What is asthma?
Asthma is a chronic inflammatory condition of the airway of the lungs. The inflammation causes swelling, increased mucus production, and thickening of the airway lining. Symptoms include coughing, wheezing, shortness-of-breath, and chest-tightness. The muscle layer of the lungs can become “twitchy,” which can lead to an acute asthma attack when exposed to irritants in the environment.
Are asthma symptoms always severe?
No- that is a common misunderstanding. Like many medical conditions, some people have very mild symptoms and some will have more severe symptoms. For some, asthma occurs intermittently and for others asthma symptoms occur on a daily basis. Many people are fearful of being diagnosed with asthma. Often times, this fear comes from seeing friends or family who have suffered from severe asthma. It is important to know that the overwhelming majority of patients with asthma are able to live their lives without significant restrictions. Many Olympic athletes have asthma!! Following up with your doctor and following your treatment regimen will go a long way towards keeping your lungs in tip-top shape.
What can make my asthma symptoms worse?
Environmental allergies are a very common asthma trigger, but there are many things that can trigger an asthma attack.
A person may have one or more of the following triggers:
- Allergic triggers
- Cats, dogs, dust mites, pollen, and mold.
- Foods are a rare trigger of chronic asthma symptoms
- Environmental irritants
- Weather changes, extremes of temperature, humidity
- Strong odors, cleaning agents, dust
- Air pollution
- Cigarette smoke
- Acute or chronic sinus infections
- Viral upper respiratory infections (common cold, influenza)
- Blood pressure medications and glaucoma eye drops called beta-blockers
- Anti-inflammatory medications including: aspirin, naproxen, ibuprofen, Advil®, Aleve®, Naprosyn®, or Motrin® (Link to NSAID allergy)
- Acid reflux
- Laughing or crying
Will I have asthma for the rest of my life?
The answer depends on many factors and must be individualized for each person. In short, there is no cure for asthma. However, if there are obvious triggers that can be avoided such as pet allergies, asthma symptoms may improve significantly.
Can asthma occur at any age?
Although the majority of people will develop asthma in childhood, asthma symptoms can occur for the first time at any age. Of course, other medical problems such as certain heart and lung conditions should also be considered in those with advancing age.
I am feeling better since starting my asthma medications, can I stop them?
When adequately treated, most patients with asthma should not experience significant limitations in their daily life. In fact, many Olympic athletes have asthma and are able to compete without any restrictions. For most patients, daily anti-inflammatory medications for asthma will greatly reduce the inflammation of the lungs and will allow them to go about their normal life most of the time. However, because asthma is frequently a chronic condition, stopping asthma medications may allow symptoms to return. It is important to discuss all medication changes with your doctor. Importantly, symptoms of asthma can come and go over time. A person may go weeks or months without any symptoms of asthma. Your asthma doctor will design a treatment regimen based on the frequency and severity of your asthma symptoms.
My doctor prescribed an inhaled corticosteroid medication that I take everyday. It has been two days and I don’t feel any better. Is that normal?
es. Inhaled steroids improve symptoms gradually and may take up to two weeks for symptoms to improve. Patients taking Advair®, Symbicort®, or Dulera® may notice improvement in their symptoms within 1-2 days.
My doctor prescribed a daily asthma inhaler that contains a corticosteroid. Are steroids dangerous?
Corticosteroids are medications used to treat inflammation in the body. Asthma inhalers that contain corticosteroid medications work topically along the lining of the lungs to stop the inflammation. Only a small amount of the medication is absorbed into the system after inhaling. Inhaled corticosteroid medications have been used safely to treat asthma for over 20 years. An asthma patient requiring high doses of inhaled steroid medications will need to follow up closely with their doctor to make sure rare side effects are avoided. It is important to talk to your doctor about medication risks and benefits.
What are common side effects of inhaled steroid medications?
- Thrush: white spots on the back of the throat caused by a superficial fungal infection. Rinsing your mouth after each use and using your inhaler properly can help reduce the chances of developing thrush. A fungal mouth rinse can be used to threat the thrush.
- Hoarseness: some patients can experience hoarseness while using an inhaled corticosteroid medication. Mouth-rinsing after each inhalation can help prevent the hoarseness. Most patients are able to find an inhaler that limits this side effect.
- Growth in children: children requiring a daily inhaled corticosteroid medication may lose 1 cm of vertical height during the first year of treatment. This does not occur year-after-year and is followed by a “catch-up” growth period. Adult height should not be affected. Also, children with uncontrolled asthma can also experience a decreased growth rate.
- Other less common side effects can occasionally occur at higher doses and include:
- Osteoporosis (thinning of the bone)
- Cushing syndrome
Can someone have asthma and not realize it?
For many people, asthma is a chronic condition that develops over many months or years. Studies have shown that the majority of patients with asthma are not always able to tell when their asthma is controlled. Patients may “get used” to their symptoms over time and may even subconsciously limit their activity to avoid the discomfort. Many asthma patients will not realize how significant their asthma symptoms have become until they have received proper treatment. An analogy I use is what happens when someone begins wearing glasses or contact lens for the first time. Because the change in vision occurred gradually, many people forget what it was like to see with perfect vision. In the same way, many patients with asthma get used to not breathing at full capacity.
Is it true that “bronchitis” can be caused by asthma?
Bronchitis is the general term used to describe inflammation of the larger airway leading into the lungs. The primary symptom of bronchitis is a cough, which typically occurs following a bacterial or viral respiratory infection. In susceptible people, the infection can cause wheezing, chest-tightness, and shortness-of-breath in addition to the cough. If you experience these symptoms following an upper respiratory infection, you may be suffering from an intermittent type of asthma triggered by the infection.
I have had a chronic cough that doesn’t seem to go away. Is it caused by allergies or asthma?
A chronic cough can be very frustrating for many patients and their families. Repetitive coughing can be exhausting and cause considerable suffering. There are many causes of a chronic cough. In fact, some patients have two or more causes contributing to the cough at the same time. A chronic cough should always be evaluated promptly to make sure rare but serious conditions are considered. In non-smoking adults: asthma, post-nasal drainage, and acid reflux are the most common causes of a chronic cough. In my experience, a chronic cough can be adequately treated over 90% of the time. Even if you have been suffering for many years, a solution may be closer than you realize.
My child was diagnosed with asthma. Is there a chance he/she will outgrow it?
Childhood asthma can follow many different patterns:
- Some children will experience wheezing during early childhood and outgrow their asthma symptoms by later childhood
- Other children will have asthma symptoms that persist into adolescence and adulthood
Factors that increase the risk of persistent asthma past early childhood include:
- Physician diagnosed eczema (atopic dermatitis)
- Physician-diagnosed food allergies
- Wheezing or other asthma symptoms in between upper respiratory infections
- Mother or father with asthma.
- Multiple environmental allergies such as pollens, pets, dust mites, or mold
- Approximately 50% of children will outgrow their asthma by later childhood
How is asthma diagnosed?
A patient’s history is very important in diagnosing asthma. A doctor will suspect asthma if a patient is experiencing coughing, wheezing, shortness-of-breath or heaviness in the chest. If the patient is old enough, the doctor may perform a computerized breathing test called spirometry. This gives an objective assessment of a person’s lung function. The doctor may then start a trial of an asthma medication depending on the severity and frequency of the symptoms. If a patient’s symptoms improve significantly with the asthma medication, a diagnosis of asthma is likely. Other tests may be ordered when asthma is suspected including a chest x-ray,specialized breathing tests, and certain blood tests.