Everything You Need to Know About Asthma: Symptoms, Treatment, and More

Author: Dr. Andrea Pinto, M.D.

Asthma is a chronic respiratory condition that can cause asthma attacks and allergy-like symptoms. Asthma is a relatively common condition that affects a significant number of people around the world, particularly children.

The symptoms range from very mild to life threatening. If you or someone in your family have asthma, learning how to manage the symptoms and quickly treat an asthma attack could be life saving.

Read on to learn more about asthma, what causes it, practical preventative measures, and treatment.

What is asthma?

Asthma, also known as bronchial asthma, is a long-term respiratory condition that causes symptoms in recurrent episodes. During these episodes, commonly known as asthma attacks, the airways become swollen and narrow, and they secrete extra mucus. These result in difficult breathing that can trigger multiple respiratory symptoms.

There’s no cure for asthma, but different treatments and prevention methods can manage it. The severity of your asthma can vary significantly over time. Asthma can affect people regardless of age, but in many cases, symptoms improve or even disappear over time. Some patients, however, never outgrow asthma — in other cases, symptoms could return after being dormant if suddenly exposed to air pollution or allergens.

Asthma can produce allergy-like symptoms, and it can be related to allergies. A specific type of asthma, called Allergic Asthma, is triggered by breathing in allergens.

Common allergens that cause allergic asthma attacks include:

• Dust mites
• Pollen
• Pet dander
• Mould
• Cockroaches

In severe cases, an allergic asthma attack can be triggered by touching or unknowingly eating an allergen. Although uncommon, this type of asthma attack can lead to life-threatening symptoms and anaphylactic shock.

Other types of asthma include exercise-induced asthma, nocturnal asthma, eosinophilic asthma, aspirin-induced asthma, and occupational asthma.

The symptoms of an asthma attack include:

• Dyspnea or difficult breathing
• Wheezing
• Coughing
• Chest tightness or pain
• Trouble sleeping caused by respiratory symptoms
• Fatigue

In children, asthma can cause additional symptoms that include:

• Difficulty eating (or sucking, in babies and infants)
• Persistent coughing, especially at night
• Panting or coughing after mild physical activities
• Frequent colds
• Rapid breathing

How is asthma diagnosed?

If you suspect that you or your child have asthma, visit your doctor. They’ll perform a thorough physical examination and take your personal and family history. If necessary, they’ll refer you to a respiratory specialist, called a Pulmonologist.

A Pulmonologist could use different tests to confirm an asthma diagnosis.

Common tests include:

• Spirometry: this test measures how much air you inhale and exhale, and how quickly you can do so.
• Peak flow: this procedure determines how much air you can exhale. Many asthma patients take this test regularly to check the evolution of their symptoms and whether their treatment is working. With a Peak Flow Meter, this test can be performed at home.
• Chest X-ray: to rule out other conditions.
• Allergy tests: these tests can help your doctor determine whether you have allergic asthma and the exact triggers that you should avoid.

Depending on the severity of your condition, your doctor could order additional testing. Asthma can be classified depending on the frequency of your episodes and the severity of your symptoms into:

• Mild intermittent asthma
• Mild persistent asthma
• Moderate persistent asthma
• Severe persistent asthma

What should I avoid to prevent an asthma attack?

Different patients react to different triggers, so it’s important to recognize which substances and situations can cause asthma attacks for you. Preventing these triggers can cause a significant reduction in the severity and frequency of your asthma attacks.

Common triggers of asthma symptoms include:

• Air pollution
• Tobacco smoke
• Cleaning products
• Perfumes or strongly-scented hygiene products
• Pet dander
• Dust
• Mold
• Cold air
• Sudden temperature changes
• Certain medications
• Strenuous exercise

Treatments for asthma

There are various medications to treat and prevent asthma attacks. Your doctor will design a treatment plan for you, taking into consideration your triggers and the severity of your symptoms.

You may have to use two different treatment plans: one for acute asthma symptoms, and one for maintenance and prevention.

Fast-acting medications commonly used to treat acute asthma attacks include:

• Short-acting beta2-adrenoceptor agonists (SABA)
  • Salbutamol
  • Levalbuterol

• Anticholinergic medications
  • Ipratropium
  • Tiotropium bromide

• Adrenergic agonists
  • Epinephrine

• Oral, inhaled, or intravenous corticosteroids
  • Beclomethasone
  • Fluticasone
  • Budesonide
  • Methylprednisolone
  • Prednisone

Long-term treatment plans for asthma management and control can include:

• Corticosteroids
  • Beclomethasone

• Long-acting beta-adrenoceptor agonists (LABA)
  • Salmeterol
  • Formoterol

• Leukotriene receptor antagonists
  • Montelukast
  • Zafirlukast

• Theophylline
• Biologics
  • Omalizumab
  • Mepolizumab
  • Benralizumab
  • Reslizumab

There are also combination medications available, usually in the form of inhalers. These inhalers combine a corticosteroid and a long-acting beta-agonist, such as:

• Fluticasone and salmeterol
• Fluticasone and vilanterol
• Budesonide and formoterol
• Mometasone and formoterol

A severe asthma attack can require immediate medical assistance, especially if symptoms don’t subside after using rescue medications or if you don’t have these medications on hand.