Asthma is a chronic disease that affects the function and lining of the airways or tubes of the lungs. It narrows the airways and makes it difficult to breathe.

Asthma may be caused by a combination of factors including environment, genetics and biology.

Asthma Triggers

You may experience asthma symptoms if your airways have increased sensitivity to certain triggers. The triggers cause the lining of the airways to swell and produce extra fluid called mucus. At the same time, the muscles around the outside of the airway tighten in response to the irritation. All of these reactions narrow the airways and make it difficult to breathe. This response is often referred to as an asthma attack.

Possible triggers of an asthma attack include:

  • Viral illness
  • Exercise
  • Cold weather
  • Sinusitis
  • Gastroesophageal reflux disease (GERD)
  • Sulfites used in dried fruits and wine
  • Medications, such as aspirin, ibuprofen and beta-blockers
  • Exposure to irritants or allergens, including:
    • Cigarette smoke
    • Smoke from a wood-burning stove
    • Pet dander
    • Dust
    • Chemicals
    • Mold and mildew
    • Pollen
    • Smog or air pollution
    • Perfumed products

Risk Factors

Factors that may increase your risk for asthma include:

  • Regularly breathing in cigarette smoke, including secondhand smoke
  • Regularly breathing in industrial or agricultural chemicals
  • A family member who has asthma
  • History of multiple respiratory infections during childhood
  • Being overweight
  • Having allergies

Asthma symptoms include:

  • Wheezing
  • Tightness in the chest
  • Trouble breathing
  • Shortness of breath
  • Cough
  • Chest pain
  • Limited exercise tolerance, difficulty keeping up with peers

Diagnostic Testing for Asthma

Your doctor will ask about your symptoms and medical history and perform a physical exam.

Tests may include:

  • Peak flow exam — you'll blow quickly and forcefully into a special instrument that measures your output of air
  • Pulmonary function testing (PFTs) — you'll breathe into a machine that records information about your lung function
  • Reversibility testing — you'll take medicine so your doctor can observe how much they relieve airflow obstruction
  • Bronchoprovocation testing — your doctor will look at lung function after you're exposed to methacholine to stimulate asthma; it can help to confirm asthma in unclear cases
  • Exhaled nitric oxide — this marks airway inflammation and helps monitor asthma control

Your doctor may also do some allergy tests to help determine if allergies are causing your symptoms. The test may include skin pricks or blood tests.

Asthma Treatments

The treatment strategy for asthma includes:

  • Medications
  • Preventing asthma attacks
  • Monitoring your asthma

You and your doctor should also create an asthma action plan. This is a plan you will follow to help control your asthma and handle asthma attacks.

See an Asthma Specialist

Asthma Medications

We prescribe two types of asthma medications: those that control asthma, and those that stop asthma attacks.

Medications Used to Control Asthma

These medications control chronic swelling:

  • Inhaled corticosteroid—used daily to reduce inflammation in your airways
  • Long-acting beta-agonists—(such as inhaled salmeterol ) used daily to prevent asthma attacks. In most cases, prescribed with an inhaled corticosteroid
    • May increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breath), and hospitalization—If you have any concerns, talk to your doctor.
  • Cromolyn sodium or nedocromil sodium inhaler—used daily to prevent asthma flare-ups or to prevent exercise-induced symptoms
  • Zafirlukast, zileuton, and montelukast —taken daily to help prevent asthma attacks
  • Omalizumab —a monoclonal antibody against immunoglobulin E (IgE), given as an injection under the skin, used along with other medications for patients with harder to control asthma
  • Theophylline —taken daily to help prevent asthma attacks, not as commonly used because of interactions with other drugs

Medications Used to Treat an Asthma Attack

These medications treat existing asthma attacks:

  • Quick-acting beta-agonists—(such as inhaled albuterol, Xopenex) relax your airways so that they become wider again, may also be used to avoid exercise-induced asthma attacks
  • Anticholinergic agents—inhaled medications, such as ipratropium, that function as a bronchodilator, typically only used in an emergency setting
  • Corticosteroids—pills, injections or IV medications given to treat acute flare-up of symptoms
    • Pills may be taken for a longer period of time. They may also be recommended to help control asthma if you have severe asthma that isn't responding to other treatments.

Preventing Asthma Attacks

Allergy avoidance can be very effective with asthma that is exacerbated by allergens. Some general tips for allergen avoidance include:

  • Avoid outside activities if there are high levels of air pollution, pollen, or mold spores.
  • Keep your windows closed during seasons with high pollen or mold spores. Air conditioning may help filter out allergens during warm seasons.
  • Consider getting a portable HEPA unit air cleaner to use in sleeping areas.
  • Consider getting HEPA filters for your heating/cooling system and your vacuum cleaner.
  • Have someone else vacuum for you. Avoid a room that has been freshly vacuumed. If you do vacuum, use a dust mask.
  • Keep the humidity down in your house. This may help prevent the growth of mold.
  • Treat allergies and sinusitis as recommended.
  • Avoid strenuous outdoor exercise during days with high air pollution, a high pollen count, or a high ozone level.
  • Get a yearly seasonal flu shot. Colds and the flu can exacerbate asthma.
  • Don't smoke. If you are pregnant, it is very important that you do not smoke.
  • Avoid secondhand smoke. Do not allow anyone to smoke in your home.
  • Don't use a wood-burning stove or fireplace, including unvented gas fireplaces.
  • If cold weather triggers your asthma, avoid strenuous activities in cold weather. If you must, use a scarf or mask to warm the air before it reaches your lungs.
  • Avoid strong chemicals or odors like perfume.

Monitoring Your Asthma

Your asthma plan may need to be adjusted to adapt to changes in your life or health. Staying in contact with your doctor between visits can help you have better control of your asthma. You can reach your UVA provider through MyChart.

Online programs aimed at helping you manage your own symptoms can improve asthma control and lung function. Check out American Lung Association or Asthma and Allergy Foundation of America.

Talk to your doctor about:

  • An appropriate level of exercise for you
  • Allergy shots
  • Breathing exercises
  • Ways to track your asthma to help identify and treat flare-ups right away
  • Your work, hobbies, and home activities to see if any of these may be causing or worsening your asthma

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.