Asthma is a common chronic disease and is caused by an increased reaction of the airways to various stimuli or “triggers”. Asthma breathing problems usually happen in “episodes” or attacks. During asthma attacks, the airways are more obstructed and the airflow decreases. This leads to difficulty in breathing with the familiar “wheeze,” a high-pitched whistling sound. Asthma can also occur without wheezing and in adults, symptoms can be subtler, including a nighttime cough, a cough that worsens with exercise or activity, or just a chronic cough that won’t go away.
To establish a diagnosis of asthma, a doctor rules out every other possible cause of the symptoms. The doctor asks questions about the family’s history, performs a physical exam, and possibly orders laboratory and breathing tests. Even though asthma cannot be cured, it can almost always be controlled.
The treatment of asthma is based on the severity of asthma symptoms and the degree of airway obstruction.
Maintenance treatments for asthma and episodic asthma attacks usually include bronchodilator (opens up airways) type of medicines, which can be given with a nebulizer and/or a pump inhaler. For moderate or severe attacks, an oral steroid is also often needed.
Bronchodilator medications are also often called “reliever” or ”quick relief” or “rescue” medications, since they quickly relieve asthma symptoms. They are only used on an “as needed” basis and you should not be needing to use them more than twice a week or anytime at night if asthma is being well controlled. The other type of medications that are used to treat asthma are the maintenance or preventative medications, which help to prevent asthma symptoms, when asthma symptoms become more persistent.
In addition to your primary care physician, pulmonologists (lung specialists) and allergists who also treat asthma. If your asthma is difficult to control, with frequent attacks and regular use of a “rescue” medicine or an oral steroid, then you may be referred to an asthma specialist by your primary care physician.
In addition to regular use of any prescribed asthma medications, you can help to control asthma by figuring out what triggers your asthma symptoms and avoid those things. Common triggers include: smoke and other irritants, dust mites, cockroaches, molds, changes in the weather or exposure to cold, animals, upper respiratory tract infections, air pollution, and having uncontrolled allergies. Exercise is also a common trigger, but instead of avoiding physical activity, exercise induced asthma symptoms can be improved by using a ‘reliever’ medicine before those activities.
It is important to be educated about asthma by your asthma doctor: how to use an inhaler and/or nebulizer, avoiding triggers, the differences between reliever/rescue and maintenance/preventative medications and when to use them, use and interpretation of your peak flows, and how to manage an asthma attack. You should have a specific asthma management plan given to you by your doctor so that you know what to do when your asthma symptoms flare.