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Asthma attacks, or just wheezing? – Asthma disease.

Asthma is an inflammatory and respiratory condition. It presents itself in the form of “asthma attacks” or symptomatic episodes. 

Asthma is a complex and common condition. In the United States alone, there are around 26 million people affected by this condition. Also, it is the most common chronic condition in childhood. It affects approximately 7 million kids. It primarily affects young patients, with more than half of all asthma cases diagnosed before 18 years old. 

In the following writing, you will find all the critical aspects of this condition explained by a doctor. We encourage you to keep reading it to find out more about this common condition. 

What is asthma? 

Asthma is a chronic, inflammatory disease of the airways. To understand it, we first need to know how the normal breathing process works. During breathing, the air enters through your nose or mouth. Then, it goes down a single tubular structure, the trachea, which then divides into the bronchi.

The bronchi then divide into smaller branches until they get to the lung tissue. This is made up of alveoli, sac-like structures that pass oxygen into your blood. It also happens all the way backward to release carbon dioxide.

Asthma is a complex disease that involves several changes in the functioning of the airways. In asthma, the inflammatory reaction affects your bronchi, which pass air in and out of your lungs. This results in episodes of respiratory symptoms, commonly known as “asthma attacks.” I will explain this aspect later in this article. It can cause a variety of symptoms that can be mild or severe depending on the patient. For some patients, asthma is just a minor inconvenience in their lives. In the case of other patients, it can even be life-threatening. 

Usually, this disease starts early in life, during your childhood. However, it can still appear in your adult years. The disease is considered a lifelong condition, even if you spend years without an asthma episode. 

What are some of the main causes of asthma?

There is no exact cause to explain this disease. Doctors agree that it’s a combination of several factors. The main reason for asthma to occur is airway inflammation. This results in increased discharge of mucus, muscle contraction of the bronchi, and swelling of the bronchi’s inner lining. This is what causes the obstruction of the airway and the symptoms of an asthma attack.

Nevertheless, this latter process starts after exposure to a trigger. Asthma triggers are usually irritants of the airway that can start an inflammatory reaction, resulting in an asthma attack. The link between asthma and allergic conditions is close. Patients with allergies usually develop this condition as another form of manifestation of the allergy. 

There is also an important genetic factor to develop this condition. This means that anyone who has a family member with asthma is more likely to develop this condition. For children, the chances of having this disease increase significantly if both parents are asthmatic patients. 

In conclusion, allergic and genetic factors are the most important in the development of asthma. 

How is categorized?

The illness’s inflammation categories include acute, sub-acute, and chronic types. All these types of inflammation contribute differently to asthma symptoms. The prevention of severe asthma episodes is hard. Its reversion is only possible by specific medication; however, prevention of chronic inflammation is possible and a must due to its well-known complications in the long run.

Acute asthma, which is also known as exacerbations or attacks, can be fatal. When the patients are out of treatment, asthma attacks become more frequent and severe. But even if controlled, no asthma patient is safe. Therefore, any individual should have an asthma action plan. This presentation of the disease display the most bothersome symptoms. Besides, asthma attacks threaten life by a reduction of lung functions, which impossibilities the patients to get oxygen for their tissues. These cases usually have a substantial impairment in lung function with a reduction of the peak flow meter.

What exactly happens during an asthma attack? 

An asthma attack is the common name of an asthma flare or exacerbation. This always starts with exposure to an allergen or trigger. The trigger can be different for every patient.

After the exposure, the airways experience an inflammatory reaction. There’s a release of inflammatory substances and cells of your immune system. This increases the production of mucus in the bronchi and muscle contraction and swelling of the bronchi membranes. The gathering of these three things results in a smaller caliber of the airway.

The consequence is an obstructed airway and impaired airflow. Also, this results in the common respiratory symptoms of every asthma attack, like coughing and wheezing. Additionally, since the airflow is impaired, there is less oxygen that gets to the alveoli. This can affect the oxygenation of other tissues of your body. 

What are some common asthma triggers? 

Almost anything that can act as an irritant of the airway can trigger an asthma attack. The triggers may vary from patient to patient. If you have asthma, you may have different triggers than another asthma patient. This is entirely normal. In fact, a way to managing asthma is to know your personal triggers and avoid them. Some of the most common triggers are: 

  • Tobacco smoke: It’s no surprise that tobacco is harmful to the airway in more than one aspect. However, it is also detrimental even if you don’t smoke. This means that you are exposed to tobacco smoke when another person is smoking. Secondhand smoke is a powerful trigger as well. 
  • Dust mites: These are microscopic bugs. They are a common trigger for asthma patients and live in most houses. Dust mites live in pillows, mattresses, and bedding. 
  • Air pollution: Contamination or air pollution can also trigger asthma attacks. Asthma patients should avoid the combination of factories, car smoke, or wildfire smoke. 
  • Pests: Unwanted animals or insects, like mice or cockroaches, can damage your health in many ways. One of them is causing asthma exacerbations. 
  • Pets: Pets like dogs, cats, rodents, and birds can trigger asthma attacks too. First, doctors thought it was only because of pets’ fur. Later, they found that most patients weren’t allergic to their pet’s fur but to pet dander. This is like dust, made up of animals’ dead skin cells, which usually causes allergic reactions. 
  • Cleaning and disinfection products: Or almost anything with added fragrance can cause asthma flares.
  • Other triggers include viral infections, physical exercise, weather, and intense emotions like stress.  

Who is more likely to develop this condition? 

Many risk factors can make you more likely to develop it. The most important risk factors include: 

  • Gender: In small children, boys are more likely to develop asthma than girls. Then, this proportion changes in the adult years, and women are more likely than men to develop asthma. 
  • Family history of asthma: In this condition, the genetic factor has a lot of weight on your chances of getting it. A person who has a parent with asthma has three to six times more chance of having it. In fact, more than half of the patients with asthma have at least one parent who suffers from this disease. 
  • History of allergic reactions: Or, as doctors call it, atopy is a major risk factor. If you suffer from other allergic conditions like rhinitis, conjunctivitis, or dermatitis (eczema), you are more likely to have this disease. This happens because of a higher sensibility to allergens, and it is known as allergic asthma. 
  • Obesity: Many significant studies show that obese adults and children have a higher chance of suffering from this condition. 
  • Environmental factors: People who are constantly exposed to air pollution, cigarette smoke, mold, or toxic fumes have a higher chance of asthma. The same happens to people who live in very cold or humid places. All these allergens can make you develop this disease in the long term. 

How many people can it affect?

Asthma is a prevalent condition worldwide. According to the World Health Organization, it affects approximately 300 million people and kills 250,000 annually throughout the world; likewise, the United States affects nearly 7,5% of the population. It happens to be the most common chronic condition in childhood affecting 7 million US children.

In fact, due to the significant burden of this condition on the healthcare system, economy, and the overall society. A global initiative for asthma (GINA) is in charge of widespread education about it for better management and diminishing its complications.

What are the typical symptoms of a severe attack of asthma? 

First, we’ll mention what the typical symptoms of an asthma attack are. These symptoms can go from mild to severe, depending on the patient. Also, your symptoms can progress and become more powerful or more frequent over time. The most common asthma symptoms include: 

  • Coughing: More common at night due to temperature change. Asthma cough commonly comes with sputum as a result of increased mucus in the airway. 
  • Wheezing: A high-pitched whistling sound that appears when you breathe. Occurs because of the passing of air through a closed airway. 
  • Chest tightness or pressure: Resulting from the contraction of bronchi muscle and extra effort to breath.
  • Shortness of breath.
  • Feeling tired or even weak: Especially while exercising. 
  • Alterations in lung function: Only can be measured with a peak flow meter.
  • Difficulty sleeping or nocturnal asthma.
  • Other respiratory symptoms: Like runny nose and sore throat, indicating a possible viral infection.

Now, you start to imagine what a severe asthma attack can look like. During a severe attack, asthma patients can experience: 

  • Severe wheezing.
  • Very rapid breathing and difficulty to do so.
  • Chest pain or pressure.
  • Difficulty talking.
  • Use of accessory muscles: Showing as tightened neck and chest muscles. 
  • Blue lips or nails.

Do you are experiencing only a cough?

When a cough is the only asthma symptom, the asthma trigger’s probabilities have its location in the body’s upper section. The most common diseases causing involved are post-nasal drip, chronic sinusitis, gastric reflux, or some other rarer lung conditions.

What are the complications of asthma? 

Asthma can result in many complications if left untreated. From a medical point of view, patients with asthma have a higher chance of developing respiratory failure. It can be potentially fatal.

Moreover, a closed airway with excess mucus is the perfect environment for bacteria to grow. This is why asthma patients are very likely to develop pneumonia and other respiratory infections.

In the long term, asthma can cause a remodeling of the airway. This is basically a change in the structure of the airways due to chronic inflammation that results from chronic asthma. This remodeling can lead to loss of lung function, chronic coughing, and thicker airway walls. Also, asthma patients are more likely to need hospitalization to get treatment and oxygen supply. Finally, patients can experience unpleasant side effects from their asthma medications. 

From a lifestyle point of view, having asthma can affect the patient’s life. For adults, asthma is the reason for frequent sick days from work and increased risk of depression. For children, asthma can mean having growth delay and a higher risk for learning disabilities. 

Does asthma shorten your life? 

Actually, we have good news for you. Multiple studies have shown that asthma patients have the same life expectancy as any other person. Of course, this can only occur with the proper treatment and life changes to avoid asthma attacks and complications. So, we really encourage you to seek medical help if you think you have asthma. This way, you can start controlling the disease and prevent future inconveniences. 

What tests and procedures diagnose asthma? 

If you think you may have asthma, you need to get medical help. Only a doctor can confirm the diagnosis and prescribe the right treatment for you. To diagnose asthma, doctors need to fill several criteria. First, they will ask questions about your symptoms and your general medical history. You must tell your doctor if you suffer from any allergies. Here, they can ask if there is any family history of asthma. Then, they will perform a physical examination. They will take a look at your chest to see if there is an extra effort to breathe.

Then, they will listen to your lungs with a stethoscope. This way, they can determine if there are signs of obstructed airways. Doctors can ask for imaging studies, but they are not very useful in asthma diagnosis. They are often used to out rule other conditions that can cause similar symptoms.

The definite diagnosis of this disease is made through breathing or pulmonary/lung function tests. The most commonly used test is spirometry. It measures the airflow into and out of your lungs. This test consists of blowing into a tube that measures the speed of the airflow. If it’s decreased, then you and obstruction in your airways that can be asthma. Also, doctors can measure the airflow before and after giving you an asthma medicine known as a bronchodilator. If there’s a change between the two measurements, the diagnosis of this condition is confirmed. 

What should someone do when experiencing an asthma attack?

If it’s the first time you are having an asthma attack, try to keep calm. Then, head to the hospital as soon as you can. This is only to determine if your symptoms are caused by asthma or by some other condition. After you have the diagnosis, it’s easier to control your asthma attacks. 

If you already have the diagnosis, then you should have your treatment. Try to keep your asthma medications with you at all times. If you start experiencing symptoms of an asthma attack, keep calm. Stress and panicking can make asthma attacks worse.

Then, start to take slow, deep, and steady breaths as you remain seated. If there are people with you, ask them to look for your inhaler. If you are alone, focus on the slow breaths as you look for your inhaler. Also, you can try to eliminate what’s triggering your attack if possible. Once you get your inhaler, take puffs from it as your doctor indicated. Not every inhaler contains the same drug, so the way each one is used differently. Then, wait around 20 minutes to see if your symptoms get better. If they are not, or they are getting worse, you should get medical help. 

How is asthma treated? 

There is no definite cure for asthma; doctors can only treat the symptoms. In fact, treating and managing asthma can be very difficult to do. This is why only doctors who are asthma specialists should be the ones to prescribe your treatment.

Since it can be difficult to manage, every patient should have an individualized asthma action plan. One of the first steps to effectively treating asthma is to identify your triggers. Once you do this, you can start to avoid them, and this way, prevent asthma attacks from happening. The treatment should include fast-acting and long-term control asthma medications. 

Fast-acting medications include inhaled bronchodilators: like salbutamol and ipratropium. On the other side, long-term control includes inhaled corticosteroids (like fluticasone), long-acting bronchodilators (like salmeterol and formoterol), and antileukotriene agents (like montelukast).

When is the disease controlled?

The proper term of “control” in this condition occurs when asthma management reduces or totally removes airflow obstruction symptoms. It has two main focuses, symptoms and risk factors for not desirable outcomes.

The level of control would depend on four questions: Daytime symptoms more than twice a week? Is there any night walking due to asthma (nocturnal asthma)? Did the patient need a reliever more than twice a week? And, any activity limitation due to asthma? If the response to all these questions is no, then the disease is thought to be in control. If the answer to 1 or 2 of the items is yes, it is partly controlled. And, if the person answers yes in 3 or 4 questions, then it is out of control.

The possible risk factors include medication, lung disease, or exposure to nocive particles or allergens in the work environment. The latter could cause an allergic reaction or lung affection (occupational asthma) to trigger a worse asthma episode. To not have risk factors includes having a healthy lung, so it needs continuous assessment with lung exams.

Why is your asthma bad at night?

There are many reasons why doctors think asthma’s nighttime symptoms get worse at night. Some of the stronger hypotheses include: 

  • Increased exposure to allergens: especially dust mites, since you are in bed where they inhabit. 
  • Cooling of the airways: of course, the temperature lowers at night, and as you know, cold is a major asthma trigger. 
  • Being in a reclining or horizontal position: can make the mucus go up and make you cough more during the night. 
  • Hormones: some specific hormones increase levels during the night and play a role in asthma development. 

Is exercise good for asthma? 

Even though exercise induced asthma exists, exercise can be good for treating asthma. Asthma patients should still get regular exercise and engage in physical activities. Exercise can benefit your symptoms. Also, it can increase your lung capacity and reduces inflammation of the airway. Some recommendations to exercise with asthma include: 

  • Using your inhaler before exercise.
  • Avoid exercising outside during cold weather (cover your nose and mouth with a scarf to prevent the cold air from affecting your airways).
  • Limit your exposure to possible outside allergens: like pollution, pollen, and smoke. 
  • Avoid sports that require long and continuous activity: like soccer. 

Asthma in smokers

Smoking is a very-known risk factor for developing asthma, directly or indirectly. Cigarette smoke can evoke allergic reactions and common asthma symptoms. In light of this, patient education is core to protecting asthma sufferers from a severe asthma attack.

However, in older patients smoking cigarettes is also in high association with chronic obstructive pulmonary diseaseThese two conditions could overlap, particularly in the elderly. The differentiation is mostly through medical records. The physician must have a closer look because when together, they are way more dangerous. For this type of case, inhaled corticosteroids are a recommendation for the patient to diminish airway inflammation.

Do you think you have asthma?

This tool is an Asthma Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for the disease. Therefore, the tool will tell anybody who uses it the likelihood of having asthma. Using the tool is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.


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