma symptoms, it is called an asthma episode or attack. In an asthma attack, muscles around the airways tighten up, making the airway openings narrower so less air can flow through. Inflammation increases and the airways become more swollen and narrow. Cells in the airways also make more mucus than usual. This extra mucus also narrows the airways. These changes cause the symptoms of asthma and 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.
If you have asthma, you should see your doctor regularly. You will need to learn what things cause your asthma symptoms to worsen and how to avoid them. Your doctor will also prescribe medicines to keep your asthma under control.
It is not clear exactly what makes the airways of people with asthma inflamed in the first place. Your inflamed airways may be due to a combination of things. We know that if other people in your family have asthma, you are more likely to develop it. New research suggests exposures early in your life (like tobacco smoke, infections, and some allergens) may be important.
There are things that can make asthma symptoms worse and lead to asthma attacks. Some of the more common things that can worsen your asthma symptoms are exercise, allergens, irritants, and viral infections. Some people only have asthma with exercise or a viral infection. The lists below give some examples of things that can worsen asthma symptoms.
This is not a complete list of all the things that can worsen asthma. People can have trouble with one or more of these. It is important for you to learn which ones are problems for you. Your doctor can help you identify which things affect your asthma and ways to avoid them.
In the United States, about 15 million people have asthma. Nearly 5 million of them are children. Asthma is closely linked to allergies. Most, but not all, people with asthma have allergies. Children with a family history of allergy and asthma are more likely to have asthma.
Although asthma affects people of all ages, it often starts in childhood and is more common in children than adults. More boys have asthma than girls, but in adulthood, more women have asthma than men.
Although asthma is a problem among all races, blacks have more asthma attacks and are more likely than whites to be hospitalized for asthma attacks and to die from asthma.
Common asthma symptoms include:
People With Asthma May Have:
If you notice that you or your child has these symptoms, talk to your doctor or your child's doctor. Not all people have these symptoms, and symptoms may vary from one asthma attack to another. Symptoms can differ in how severe they are: sometimes symptoms can be mildly annoying; other times they can be serious enough to make you stop what you are doing, and sometimes symptoms can be so serious that they are life threatening. Symptoms also differ in how often they occur. Some people with asthma only have symptoms once every few months, others have symptoms every week, and still other people have symptoms every day. With proper treatment, however, most people with asthma can expect to have minimal or no symptoms.
Some things your doctor will ask about include:
Your doctor will then listen to your breathing and look for signs of asthma or allergies. Your doctor will probably use a device called a spirometer (speh-ROM-et-er) to check your airways. This test is called spirometry (speh-ROM-eh-tree). The test measures how much air and how fast you can blow air out of your lungs after taking a deep breath. The results will be lower than normal if your airways are inflamed and narrowed, as in asthma, or if the muscles around your airways have tightened up. As part of the test, your doctor may give you a medication that helps open up narrowed airways to see if it changes or improves your test results. Spirometry is also used to check your asthma over time to see how you are doing.
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. One test commonly used is a bronchial challenge test. A substance such as methacholine, which causes narrowing of the airways in asthma, is inhaled. The effect is measured by spirometry. Children under age 5 usually cannot use a spirometer successfully. If spirometry cannot be used, the doctor may decide to try medication for a while to see if the child's symptoms get better.
Besides spirometry, your doctor may also recommend that you have:
Other tests, such as a chest x-ray or an electrocardiogram, may be needed to find out if a foreign object, or other lung diseases or heart disease could be causing asthma symptoms. A correct diagnosis is important because asthma is treated differently from other diseases with similar symptoms.
Depending on the results of your physical exam, medical history, and lung function tests, your doctor can determine how severe your asthma is. This is important because your asthma severity will determine how your asthma should be treated. A general way to classify severity is to consider how often a person has symptoms when that person is not taking any medicine or when his or her asthma is not well controlled. Based on symptoms, the four levels of asthma severity classification are:
Mild Intermittent (comes and goes) — when your asthma is not well controlled, you have asthma symptoms twice a week or less, and you are bothered by symptoms at night twice a month or less.
Mild Persistent Asthma — when your asthma is not well controlled, you have asthma symptoms more than twice a week, but no more than once in a single day. You are bothered by symptoms at night more than twice a month. You may have asthma attacks that affect your activity.
Moderate Persistent Asthma — when your asthma is not well controlled, you have asthma symptoms every day, and you are bothered by nighttime symptoms more than once a week. Asthma attacks may affect your activity.
Severe Persistent Asthma — when your asthma is not well controlled, you have symptoms throughout the day on most days, and you are bothered by nighttime symptoms often. In severe asthma, your physical activity is likely to be limited. Anyone with asthma can have a severe attack—even those who have intermittent or mild persistent asthma.
You and your doctor together can decide about your treatment goals and what you need to do to control your asthma. Asthma treatment includes: Avoiding things that bring on your asthma symptoms or make symptoms worse. Doing so can reduce the amount of medicine you need to control your asthma. Allergy medicine and allergy shots in some cases may help your asthma.
Using Asthma Medicines.
With proper treatment, you should ideally have these results:
There are two main types of medicines for asthma:
Quick Relief Medicines Are Used Only When Needed. A type of quick relief medicine is a short-acting inhaled bronchodilator. Bronchodilators work by relaxing tightened muscles around the airways. They help open up airways quickly and ease breathing. They are sometimes called "rescue" or "relief" medicines because they can stop an asthma attack. These medicines act quickly but their effects only last for a short period of time. You should take quick relief medicines when you first begin to feel asthma symptoms like coughing, wheezing, chest tightness, or shortness of breath. Anyone who has asthma should always have one of these inhalers in case of an attack. For severe attacks, your doctor may use steroids to treat the inflammation.
Long-Term Control Medicines. The most effective, long-term control medication for asthma is an inhaled corticosteroid (kor-ti-ko-STE-roid) because this medicine reduces the swelling of airways that makes asthma attacks more likely.
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 medication to treat the ongoing inflammation. Over time, your doctor may need to make changes in your asthma medication. You may need to increase your dose, lower your dose, or try a combination of medications. 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.
As part of your asthma action plan, you may use a hand-held device called a peak flow meter at home to measure lung function. To use it, you take a deep breath and blow hard into a tube to find out how fast you can blow out. This gives you a peak flow number. You will need to find out your "personal best" peak flow number by recording the peak flow number daily for a few weeks until your asthma is under control. The highest number you get during that time is your personal best peak flow. Then you can compare future peak flow measurements to your personal best peak flow, and that will show if your asthma is staying under control or not.
Your doctor will tell you how and when to use your peak flow meter and how to use your medication based on the results. You may be asked to use your peak flow meter each morning to keep track of how well you are breathing. The peak flow meter can help warn of a possible asthma attack even before you notice symptoms. If your peak flow meter shows that your breathing is getting worse, you should follow your action plan. Take your quick relief or other medication as your doctor directed. Then you can use the peak flow meter to see how your airways are responding to the medication.
Ask your doctor about how you can help take care of your own asthma. You should know:
Children with asthma, like adults with asthma, should see a doctor for treatment. Treatment may include allergy testing, finding ways to limit contact with things that cause asthma attacks, and taking medication.
Young children will need help from their parents and other caregivers to keep their asthma under control. Older children can learn to care for themselves and follow their asthma action plan with less supervision.
Medications for asthma in children are like those adults use, but doses are smaller. Children with asthma may need both a quick-relief (or "rescue") inhaler for attacks and daily medication to control their asthma. Children with moderate or severe asthma should learn to use a peak flow meter to help keep their asthma under control. Using a peak flow meter can be very helpful because children often have a hard time describing their symptoms.
Parents should be alert for possible signs of asthma in children, such as coughing at night, frequent colds, wheezing, or other signs of breathing problems. If you suspect asthma or that your child's asthma is not in good control, take your child to a doctor for an exam and testing.
Your doctor will choose medication for your child based on the child's symptoms and test results. If your child has asthma, you will need to go to the doctor for regular followup visits and make sure that your child uses the medication properly.
“Parents should be alert for possible signs of asthma in children, such as coughing at night, frequent colds, wheezing, or other signs of breathing problems.”
Older adults may need to have adjustments in their asthma treatment because of other diseases or conditions they have. Some medicines (like beta blockers used for treating high blood pressure and glaucoma, aspirin, and nonsteroidal anti-inflammatory drugs) can interfere with asthma medications or even cause asthma attacks. Be sure to tell your doctor about all medications that you take, including over-the-counter ones. Using steroids may affect bone density in adults, so ask your doctor about taking calcium and vitamin D supplements and other ways to help keep your bones strong.
If you are pregnant, it is very important to both you and your baby to control your asthma. Uncontrolled asthma can lower the oxygen level in your blood, which means that your baby gets less oxygen too. Most asthma medications are safe to take during pregnancy. If you are pregnant or thinking about becoming pregnant, talk to your doctor about your asthma and how to have a healthy pregnancy.
Regular physical exercise is important for good health. If exercise brings on asthma symptoms, work with your doctor to find the best way to avoid having symptoms when you exercise. Some people with asthma use inhaled quick relief medication before ex-ercising to keep symptoms under control. If you use your asthma medication as directed and learn how to pace yourself, you should be able to take part in any physical activity or sport you choose. Many Olympic athletes have asthma.
If you have asthma, it is important to learn how to take care of yourself. Work with your doctor to make an action plan that you are both happy with.
If your asthma is not under control, there will be signs that you should not ignore. The following are some signs that your asthma is getting worse:
If your asthma seems to be getting worse, see your doctor. You may need to change your medication or do other things to get your asthma under control.
Children with asthma need the help of parents, other caregivers, teachers, and health care professionals to keep their asthma under control. You can help a child with asthma to keep it under control by using the following suggestings:
We don’t yet know how to prevent asthma, but there are some things that can lower the chances of an asthma attack. To prevent asthma symptoms:
Scientists do not yet know how to prevent the inflammation of the airways that leads to asthma. However, there are some theories that are being explored:
“We don’t yet know how to prevent asthma, but there are some things that can lower the chances of an asthma attack.”
Is asthma contagious?
No, asthma is not a contagious disease—no one can “catch” it from you.
What are the most common causes of asthma attacks?
Allergies to things like dust mites or pet dander, infections like colds and flu, and irritants like smoke or breathing cold air may cause asthma symptoms. Many people have asthma after exercise like running or playing hard. Things that bother one person's airways may not bother another person.
Are asthma medicines addictive?
No, the medicines used for asthma are not addictive. Be sure to take your medicines as directed and let your doctor know if you are having trouble taking your medicines.
Do asthma medicines lose their effect if they are taken for a long time?
No, your asthma medicine will not become less effective over time. Your doctor may adjust or change your medicines if your asthma symptoms change over time.
Are inhaled steroids dangerous?
The inhaled steroid medicines used to treat asthma are safe and effective. It is important to take your steroid medicine exactly as prescribed by your doctor. The steroids used for asthma are NOT the same drug as the unsafe steroids some athletes take to build muscle.
What can I do if exercise causes my asthma symptoms?
Talk to your doctor about how to prevent asthma caused by exercise. Many people take medication before exercising to avoid asthma symptoms. You can also learn how to pace yourself if you seem to be having symptoms. If your asthma is under control, you should be able to take part in any activity you choose. Many Olympic athletes have asthma.
Will allergy shots help my asthma?
You will need to have allergy tests first. Allergy shots can help with certain allergies like pollen and grasses. You should also find out what you can do to avoid the things that you are allergic to.
My child has a lot of chest colds with coughing. Could he have asthma?
Talk to your child's doctor about the colds and coughing. Some children who have a lot of colds with coughing, especially at night, do have asthma and should be treated for it.
What is a peak flow meter?
A peak flow meter is a device you can easily use at home to check how open your airways are. It can help you keep track of how well your asthma is controlled. You use it by taking a deep breath and blowing hard into a plastic piece that goes in your mouth. Then, write down the resulting number that appears on the meter. Peak flow meters are most helpful for people with moderate or severe asthma. Your doctor may ask you to use a peak flow meter regularly and keep track of the numbers.
Do babies who have wheezing when they have a cold ever “outgrow” their asthma?
Many children who have wheezing as a baby do not go on to have asthma as they get older. But other children continue to have asthma throughout their childhood. Children with allergies or a family history of asthma are more likely to continue having asthma as they get older.
“Medicines used for asthma are not addictive. Be sure to take your medicines as directed and let your doctor know if you are having trouble taking your medicines.”
Asthma ranks among the most common chronic conditions in the United States, affecting an estimated 14.9 million persons in 1995 and causing over 1.5 million emergency department visits, about 500,000 hospitalizations, and over 5,500 deaths. The estimated direct and indirect monetary costs for this disease totaled $11.3 billion in 1998. Asthma disproportionately affects children and blacks. Within the general population, asthma affects females more than males; however, among children, it affects males more. The burden of asthma has been increasing over the past 20 years, especially among children.
The information contained in this behavior change brochure will help you better understand how to live with asthma. By better understanding this disease, it is possible to live a long and vibrant life. Moreover, if you have a child living with asthma, this brochure will provide invaluable information as to how you can address this issue as a family.
The information in this brochure was drawn from the National Heart, Lung, and Blood Institute. The information is in the public domain and may be used and reprinted without permission. For more information please refer to http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html. The information was accessed in January 2005. This information is not intended to replace the advice of your healthcare provider. If you have any questions about managing your own health and/or seeking medical care, please contact a medical professional.
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2005 Wellness Councils of America
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