Understanding asthma: From symptoms to treatment options
The wheezing. The coughing. The extreme and sudden shortness of breath. These are symptoms that are attached to asthma, a surprisingly common condition.
March 24, 2023 - 8:47 am
The wheezing. The coughing. The extreme and sudden shortness of breath. These are symptoms that are attached to asthma, which is a surprisingly common condition. According to the Asthma and Allergy Foundation of America, 1 in 13, or 8 percent, of Americans have asthma.
But what is asthma exactly? Is it hereditary? How is it diagnosed? Can it be cured? Whether you or someone you love has recently been diagnosed with asthma, you may understandably have a lot of questions.
That’s why we’ve asked two medical experts to share their insights: Dr. Terrell Smith, a founding physician with Spora Health, a health care provider for people of color, and Dr. Caroline Sokol, an assistant physician at Massachusetts General Hospital and assistant professor at Harvard Medical School.
What is asthma?
Smith explains that asthma is a disease of the lungs caused by inflammation of the breathing airway. This can be caused by different irritating agents, such as smoke, chemicals and some infections of the lungs.
When someone has asthma, Sokol says, the inflamed, hyperreactive airways can “clamp down” in response to different stimuli. Chronic inflammation can lead to long-term changes to the lungs, which result in narrow airways and worsening shortness of breath.
Asthma is accompanied by asthma attacks, which typically occur when someone has a trigger. These triggers can include viral infections, allergens, increased physical activity or exposure to environmental irritants.
Contrary to popular belief, asthma isn’t something that a person is born with. In fact, it’s a disorder that many people develop when they’re young — oftentimes, toddlers first display symptoms.
“It tends to develop as the body develops and is exposed to different aspects of the environment,” Smith notes.
Although it frequently shows up in children, less commonly, adult-onset asthma may develop.
Asthma is also more common in certain groups of people. For instance, the AAFA says that women are more likely to have asthma than men. Smith adds that people of color are at a higher risk of asthma.
Are there different types?
Yes, there are indeed different types of asthma. Smith says that these include occupational asthma, exercise-induced asthma, allergic asthma, adult-onset asthma and several others. He adds that although the reaction within the body ultimately leads to the same symptoms, the cause of the asthma is important, as this will guide a doctor in how it should be treated and triggers that should be avoided.
According to Sokol, asthma can also be classified by whether it’s caused by outside triggers, like allergens and irritants, or whether it’s a different trigger that’s always present in a person’s life.
What are the symptoms?
Although asthma symptoms can vary, Smith says that the most common symptoms he has encountered are coughing and wheezing. Other common symptoms include difficulty breathing with activity, chest tightness, difficulty taking a deep breath and shortness of breath.
Sokol adds that patients can also experience nighttime symptoms that lead them to wake up short of breath.
How is asthma diagnosed?
Sokol explains that asthma can be diagnosed with an in-depth discussion about the history of one’s symptoms and triggers, along with a thorough physical exam.
“Asthma specialists will often be able to perform spirometry in their office,” she says. “Spirometry is a breathing test that measures your lung sizes and amount of air you can quickly breathe out.”
Is asthma curable?
Smith says that asthma isn’t curable — instead, it’s treatable. “Management of symptoms is very important, as well as avoidance of chemicals or environmental factors that increase the frequency of asthma attacks,” he says.
Even though some children “grow out” of asthma, as Sokol says, in general, asthma is not curable.
She adds that in cases where asthma is caused only by allergic triggers, it’s possible to use allergy shots or allergen immunotherapy to prevent reactions to the culprit allergen. This could lead to a “cure” for asthma, although in the vast majority of cases, allergic asthmatics have multiple triggers.
What treatments are available?
There are many treatment options available. But the first line of defense is avoiding anything that worsens your symptoms.
“As someone who has asthma, I have come to learn that this is the easiest way,” Smith says. “For example, if I’m on a hike and it becomes difficult to breathe, I will slow down. If I am near a fire and it becomes a bit tougher to breathe, I make sure I stay away from the smoke. Trust your body and your judgment — that is the best way to avoid asthma attacks.”
He says that asthma treatment tends to fall into two major categories: rescue medications that dilate the airway during an asthma attack and maintenance medications that reduce or even prevent inflammation. Acute attacks benefit from beta-agonist inhalers like albuterol to relax the muscles around the airways, and for chronic symptoms, inhaled steroids can prevent attacks.
“There are many different inhalers that come in different combinations, but these are the basic ideas for reducing asthma symptoms,” Smith says. “In severe cases, oral or even intravenous steroids are given.”