Asthma is an inflammatory disease of the airways to the lungs. It makes breathing difficult and can make some physical activities challenging or even impossible.

According to the Centers for Disease Control and Prevention (CDC), approximately 25 million Americans have asthma.

It’s the most common chronic condition among American children: 1 child out of every 12 has asthma.

To understand asthma, it’s necessary to understand a little about what happens when you breathe.

Normally, with every breath you take, air goes through your nose or mouth and down into your throat and into your airways, eventually making it to your lungs.

There are lots of small air passages in your lungs that help deliver oxygen from the air into your bloodstream.

Asthma symptoms occur when the lining of your airways swell and the muscles around them tighten. Mucus then fills the airways, further reducing the amount of air that can pass through.

These conditions can then bring on an asthma “attack,” the coughing and tightness in your chest that’s typical of asthma.

The most common symptom of asthma is wheezing, a squealing or whistling sound made when you breathe.

Other asthma symptoms may include:

  • coughing, especially at night, when laughing, or during exercise
  • tightness in the chest
  • shortness of breath
  • difficulty talking
  • anxiousness or panic
  • fatigue

The type of asthma that you have can determine which symptoms you experience.

Not everyone with asthma will experience these particular symptoms. If you think the symptoms you’re experiencing could be a sign of a condition such as asthma, make an appointment to see your doctor.

The first indication that you have asthma may not be an actual asthma attack.

There are many different types of asthma. The most common type is bronchial asthma, which affects the bronchi in the lungs.

Additional forms of asthma include childhood asthma and adult-onset asthma. In adult-onset asthma, symptoms don’t appear until at least age 20.

Other specific types of asthma are described below.

Allergic asthma (extrinsic asthma)

Allergens trigger this common type of asthma. These might include:

  • pet dander from animals like cats and dogs
  • food
  • mold
  • pollen
  • dust

Allergic asthma is often seasonal because it often goes hand-in-hand with seasonal allergies.

Nonallergic asthma (intrinsic asthma)

Irritants in the air not related to allergies trigger this type of asthma. These irritants might include:

  • burning wood
  • cigarette smoke
  • cold air
  • air pollution
  • viral illnesses
  • air fresheners
  • household cleaning products
  • perfumes

Occupational asthma

Occupational asthma is a type of asthma induced by triggers in the workplace. These include:

  • dust
  • dyes
  • gases and fumes
  • industrial chemicals
  • animal proteins
  • rubber latex

These irritants can exist in a wide range of industries, including:

  • farming
  • textiles
  • woodworking
  • manufacturing

Exercise-induced bronchoconstriction (EIB)

Exercise-induced bronchoconstriction (EIB) usually affects people within a few minutes of starting exercise and up to 10–15 minutes after physical activity.

This condition was previously known as exercise-induced asthma (EIA).

Up to 90 percent of people with asthma also experience EIB, but not everyone with EIB will have other types of asthma.

Aspirin-induced asthma

Aspirin-induced asthma (AIA), also called aspirin-exacerbated respiratory disease (AERD), is usually severe.

It’s triggered by taking aspirin or another NSAID (nonsteroidal anti-inflammatory drug), such as naproxen (Aleve) or ibuprofen (Advil).

The symptoms may begin within minutes or hours. These patients also typically have nasal polyps.

About 9 percent of people with asthma have AIA. It usually develops suddenly in adults between the ages of 20 and 50.

Nocturnal asthma

In this type of asthma, symptoms worsen at night.

Triggers that are thought to bring on symptoms at night include:

  • heartburn
  • pet dander
  • dust mites

The body’s natural sleep cycle may also trigger nocturnal asthma.

Cough-variant asthma (CVA)

Cough-variant asthma (CVA) doesn’t have classic asthma symptoms of wheezing and shortness of breath. It’s characterized by a persistent, dry cough.

If it’s not treated, CVA can lead to full-blown asthma flares that include the other more common symptoms.

There’s no single test or exam that will determine if you or your child has asthma. Instead, your doctor will use a variety of criteria to determine if the symptoms are the result of asthma.

The following can help diagnose asthma:

  • Health history. If you have family members with the breathing disorder, your risk is higher. Alert your doctor to this genetic connection.
  • Physical exam. Your doctor will listen to your breathing with a stethoscope. You may also be given a skin test to look for signs of an allergic reaction, such as hives or eczema. Allergies increase your risk for asthma.
  • Breathing tests. Pulmonary function tests (PFTs) measure airflow into and out of your lungs. For the most common test, spirometry, you blow into a device that measures the speed of the air.

Doctors don’t typically perform breathing tests in children under 5 years of age because it’s difficult to get an accurate reading.

Instead, they may prescribe asthma medications to your child and wait to see if symptoms improve. If they do, your child likely has asthma.

For adults, your doctor may prescribe a bronchodilator or other asthma medication if test results indicate asthma.

If symptoms improve with the use of this medication, your doctor will continue to treat your condition as asthma.

To help diagnose and treat asthma, the National Asthma Education and Prevention Program (NAEPP) classifies the condition based on its severity before treatment.

Asthma classifications include:

  • Intermittent. Most people have this type of asthma, which doesn’t interfere with daily activities. Symptoms are mild, lasting fewer than two days per week or two nights per month.
  • Mild persistent. The symptoms occur more than twice a week — but not daily — and up to four nights per month.
  • Moderate persistent. The symptoms occur daily and at least one night every week, but not nightly. They may limit some daily activities.
  • Severe persistent. The symptoms occur several times every day and most nights. Daily activities are extremely limited.

No single cause has been identified for asthma. Instead, researchers believe that the breathing condition is caused by a variety of factors. These factors include:

  • Genetics. If a parent or sibling has asthma, you’re more likely to develop it.
  • History of viral infections. People with a history of severe viral infections during childhood (e.g. RSV) may be more likely to develop the condition.
  • Hygiene hypothesis. This theory explains that when babies aren’t exposed to enough bacteria in their early months and years, their immune systems don’t become strong enough to fight off asthma and other allergic conditions.

Treatments for asthma fall into three primary categories:

  • breathing exercises
  • quick-acting treatments
  • long-term asthma control medications

Your doctor will recommend one treatment or combination of treatments based on:

  • the type of asthma you have
  • your age
  • your triggers

Breathing exercises

These exercises can help you get more air into and out of your lungs. Over time, this may help increase lung capacity and cut down on severe asthma symptoms.

Your doctor or an occupational therapist can help you learn these breathing exercises for asthma.

Quick-relief asthma treatments

These medications should only be used in the event of asthma symptoms or an attack. They provide quick relief to help you breathe again.

Bronchodilators

Bronchodilators work within minutes to relax the tightened muscles around your airwaves. They can be taken as an inhaler (rescue) or nebulizer.

First aid asthma treatment

If you think that someone you know is having an asthma attack, tell them to sit them upright and assist them in using their rescue inhaler or nebulizer. Two to six puffs of medication should help ease their symptoms.

If symptoms persist for more than 20 minutes, and a second round of medication doesn’t help, seek emergency medical attention.

If you frequently need to use quick-relief medications, you should ask your doctor about another type of medication for long-term asthma control.

Long-term asthma control medications

These medications, taken daily, help reduce the number and severity of your asthma symptoms, but they don’t manage the immediate symptoms of an attack.

Long-term asthma control medications include the following:

  • Anti-inflammatories. Taken with an inhaler, corticosteroids and other anti-inflammatory medications help reduce swelling and mucus production in your airwaves, making it easier to breathe.
  • Anticholinergics. These help stop your muscles from tightening around your airwaves. They’re usually taken daily in combination with anti-inflammatories.
  • Long-acting bronchodilators. These should only be used in combination with anti-inflammatory asthma medications.
  • Biologic therapy drugs. These new, injectable medications may help people with severe asthma.

Bronchial thermoplasty

This treatment uses an electrode to heat the airwaves inside the lungs, helping to reduce the size of the muscle and prevent it from tightening.

Bronchial thermoplasty is intended for people with severe asthma. It isn’t widely available.

When your asthma symptoms get progressively worse, it’s known as an exacerbation, or an asthma attack.

It becomes increasingly difficult to breathe because your airways are swollen and your bronchial tubes have narrowed.

The symptoms of an exacerbation may include:

  • hyperventilation
  • cough
  • wheezing
  • shortness of breath
  • increased heart rate
  • agitation

Although an exacerbation can end quickly without medication, you should contact your doctor because it can be life threatening.

The longer an exacerbation continues, the more it can affect your ability to breathe. That’s why exacerbations often require a trip to the emergency room.

Exacerbations can be prevented by taking medications that help manage your asthma symptoms.

Chronic obstructive pulmonary disease (COPD) and asthma are commonly mistaken for one another.

They result in similar symptoms, including wheezing, coughing, and trouble breathing. However, the two conditions are quite different.

COPD is an umbrella term used to identify a group of progressive respiratory diseases that include chronic bronchitis and emphysema.

These diseases cause reduced airflow due to inflammation in the airways. The conditions may worsen over time.

Asthma can occur at any age, with a majority of diagnoses coming in childhood. Most people with COPD are at least age 45 at the time of their diagnosis.

Over 40 percent of people with COPD also have asthma, and the risk for having both conditions increases with age.

It’s not clear what causes asthma besides genetics, but asthma attacks are often the result of exposure to triggers, such as physical activity or smells. These triggers can make breathing problems worse.

The most common cause of COPD is smoking. In fact, smoking accounts for up to 9 out of 10 COPD-related deaths.

The goal of treatment for both asthma and COPD is to reduce symptoms so you can maintain an active lifestyle.

Certain conditions and environments may also trigger symptoms of asthma. The list of possible causes and triggers is extensive. Triggers include:

  • Illness. Respiratory illnesses such as viruses, pneumonia, and the flu can trigger asthma attacks.
  • Exercise. Increased movement may make breathing more difficult.
  • Irritants in the air. People with asthma may be sensitive to irritants, such as chemical fumes, strong odors, and smoke.
  • Allergens. Animal dander, dust mites, and pollen are just a few examples of allergens that can trigger symptoms.
  • Extreme weather conditions. Conditions such as very high humidity or low temperatures may trigger asthma.
  • Emotions. Shouting, laughing, and crying may trigger an attack.

Because researchers have yet to identify the exact cause of asthma, it’s challenging to know how to prevent the inflammatory condition.

However, more information is known about preventing asthma attacks. These strategies include:

  • Avoiding triggers. Steer clear of chemicals, smells, or products that have caused breathing problems in the past.
  • Reducing exposure to allergens. If you’ve identified allergens, such as dust or mold, that trigger an asthma attack, avoid them as best you can.
  • Getting allergy shots. Allergen immunotherapy is a type of treatment that may help alter your immune system. With routine shots, your body may become less sensitive to any triggers you encounter.
  • Taking preventive medication. Your doctor may prescribe medication for you to take on a daily basis. This medication may be used in addition to the one you use in case of an emergency.

Your doctor can help you put an asthma action plan in place so that you know which treatments to use and when.

In addition to using maintenance medications, you can take steps each day to help make yourself healthier and reduce your risk for asthma attacks. These include:

  • Eating a healthier diet. Eating a healthy, balanced diet can help improve your overall health.
  • Maintaining a healthy weight. Asthma tends to be worse in people with overweight and obesity. Losing weight is healthy for your heart, your joints, and your lungs.
  • Quitting smoking. Irritants such as cigarette smoke can trigger asthma and increase your risk for COPD.
  • Exercising regularly. Activity can trigger an asthma attack, but regular exercise may actually help reduce the risk of breathing problems.
  • Managing stress. Stress can be a trigger for asthma symptoms. Stress can also make stopping an asthma attack more difficult.

Nutrient-rich foods are vital to helping reduce symptoms, but food allergies can trigger asthma symptoms.

At the moment, there’s no cure for asthma. However, there are many effective treatments that can decrease asthma symptoms. Lifestyle changes and medications can also help improve your quality of life.

If you haven’t been diagnosed with asthma but are experiencing symptoms such as wheezing, coughing, or shortness of breath, you should let your doctor know.

Once you’re diagnosed with asthma, you should see your doctor at least once a year or more frequently if you have persistent symptoms after using treatments.

Call your doctor immediately if you:

  • feel weak
  • can’t perform daily activities
  • have a wheeze or cough that won’t go away

It’s important to educate yourself about your condition and its symptoms. The more you know, the more proactive you can be in improving your lung function and how you feel.

Talk with your doctor about:

  • your type of asthma
  • what triggers your symptoms
  • what daily treatments are best for you
  • your treatment plan for an asthma attack