Do I Have Asthma?
There are an estimated 25 million people living in the United States with asthma, many of whom may not be aware they have it. If left untreated, asthma can result in loss of sleep, exercise limitations, missed school or work, emergency room visits and, in a few cases, death. Asthma can't be cured, but its symptoms can be controlled.
What Is Asthma?
Asthma is a long-term disease that causes inflammation and swelling of the airways causing narrowing of the airways and resulting in breathing difficulties. Inflamed airways are more sensitive to triggers such as dust, pet dander, pollen, smoke, exercise, stress, or cold air.
Symptoms of asthma include:
- Shortness of breath/trouble breathing
- Chest tightness, pain, and/or pressure
- Coughing, especially at night or in the morning
What Causes Asthma?
Asthma is caused by inflammation in the airways of the lungs. Asthma has a strong genetic component, so if you have asthma, others in your family may have asthma as well. If you have a parent with asthma, you are three to six times more likely to develop asthma.
Although we don't know exactly why some people develop asthma, we do know that it is important to identify what triggers an asthma attack or exacerbation. Typical triggers include:
- Allergens (pollen, mold, animal dander, dust mites)
- Tobacco smoke
- Air pollution
- Airway infections
- Physical exertion
- Weather conditions
It is estimated that 80 percent of children with asthma and more than 50 percent of adults have allergies that trigger their asthma symptoms. “Allergic Asthma” is the most common form of asthma, so identifying your specific allergic triggers is an essential part of developing a management plan.
How Is Asthma Diagnosed?
Asthma can be difficult to diagnose, especially in young children. A board certified allergy and asthma specialist will diagnose asthma after an extensive patient interview, physical exam, and a lung function test. Because of the strong link between asthma and allergies, allergy skin testing is often performed.
How Is Asthma Treated?
Though there is not a cure for asthma, the symptoms can be well controlled through physician recommended medications and trigger avoidance. Your allergists will recommend an asthma management plan that may include:
- Quick-relief medications - these work quickly to relieve and control sudden symptoms.
- Long-term controller medications - controller medications work by reducing the inflammation in the airways and preventing future symptoms.
- Biologics - a relatively new class of medications that target the patient's immune system to prevent an attack, rather than treating the symptoms. Biologics are indicated for moderate to severe asthma and are used in treating specific types of asthma, specifically allergic asthma and eosinophilic asthma.
Since a high percentage of asthma patients suffer from allergies, controlling those allergies is the first step to controlling asthma. Nasal allergy symptoms can be controlled through medications or allergy immunotherapy. Studies have shown that allergy shots can reduce the symptoms of allergies and prevent the development of asthma.
In 2020, The National Institutes of Health (NIH) released updated guidelines for diagnosis, management and treatment of asthma. The update included the recommendation of allergy shots as an extra treatment for people with mild to moderate allergic asthma.
Anyone with asthma should have and follow an Asthma Action Plan.
Is My Asthma Well Controlled?
The goal for the care of patients with asthma is to ensure proper control, since, when properly managed; asthmatics can lead full, healthy lives. Conversely, poorly controlled asthma leads to significant numbers of hospitalizations, emergency room visits, and doctor appointments. It can also lead to inactivity, which has additional health consequences.
Research studies have shown that patients often overestimate their level of asthma control. In the Asthma In-Home (AIM) Study, close to 70 percent of the participants overestimated their asthma control. The Centers for Disease Control and Prevention (CDC) estimates that 50% of children with asthma have uncontrolled asthma. Diagnosis and proper care and monitoring by an asthma specialist is crucial in achieving optimal health.
Allergists often discuss the “Rule of Two's” to help patients assess their level of control:
- Are you waking up during the night with asthma symptoms more than two times per month?
- Are you using your quick-relief/rescue inhaler more than two times per week?
- Are you refilling your bronchodilator (medication that opens the airways) more than two times per year?
If you answered yes to any or all of these questions, your asthma is not well controlled.
The keys to living an active, healthy life with asthma:
- Proper diagnosis by an asthma specialist
- Identification of your asthma triggers
- Allergy testing if indicated
- Asthma management plan
- Regular follow-up to ensure your management plan is optimized.
Additional information on asthma: