Asthma: Symptoms, Treatment, and Prevention

Asthma is an inflammatory disease of the airways to the lungs. It makes breathing difficult and can make some physical activities challenging or even impossible.

According to the Centers for Disease Control and Prevention (CDC), about 25 million Americans have asthma. It’s the most common chronic condition among American children: 1 child out of every 12 has asthma.

To understand asthma, it’s necessary to understand a little about what happens when you breathe. Normally, with every breath you take, air goes through your nose or mouth, down into your throat, and into your airways, eventually making it to your lungs.

There are lots of small air passages in your lungs that help deliver oxygen from the air into your bloodstream.

Asthma symptoms occur when the lining of your airways swells and the muscles around them tighten. Mucus then fills the airways, further reducing the amount of air that can pass through.

These conditions can then bring on an asthma “attack,” which is the coughing and tightness in the chest that’s typical of asthma.

The most common symptom of asthma is wheezing. This is a squealing or whistling sound that occurs when you breathe.

Other asthma symptoms may include:

• coughing, especially at night, when laughing, or during exercise
• tightness in the chest
• shortness of breath
• difficulty talking
• anxiousness or panic
• fatigue
• chest pain
• rapid breathing
• frequent infections
• trouble sleeping

The type of asthma that you have can determine which symptoms you experience.

Some people experience symptoms consistently throughout the day. Others may find that certain activities can make symptoms worse.

Not everyone with asthma will experience these particular symptoms. If you think the symptoms you’re experiencing could be a sign of a condition such as asthma, make an appointment to see your doctor.

Also, keep in mind that even if your asthma is well-managed, you may still occasionally experience a flare-up of symptoms. Flare-ups often improve with the use of quick-acting treatments, like an inhaler, but may require medical attention in severe cases.

Signs of an asthma flare-up may include:

• coughing
• wheezing
• throat clearing
• difficulty sleeping
• chest pain or tightness
• fatigue

If your symptoms worsen or don’t improve with the use of an inhaler, you should seek immediate medical treatment.

You should also seek treatment if you experience symptoms of an asthma emergency, including:

• severe breathing difficulty
• gasping for air
• confusion
• pale lips or fingernails
• dizziness
• difficulty walking or talking
• blue lips or fingernails

Although asthma is especially common in children, many people don’t develop asthma until they are adults.

No single cause has been identified for asthma. Instead, researchers believe it’s caused by a variety of factors. These factors include:

• Genetics. If a parent or sibling has asthma, you’re more likely to develop it.
• History of viral infections. People with a history of severe viral infections during childhood, such as respiratory syncytial virus infection (RSV), may be more likely to develop the condition.
• Hygiene hypothesis. This theory explains that when babies aren’t exposed to enough bacteria in their early months and years, their immune systems don’t become strong enough to fight off asthma and other allergic conditions.

Many factors can also trigger asthma and cause symptoms to worsen. Triggers for asthma can vary and some people may be more sensitive to certain triggers than others.

The most common triggers include:

• health conditions, such as respiratory infections
• exercise
• environmental irritants
• allergens
• intense emotions
• extreme weather conditions
• pests
• certain medications, including aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

There’s no single test or exam that will determine if you or your child has asthma. Instead, your doctor will use a variety of criteria to determine if the symptoms are the result of asthma.

The following can help diagnose asthma:

• Health history. If you have family members with the breathing disorder, your risk is higher. Alert your doctor to this genetic connection.
• Physical exam. Your doctor will listen to your breathing with a stethoscope. You may also be given a skin test to look for signs of an allergic reaction, such as hives or eczema. Allergies increase your risk for asthma.
• Breathing tests. Pulmonary function tests (PFTs) measure airflow into and out of your lungs. For the most common test, spirometry, you blow into a device that measures the speed of the air.

Doctors don’t typically perform breathing tests in children under 5 years of age because it’s difficult to get an accurate reading.

Instead, they may prescribe asthma medications to your child and wait to see if symptoms improve. If they do, your child likely has asthma.

For adults, your doctor may prescribe a bronchodilator or other asthma medication if test results indicate asthma. If symptoms improve with the use of this medication, your doctor will continue to treat your condition as asthma.

Your doctor will also need to determine the type of asthma you have. The most common type is allergic asthma, representing 60 percent of all cases of asthma.

Additional types of asthma are related to a person’s stage in life. Though asthma can appear at any age, pediatric asthma specifically affects children and adult-onset asthma doesn’t appear until adulthood.

Other specific types of asthma are described below.

Allergic asthma

Allergens trigger this common type of asthma. These might include:

• pet dander from animals like cats and dogs
• food
• mold
• pollen
• dust

Allergic asthma is often seasonal because it goes hand-in-hand with seasonal allergies.

Non-allergic asthma

Irritants in the air not related to allergies trigger this type of asthma. These irritants might include:

• burning wood
• cigarette smoke
• cold air
• air pollution
• viral illnesses
• air fresheners
• household cleaning products
• perfumes

Occupational asthma

Occupational asthma is a type of asthma induced by triggers in the workplace. These include:

• dust
• dyes
• gases and fumes
• industrial chemicals
• animal proteins
• rubber latex

These irritants can exist in a wide range of industries, including:

• farming
• textiles
• woodworking
• manufacturing

Exercise-induced bronchoconstriction (EIB)

Exercise-induced bronchoconstriction (EIB) usually affects people within a few minutes of starting exercise and up to 10 to 15 minutes after physical activity.

This condition was previously known as exercise-induced asthma (EIA).

Up to 90 percent of people with asthma also experience EIB, but not everyone with EIB will have other types of asthma.

Aspirin-induced asthma

Aspirin-induced asthma (AIA), also called aspirin-exacerbated respiratory disease (AERD), is usually severe.

It’s triggered by taking aspirin or another NSAID, such as naproxen (Aleve) or ibuprofen (Advil).

The symptoms may begin within minutes or hours. People with AIA also typically have nasal polyps.

About 9 percent of people with asthma have AIA. It usually develops suddenly in adults between the ages of 20 and 50.

Nocturnal asthma

In this type of asthma, symptoms worsen at night.

Triggers that are thought to bring on symptoms at night include:

• heartburn
• pet dander
• dust mites

The body’s natural sleep cycle may also trigger nocturnal asthma.

Cough-variant asthma (CVA)

Cough-variant asthma (CVA) doesn’t have classic asthma symptoms of wheezing and shortness of breath. It’s characterized by a persistent, dry cough.

If it’s not treated, CVA can lead to full-blown asthma flares that include the other more common symptoms.

To help treat asthma, the National Asthma Education and Prevention Program (NAEPP) classifies the condition based on its severity before treatment.

Asthma classifications include:

• Intermittent. Most people have this type of asthma, which doesn’t interfere with daily activities. Symptoms are mild, lasting fewer than 2 days per week or 2 nights per month.
• Mild persistent. The symptoms occur more than twice a week — but not daily — and up to 4 nights per month.
• Moderate persistent. The symptoms occur daily and at least 1 night every week, but not nightly. They may limit some daily activities.
• Severe persistent. The symptoms occur several times every day and most nights. Daily activities are extremely limited.

Treatments for asthma fall into four primary categories:

• quick relief medications
• long-term control medications
• a combination of quick relief and long-term control medications. The most current asthma clinical guidelines, released in 2020 by the NAEPP, recommend this treatment. However this treatment is not yet approved by the Federal Drug Administration (FDA).
• biologics, which are given by injection or infusion usually only for severe forms of asthma

Your doctor will recommend one treatment or a combination of treatments based on:

• the type of asthma you have
• your age
• your triggers

Your treatment plan may also involve learning your triggers, monitoring your symptoms carefully, and taking steps to avoid flare-ups.

Quick-relief asthma treatments

These medications should only be used in the event of asthma symptoms or an attack. They provide quick relief to help you breathe again.

Bronchodilators

Bronchodilators work within minutes to relax the tightened muscles around your airwaves and decrease symptoms quickly.

Although they can be administered orally or injected, bronchodilators are most commonly taken with an inhaler (rescue) or nebulizer.

They can be used to treat sudden symptoms of asthma or taken before exercise to prevent a flare-up.

First aid asthma treatment

If you think that someone you know is having an asthma attack, tell them to sit them upright and assist them in using their rescue inhaler or nebulizer.

The dosage will vary depending on the medication. Check the instructions insert to make sure you know how many puffs of medications you need in the event of an attack.

If symptoms persist for more than 20 minutes, and a second round of medication doesn’t help, seek emergency medical attention.

If you frequently need to use quick-relief medications, ask your doctor about another type of medication for long-term asthma control.

Long-term asthma control medications

These medications are taken daily to help reduce the number and severity of your asthma symptoms, but they don’t manage the immediate symptoms of an attack.

Long-term asthma control medications include:

• Anti-inflammatories. Taken with an inhaler, corticosteroids and other anti-inflammatory medications help reduce swelling and mucus production in your airways, making it easier to breathe.
• Anticholinergics. These help stop your muscles from tightening around your airways. They’re usually taken daily in combination with anti-inflammatories.
• Long-acting bronchodilators. These should only be used in combination with anti-inflammatory asthma medications.

Biologics

Doctors use biologics to treat severe asthma that doesn’t respond to other medications or to treatment by trigger control.

They work by targeting specific antibodies in your body. This disrupts the pathway that leads to asthma-causing inflammation.

There are five types of biologic medications on the market, and others in development. These medications need to be administered either by injection or by infusion in your doctor’s office.

Bronchial thermoplasty

This treatment uses an electrode to heat the airways inside the lungs, helping to reduce the size of the surrounding muscle and prevent it from tightening.

This minimally invasive procedure is performed by a doctor in a clinic or hospital and usually takes around an hour.

Bronchial thermoplasty is intended for people with severe asthma and can provide relief from symptoms for up to 5 years.

However, because it’s a relatively new procedure, it’s not yet widely available.

When your asthma symptoms get progressively worse, it’s known as an exacerbation, or an asthma attack.

It becomes increasingly difficult to breathe because the airways are swollen and the bronchial tubes have narrowed.

The symptoms of an exacerbation may include:

• hyperventilation
• cough
• wheezing
• shortness of breath
• increased heart rate
• agitation
• confusion
• blue lips

Although an exacerbation can end quickly without medication, you should contact your doctor because it can be life threatening.

The longer an exacerbation continues, the more it can affect your ability to breathe. That’s why exacerbations often require a trip to the emergency room.

Exacerbations can be prevented by taking medications that help manage your asthma symptoms.

Because researchers have yet to identify the exact cause of asthma, it’s challenging to know how to prevent the inflammatory condition.

However, more information is known about preventing asthma attacks. These strategies include:

• Avoiding triggers. Steer clear of chemicals, smells, or products that have caused breathing problems in the past.
• Reducing exposure to allergens. If you’ve identified allergens, such as dust or mold, that trigger an asthma attack, avoid them if possible.
• Getting allergy shots. Allergen immunotherapy is a type of treatment that may help alter your immune system. With routine shots, your body may become less sensitive to any triggers you encounter.
• Taking preventive medication. Your doctor may prescribe medication for you to take on a daily basis. This medication may be used in addition to the one you use in case of an emergency.

Your doctor can help you put an asthma action plan in place so that you know which treatments to use and when.

In addition to using maintenance medications, you can take steps each day to help make yourself healthier and reduce your risk for asthma attacks. These include:

• Eating a healthier diet. Eating a healthy, balanced diet can help improve your overall health.
• Maintaining a moderate weight. Asthma tends to be worse in people with overweight and obesity. Losing weight is healthy for your heart, your joints, and your lungs.
• Quitting smoking, if you smoke. Irritants such as cigarette smoke can trigger asthma and increase your risk for COPD.
• Exercising regularly. Activity can trigger an asthma attack, but regular exercise may actually help reduce the risk of breathing problems.
• Managing stress. Stress can be a trigger for asthma symptoms. Stress can also make stopping an asthma attack more difficult.

Nutrient-rich foods are vital to helping reduce symptoms, but food allergies can trigger asthma symptoms.

At the moment, there’s no cure for asthma. However, there are many effective treatments that can decrease asthma symptoms. Lifestyle changes and medications can also help improve your quality of life.

If you haven’t been diagnosed with asthma but are experiencing symptoms such as wheezing, coughing, or shortness of breath, you should let your doctor know. You can connect to a physician in your area using the Healthline FindCare tool.

Once you’re diagnosed with asthma, you should see your doctor at least once a year or more frequently if you have persistent symptoms after using treatments.

Call your doctor immediately if you:

• feel weak
• can’t perform daily activities
• have a wheeze or cough that won’t go away

It’s important to educate yourself about your condition and its symptoms. The more you know, the more proactive you can be in improving your lung function and how you feel.

Talk with your doctor about:

• your type of asthma
• what triggers your symptoms
• what daily treatments are best for you
• your treatment plan for an asthma attack

Asthma is a condition that inflames the lungs and makes it difficult to breathe. It can affect both adults and children in different forms and in different levels of severity.

There are different medications available to treat asthma. The most common treatments are bronchodilators, which can be short-term to treat an asthma attack or long-term for management of symptoms over time.

Lifestyle changes may also help reduce asthma flare-ups. This can include dietary changes, exercise, or stress management. Speak with your doctor to identify the type of asthma you may have and the best treatment and management options for you.

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