What Is Asthma?
Asthma is a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and it makes it hard to breathe. Severe asthma can cause trouble talking or being active. You might hear your doctor call it a chronic respiratory disease. Some people refer to asthma as "bronchial asthma."
Asthma is a serious disease that affects about 25 million Americans and causes nearly 1.6 million emergency room visits every year. With treatment, you can live well. Without it, you might have to go to the ER often or stay at the hospital, which can affect your daily life.
Know the Early Symptoms of Asthma
Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These signs may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.
In general, these signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse. Early warning signs of an asthma attack include:
If you have these warning signs, adjust your medication, as described in your asthma action plan.
Know the Symptoms of an Asthma Attack
An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.
All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:
- Severe wheezing when breathing both in and out
- Coughing that won't stop
- Very rapid breathing
- Chest pain or pressure
- Tightened neck and chest muscles, called retractions
- Difficulty talking
- Feelings of anxiety or panic
- Pale, sweaty face
- Blue lips or fingernails
The severity of an asthma attack can escalate rapidly, so it's important to treat these asthma symptoms immediately once you recognize them.
Without immediate treatment, such as with your asthma inhaler or bronchodilator, your breathing will become more labored. If you use a peak flow meter at this time, the reading will probably be less than 50%. Many asthma action plans suggest interventions starting at 80% of normal.
As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so there is not enough air movement to produce wheezing. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.
If you do not receive adequate asthma treatment, you may eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as cyanosis, means you have less and less oxygen in your blood. Without aggressive treatment for this asthma emergency, you may lose consciousness and eventually die.
If you are experiencing an asthma attack, follow the "Red Zone" or emergency instructions in your asthma action plan immediately. These symptoms occur in life-threatening asthma attacks. You need medical attention right away.
Other Asthma Treatments
Medications aren’t the only way to control asthma. Your doctor might also try a condition called bronchial thermoplasty.
People with asthma often have extra smooth muscle in their airway walls. In this procedure, your doctor uses a small tube called a bronchoscope to send heat to the walls and reduce the smooth muscle. You’ll get the treatment over three visits about 2 or 3 weeks apart.
Asthma Action Plan
You and your doctor will work together to create an action plan. It can be on paper or online. Either way, it will boost your efforts to control your condition with information and directions on:
Lung Function Tests
Lung function tests are a way to check how well your lungs are working. Doctors use them to diagnose asthma and to monitor its progression. Monitoring asthma with lung function tests is helpful, because you may not always be able to tell just from your symptoms whether your asthma is under control.
n most cases, you have lung function tests in an exam room that contains special devices to measure lung function. A specially trained respiratory therapist or technician is likely to do the tests.
Ask your doctor if you should do anything to prepare for your lung function tests. For instance, you might need to adjust your medication. You may also need to avoid heavy meals, smoking, and any irritants or other substances that might trigger an asthma attack.
Types of lung function tests
These lung function tests are commonly used to diagnose and monitor asthma:
- Spirometry is the most common. It's a simple, quick, and painless way to check your lungs and airways. You take a deep breath and exhale into a hose attached to a device called a spirometer. It records how much air you blow out (called forced vital capacity or FVC) and how quickly you do it (called forced expiratory volume or FEV). Your score is lower if your airways are swollen or constricted because of asthma or other lung diseases. Your doctor may want you to have several spirometry lung function tests to monitor your asthma over time. You might have spirometry before and after you take medication to see if the medication helps. Your doctor may also want readings taken during exercise to see how your airways react to exercise.
- Challenge tests are lung function tests used to help confirm a diagnosis of asthma. You inhale a small amount of a substance known to trigger symptoms in people with asthma, such as histamine or methacholine. After inhaling the substance, someone tests your lung function. Because challenge tests can trigger an asthma attack, you should have them done only by someone with experience.
- Peak flow meter tests measure how well your lungs push out air. Although they are less accurate than spirometry, these lung function tests can be a good way to regularly test your lung function at home -- even before you feel any symptoms. A peak flow meter can help you know what makes your asthma worse, whether treatment is working, and when you need to seek emergency care. The peak flow meter is a handheld plastic tube with a mouthpiece on one end, which you breathe into. Your doctor might ask you to use the peak flow meter each day and write down the readings. After a couple of weeks, you report the results to your doctor.
- Exhaled nitric oxide test. You’ll breathe into a tube connected to a machine that measures the amount of nitric oxide in your breath. Your body makes this gas normally, but levels could be high if your airways are inflamed.
Other Tests You May Need if You Have Asthma
Even if your lung function tests are normal, your doctor may order other tests to see what could be causing your asthma symptoms.
- Gas and diffusion tests can measure how well your blood absorbs oxygen and other gases from the air you breathe. You breathe in a small amount of a gas, hold your breath, then blow out. The gas you exhale is analyzed to see how much your blood has absorbed.
- X-rays may tell if there are any other problems with your lungs, or if asthma is causing your symptoms. High-energy radiation creates a picture of your lungs. You may be asked to briefly hold your breath while you stand in front of the X-ray machine.
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Sinuses
Nasal polyps or sinusitis may make asthma harder to treat and control. Sinusitis, also called a sinus infection, is an inflammation or swelling of the sinuses due to infection. When the sinuses become blocked and filled with fluid, bacteria grow, causing infection and inflammation. Your doctor may order a special sinus X-ray, called a CT scan, to examine your sinuses if they think you have an infection. If you have sinusitis, you will be treated with antibiotics for at least 10 to 12 days. Treating the sinusitis may help prevent asthma symptoms.
Tests for Other Conditions
The doctor may also do tests for other conditions that can make asthma worse, like:
- Gastroesophageal reflux disease (GERD)
- Allergies
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