About Asthma

What Is Asthma?

It is important to understand what asthma is, what its symptoms are, and what is happening in the airways of your lungs. Asthma is a disease in which the airways of the lungs can become inflamed, narrowed, and full of mucus. This makes it difficult to breathe, causing symptoms such as:^1,2

• Wheezing
• Coughing
• Chest tightness
• Shortness of breath

Asthma is a long-term disease

If you have asthma, you will always have it. But you can learn to control it by avoiding things that trigger your symptoms and following your doctor’s instructions.^2,3

Asthma symptoms can be different for each person. You may have symptoms frequently, or not very often, or only in certain situations.²

Asthma affects people of all ages, but it most often begins during childhood.¹

What Happens in Asthmatic Airways?

Every time you breathe, you bring air into your lungs through the airways and let it back out through the same airways.¹

If you have asthma, your airways can become inflamed, swollen, and sensitive. This makes them more likely to overreact to certain triggers.¹

When the airways react to a trigger, it causes two more things to happen:¹

• The muscles around the airways tighten, which causes the airways to become narrower.
• Cells in the lining of the airways may produce excess mucus, making the narrowing even worse.

Then you might begin to experience asthma symptoms because it is more difficult to breathe through narrow, mucus-filled airways.¹

Sometimes the symptoms are mild and go away after taking a quick-relief asthma medicine, but at other times the symptoms may get worse (asthma attack) and require additional treatment.¹

Inflammation in Large and Small Airways

The airways look a lot like the branches of a tree – larger near the base and smaller at the tips.

Asthma may cause inflammation in any or all of those branches.⁴

Why is this important?

Most of the lung’s surface area is in the smaller airways, but the small diameters of those airways make it difficult for medication to reach those inflamed surfaces.⁵

As a result, the small airways are a common place for asthma symptoms to arise.⁵

Signs and Symptoms of Asthma

Asthma symptoms can range from mild to severe and be different from person to person.¹ Some people may experience symptoms infrequently, while others may have symptoms all the time.

If something irritates your airways, your symptoms can flare up in what is called an “asthma attack.”^1,2

Common Signs and Symptoms^1,3

• Coughing—typically worse at night or early in the morning, making it hard to sleep
• Wheezing—a whistling or squeaky sound that occurs when breathing
• Chest tightness—feeling like something is squeezing or sitting on your chest
• Shortness of breath—feeling out of breath or like air isn’t leaving the lungs
• Coughing or wheezing that gets worse during a respiratory infection (e.g., cold or flu)

Not everyone with asthma has all of these symptoms, and not everyone with these symptoms has asthma. Asthma needs to be diagnosed by a doctor, who will perform certain tests of your lung function.³

Diagnosing Asthma

Asthma needs to be diagnosed by a medical professional. But before your appointment, you can fill out the following Asthma Symptoms Checklist, and bring it with you to help review your symptoms with your doctor.

At Your Doctor's Appointment

To determine whether your symptoms are due to asthma or something else, your doctor will ask about your:¹

• asthma symptoms
• triggers for your asthma symptoms
• medical history
• family members who may also have asthma symptoms

Then the doctor will perform a physical examination and certain tests to measure your lung function.

Tests to evaluate lung function^1,2

How Asthma Is Classified

Your doctor will determine the severity of your asthma based on the information gathered from your medical and family history, your physical examination, and your lung function test results. There are four categories that are used to classify asthma severity:²

• Mild Intermittent — Mild symptoms up to 2 days each week and up to 2 nights each month.
• Mild Persistent — Symptoms more than 2 times each week, but no more than 1 time on a single day.
• Moderate Persistent — Symptoms at least 1 time each day and more than 1 night a week.
• Severe Persistent — Symptoms, on most days, throughout the day and frequently at night.

Treating Asthma

Although asthma has no cure, treatments can be used to keep it under control. Asthma that is well controlled can:¹

• prevent troublesome symptoms, such as coughing and shortness of breath
• reduce your need for quick-relief medicines
• help you maintain good lung function
• allow you to maintain your normal activity level and sleep through the night
• prevent asthma attacks that could result in an emergency room visit or hospital stay

Managing asthma involves following your doctor’s treatment advice and avoiding your asthma triggers.¹

Medicines for Treating Asthma

There are two types of medicines for treating asthma:¹

• long-term control medicines, which reduce airway inflammation to help prevent symptoms
• quick-relief medicines, which help relieve acute symptoms when they occur

Most people with asthma need to use both kinds of medicine.¹

Long-term Control Medicines – These should be taken every day, whether or not you feel symptoms, because they are intended to reduce the inflammation and therefore prevent symptoms from starting.¹

Quick-relief Medicines – These are essential for every asthma patient to carry with them, to relieve acute symptoms if a flare-up happens. Quick-relief medicines help with immediate symptoms, but they do not treat the inflammation at all, which is why long-term control medicines are still necessary.¹

Your doctor will choose an initial treatment plan based on the severity of your asthma, but the treatment plan may be adjusted over time in order to optimize your asthma control.¹

Managing Asthma

Life shouldn’t be controlled by asthma symptoms. Fortunately, there are ways to help manage them:¹

• Follow an Asthma Action Plan (specifying your medications, when to take them, and when to call your doctor or go to the Emergency Department), including taking your medications daily
• Avoid your asthma triggers
• Record your asthma symptoms to determine whether your asthma is controlled
• Use a peak flow meter to monitor your lung function
• Visit your doctor regularly for asthma checkups

Avoiding Triggers

Asthma symptoms can be “triggered” by various irritants or situations, so it is important to learn what your specific triggers are so you can avoid them as much as possible.¹

For example, if pollen makes your asthma symptoms start or get worse, try to avoid going outside on days when the pollen count is high.¹

Common triggers include:^1-3

• Pollen (from trees, grass, and/or weeds)
• Air pollution
• Cold weather
• Pet fur or dander
• Dust mites
• Cockroaches
• Mold spores
• Cigarette or cigar smoke
• Smoke from burning wood or grass
• Strongly scented products
• Certain medications
• Certain foods
• Preservatives in foods and drinks
• Respiratory infections (cold/flu)
• Strong emotions or stress
• Physical activity

Note: Although physical activity can be a trigger for asthma in some people, you should not avoid it entirely, because physical activity is important for a healthy lifestyle. Talk with your doctor about types of physical activity you could do that would be less likely to trigger your asthma symptoms.¹

Resources

Here are some asthma-related resources to help you connect and find more information and support:

• Asthma and Allergy Foundation of America (AAFA): http://www.aafa.org/page/asthma.aspx. Accessed Jun 30, 2022.
• Allergy and Asthma Network: http://www.allergyasthmanetwork.org/. Accessed Jun 30, 2022.
• American Academy of Allergy, Asthma, & Immunology (AAAAI): http://www.aaaai.org/. Accessed Jun 30, 2022.
• American College of Allergy, Asthma, & Immunology (ACAAI): http://www.acaai.org/. Accessed Jun 30, 2022.
• American Lung Association: http://www.lung.org/. Accessed Jun 30, 2022.
• National Heart, Lung, and Blood Institute (NHLBI) – Asthma page: https://www.nhlbi.nih.gov/health/health-topics/topics/asthma. Accessed Jun 30, 2022.

Adolescents with Asthma

Of the nearly 25 million Americans who have been diagnosed with asthma (as of 2015), approximately 6 million are under the age of 18.¹

Tips for Managing Asthma in Teens:

• Help your teenager learn how to control their asthma by avoiding triggers and taking a long-term control medicine daily.^2,3
• Encourage your adolescent to play an active role in creating and following his/her Asthma Action Plan to help manage asthma symptoms.³
• Provide a copy of the Asthma Action Plan to the school nurse.⁴