Asthma is a common lung disorder characterized by episodes of coughing, wheezing and shortness of breath. Asthma is caused by inflammation of the lining of the small airways in the lungs (bronchioles) which leads to spasm or narrowing of these tubes. This spasm triggers asthma symptoms. Asthma may develop at any age, but most commonly presents in early childhood or mid-adulthood. Most cases that occur in children improve over time and with appropriate treatment. Asthma that develops in adulthood typically responds well to treatment but is less likely to be outgrown.
Asthma has a strong genetic component and often runs in families. People with allergic conditions, such as food allergies, eczema and hay fever, are at increased risk for the development of asthma as are people who have immediate family members with asthma. For reasons that are not completely clear, the incidence of asthma and other allergic diseases has been steadily rising over the past several decades.
Common symptoms of asthma include one or more of the following:
- Chest tightness shortness of breath
- Decreased exercise tolerance
People with asthma may have one or more triggers for their asthma. Common asthma triggers include:
- Viral upper respiratory infections
- Environmental allergens such as pollens, dust, mold and animal dander
- Irritants such as cigarette smoke, perfumes/cologne and cleaning solvents
- Emotional stress such as laughing and crying
- Cold air/humid air
- Change in hormone levels such as pregnancy
- Acid reflux
- Obstructive sleep apnea
Asthma is usually suspected when symptoms occur, especially at nighttime, with exercise, with colds or with allergy flare-ups. A favorable response to asthma medicines is suggestive, as well. Diagnosis and treatment of each individual case requires not only periodic exams, but also measurement of lung function, starting by age 5 or 6, and a spirometry test which measures the amount and rate of air flow from the lungs. This often is performed before and after the use of a bronchodilator medication, such as albuterol. This medication will cause a characteristic rise in air flow confirming asthma. Other tests, such as measurement of exhaled nitric oxide, also can assist in the diagnosis of asthma. Exhaled nitric oxide is a gas normally found in the breath, but increased amounts of this gas indicate asthmatic inflammation in the airways. Just as crucial as these tests, is the response to treatments and long-term lung function trend. Since allergies are a common trigger in up to 85 percent of those with asthma, allergy skin testing is an integral part of the initial evaluation of asthma in order to optimize treatment. Chest X-rays, blood work and other tests are rarely needed for the diagnosis and management of asthma, unless other medical problems are suspected. Some examples of other medical conditions that can cause or aggravate asthma include chronic sinusitis, acid reflux and sleep apnea. If these conditions are suspected, further testing and treatment may be needed to optimize treatment and outcomes.
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