THE BASICS: “What is adult asthma?”

The experience of asthma in adults varies widely, from “It’s not that much of a bother” to “I can’t breathe!” In all, more than 25 million Americans (adults and children) struggle with the effects of asthma on their breathing—and their daily lives.

Asthma is a disease in which your airways temporarily become swollen and narrow and overproduce mucus. This narrowing, also called bronchospasm, prevents free movement of air in and out of your lungs.

Breathing problems stem from the resulting shortness of breath, coughing, chest tightness, and wheezing.  Wheezing, a whistling sound during breathing, is the diagnostic hallmark of asthma.

Asthma affects people of all ages. Adult onset is common, although it often begins in childhood. More women than men have it.

There is no cure for asthma. If you have it, you have it all the time, even when you feel fine.

Asthma symptoms and attacks happen when:

  • Inflamed by asthma, your airways react strongly as you inhale certain substances, called triggers, to which they are sensitive.
  • The airways in your lungs become swollen on the inside and clogged with mucus.
  • As a result, the muscles around your airways tighten and narrow, restricting air flow so you have trouble breathing in or out.

As noted above, asthma symptoms include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing, often occurring early in the morning or at night and disrupting your sleep

If you have any of these symptoms, you may also have trouble sleeping.

Asthma symptoms can:

  • Be mild and go away with (and sometimes without) treatment
  • Worsen into an asthma attack

Your asthma may be worsening if:

  • Your symptoms are occurring more often and/or are more severe.
  • You’re having more trouble breathing and/or your peak flow meter shows decreasing lung function. (A peak flow meter is a portable, hand-held device for measuring your peak, or best, air flow at any given time.)
  • You are using a quick-relief (rescue) asthma inhaler more often than usual.

An asthma attack must be treated with quick-relief medication immediately to keep it from becoming a medical emergency. A severe asthma attack may send you to the hospital. It can even be fatal.

The cause of asthma is mostly unknown, but it appears to run in families. Known causes of asthma include occupational asthma, resulting from exposure to industrial or chemical irritants in the workplace.

To help reduce your risk of asthma attacks, be sure you know:

  • The things in your life that can trigger an attack, such as pollen, pet dander, or workplace irritants
  • Ways to avoid them
  • Steps to take to control and relieve asthma symptoms

The most common asthma triggers include:

  • Tobacco smoke: can trigger an asthma attack if you or someone near you is smoking
  • Dust mites: invisibly tiny bugs that live all around and on us and are easily breathed into your lungs
  • Air pollution: for example, from factories and street traffic
  • Cockroaches and their droppings (dander)
  • Furry pets and pet dander (skin cells that, like human dandruff, are shed from a pet’s body)
  • Mold spores
  • Smoke from burning wood or other plants: a mix of particles and gases harmful to your lungs
  • Pollens from grasses, trees, and flowers
  • Allergic responses

o   Most people with asthma also have allergies.

Asthma and allergies commonly occur in the same person. When this happens, the same substances that trigger allergy symptoms (allergens) may trigger asthma symptoms as well. This condition is called allergic asthma or allergy-induced asthma.

The most common type of asthma, allergic asthma causes about half of adult asthma.

An allergy starts when your body’s immune system mistakenly “flags” a normally harmless substance, such as dust mites, as an “invader.” This can happen at any time, even if you’ve often inhaled the substance before.

Trying to protect your body from the invader, your immune system prepares for the next “invasion” by developing special protective cells, called antibodies, that will “fight” that invader if you’re exposed to it again. Your body is now “sensitized” to the invader, which has become an allergen (trigger).

Next time you’re exposed to the allergen, the antibodies recognize it and activate mast cells (the cells that cause an allergic response) throughout your body.

  • The mast cells burst open and release chemicals, such as histamine, that cause allergy symptoms, such as swelling.
  • Swelling in your airways and nose can cause the symptoms of asthma.

If appropriate for you, allergy testing can help identify your personal allergic asthma triggers.

Less common asthma triggers include:

  • Physical exercise – Since getting exercise is important for good health, talk to your health professional about medications that may help you stay active.
  • Some medications, such as aspirin and certain prescription medications
  • Upper respiratory infections such as colds and the flu
  • Acid reflux (stomach acids rising up into the esophagus; a cause of heartburn and indigestion)
  • Weather extremes such as thunderstorms or high humidity
  • Breathing in cold, dry air
  • Some foods, food additives, and fragrances

Strong emotions can lead to very fast breathing, called hyperventilation, that can also cause an asthma attack.

Note that one or more of your personal triggers may not be listed here. Tell your doctor about everything that seems to trigger your asthma symptoms. If you aren’t sure if you have asthma, contact your doctorfor an asthma evaluation.

If you’ve been diagnosed with asthma, contact your doctor:

  • If your asthma symptoms worsen
  • To check that your asthma is under control
  • To evaluate your treatment for any changes that may be needed
  • If your peak air flow is less than half of your “personal best” peak flow number

Get medical help immediately or go to the hospital if:

  • You are so breathless you have difficulty walking and/or talking.
  • You have shortness of breath even though you aren’t actively exercising.
  • Your quick-relief asthma medication does not relieve your symptoms, a condition known as status asthmaticus.
  • Your lips or fingernails are blue.

To help ensure you make the right treatment decisions when asthma symptoms or attacks occur, ask your doctor to help you write an asthma action plan, specifying:

  • When to take each of your asthma and/or allergy medications
  • When to increase or decrease medication dosages, based on your symptoms
  • What steps you should take for each of your triggers when it occurs
  • When to call the doctor or go to the hospital or emergency room

Give a copy of your asthma action plan to one or more people close to you and at places you go to often, such as work and/or school.

Remember, asthma needs to be treated every day with your long-term controller medication(s)—even when you are not having symptoms or an attack.

You’ve increased your knowledge of asthma and know what to do to help keep it under control. Next step:

  • Getting to know the health professionals who will provide the care you need
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