Can you develop asthma as an adult? Asthma is a disease in which there is airways obstruction causing difficulty to breathe.
Although this is a disease of childhood, there is a possibility of adults developing asthma. It is one of the most common chronic diseases with a rapid evolution over the last few years. It affects women in more significant measure than men. Also, death rates are higher in people older than 65 years old than any other age. Nonetheless, asthma deaths are not so common. Within this article, you will find answers to some of the most common questions about this disease. There will be some like can asthma go away, what happens after diagnosis, and many more.
By reading this article, you will obtain critical insights about Late-Onset Asthma, its symptoms, how to diagnose it, its treatment options, and many more. Therefore, please continue reading this article to get pearls on this specific topic by a doctor’s hand.
What is Asthma?
Asthma is a complex and chronic inflammatory disease that affects people of all ages. It also is the most common chronic disease in childhood, affecting over 7 million children in the United States.
The mechanism by which asthma causes the disease can be very complex. It involves airway inflammation (swelling), intermittent airflow obstruction, and bronchial hyperresponsiveness (narrowing of the tubes carrying the air to the deepest of your lungs).
Inflammation sources can vary as they can be acute, subacute, or chronic. Importantly, airway edema (airway filled with liquid) and mucus discharge also contribute to airflow obstruction and bronchial reactivity.
The airways hyperresponsiveness in asthma is an excessive response to several stimuli, whether exogenous (from the outside) or endogenous (within the body). Among the mechanisms, it includes direct activation of airway smooth muscle causing constriction of the airways.
The severity of asthma is classified into the following categories:
- Intermittent asthma
- Mild Persistent asthma
- Moderate persistent asthma
- Severe persistent asthma
Moreover, patients with asthma of any severity level may have mild, moderate, or severe exacerbations. But to get a better understanding of the topic, an explanation of the anatomy of the lungs is also needed.
The airways of the lung consist of the following: Cartilaginous bronchi, membranous bronchi, gas-exchanging bronchi, and alveoli. The first two airways primarily function as an anatomic dead space, but they also contribute to airway resistance. This means that they act as highways for the air to get where you actually breathe it. The last gas-exchanging bronchi (also known as respiratory bronchioles) are the ones that directly communicate to the alveolar ducts.
The alveolus is a sac-like structure with special components that allow actual breathing. Therefore, in order to breathe, air must pass several structures (bronchi) to reach them.
Airway structure consists of the following:
- Mucosa, mostly composed of epithelial cells which are responsible for specialized mucus production and a transport apparatus
- Basement membrane
- The smooth muscle that extends to the alveolar entrances
- Fibrocartilaginous or fibroelastic-supporting connective tissue
How common is Asthma?
It is a common chronic disease that affects 5% to 10% of the population in the United States. The estimates are that 23.4 million people in the United States suffer from this disease, including 7 million children. Worldwide, according to statistics, there are over 300 million people with asthma. Annually, there are over 250,000 deaths with direct relation to asthma worldwide.
Although genetic factors play a significant role in developing this disease, environmental factors play a greater role than genetic predisposition. For example, if you are a genetically susceptible individual, you are at risk, but it may trigger the asthma onset when you meet with an environmental factor.
This disease is more common in industrialized countries like Canada, Germany, Australia, England, and New Zealand. The numbers on severe asthma in these countries vary from 2% to 10% of the population suffering from severe asthma. Among the factors that may act as asthma triggers are the following:
- Air Pollution
- Passive Smoking
- Change in Exposure to Environmental Allergens
Most of the time, asthma occurs in childhood, affecting boys more than girls with a ratio of 2:1. When puberty hits, the balance becomes 1:1 between males and females. However, after puberty, asthma becomes more common in females. In fact, most adult asthma cases in people over 40 years old are diagnosed in women.
Can you Develop Asthma as an Adult? How common is Asthma is it?
Although asthma is a common inflammatory disease in children that does not mean that it does not affect adults. Contrary to children, late onset asthma affects more women than men. The numbers have almost doubled the female to male ratio. From 20 years old, the average percentage of people per age range of the population that suffers from asthma is around 7%.
What are the causes?
Several causes may induce an asthma episode; this includes factors that can play a significant role in a hyperactive response of the airways. Nonetheless, it will also depend from patient to patient. Among the factors that can contribute to developing asthma are the following:
- Environmental allergens such as house dust mites, animal allergens, and fungi
- Viral respiratory tract infections
- Gastroesophageal Reflux Disease (GERD)
- Exercise or hyperventilation
- Allergic rhinitis or chronic sinusitis
- Environmental pollutants such as tobacco smoke
- Chemical Irritants like paint fumes or household sprays
- Occupational exposure
- Emotional Factors or Stress
- Aspirin or NSAID’s hypersensitivity
- Perinatal factors include prematurity, increased mother age, maternal smoking.
This list is a little bit extensive but covers the majority of the possible causes for developing asthma. However, three very specific situations may flare up an asthma crisis. These situations are the following.
- Exercise-induced asthma initiates during physical activity, and the symptoms may worsen when the air is cold and dry.
- Occupational Asthma: This type of asthma gets triggered at the workplace, and it happens mostly due to workplace irritants such as chemical fumes, gases, or dust.
- Allergic asthma: Maybe the most common of the three types of situations. It is triggered by airborne substances such as pollen, food allergy, mold spores, cockroaches waste, or particles of skin and dried saliva shed by pets.
What are the signs and symptoms of adult onset asthma?
Asthma signs and symptoms may vary from person to person. There are patients whose asthma attacks are infrequent. In contrast, other patients have symptoms in certain situations or even all the time.
The signs and symptoms of asthma are very specific, and patients are very aware of them. Even the family of the patients can be very aware of these symptoms and may predict when their asthmatic relative will develop an attack. These are some of the signs and symptoms:
- Shortness of breath
- Chest tightness, pain, or pressure within the chest
- Wheezing while exhaling is one of the cardinal signs and symptoms of asthma in children.
- Trouble to conciliate sleep and sleeping mostly because of coughing, wheezing, or shortness of breath
- Coughing or wheezing attacks can coexist with a viral respiratory tract infection like the cold or the flu
Also, patients with asthma can identify in an easier way when the symptoms are beginning to become a little more complicated. It will depend on the crisis and the patient itself as well, but it is important to see a doctor when asthma symptoms are getting out of control. The signs and symptoms that asthma is probably worsening include the following:
- Asthma signs and symptoms that become more frequent and bothersome
- Increasing difficulty breathing, as measured with a special instrument to detect how the lungs are working
- An increase in the need to use asthma medication like a quick-relief inhaler
What are the complications?
While asthma nowadays is a manageable disease, it does not mean it cannot have its complications. In fact, worldwide, there are still deaths caused by this disease. Although they are not so common, their complications can be challenging to manage unless they go to an emergency room.
The complications are the following:
- Interference with sleep, work, and other daily life activities
- Taking sick days from work or school during asthma flare-ups
- The narrowing of the airways can be permanent at some point, making it very difficult to breathe
- Side effects from long-term use of medications that may help to stabilize or keep asthma at ease
How is adult onset asthma diagnosed?
In order to diagnose asthma, the doctor should first perform a physical exam accompanied by a complete history. During the physical exam, the doctor will focus on your lungs to rule out other diseases like respiratory infections or Chronic Obstructive Pulmonary Disease (COPD).
Moreover, the doctor will ask if there is a history of asthma within the family, including any risk factors involved, such as work exposure and tobacco exposure, among others.
After doing this, the doctor may ask for some tests to measure lung function. With these tests, the doctor will know how much air moves in and out of the body as the patient breathes. Among the tests are the following:
- Spirometry: With this test, the doctor estimates the narrowing of your bronchial tubes. He or she will check how much air the patient can exhale after a deep breath and how fast the patient can breathe out.
- Peak Flow: It is a simple test that measures how hard the patient can breathe out. If the results are lower than expected, this means that your lungs may not be working too well.
It is important to notice that these tests are performed before and after using a bronchodilator. This medication can open the lungs’ airways. If the results improve after using this medication, the patient likely has asthma.
Additionally, your doctor may ask for some of these tests to confirm the diagnosis.
- Methacholine challenge
- Imaging tests such as X-Rays
- Allergy testing
- Nitric oxide test
- Sputum Eosinophils
- Provocative testing for exercise and cold-induced asthma.
What happens after being diagnosed with asthma?
After being diagnosed with asthma, the doctor must now prepare an asthma action plan for managing the disease. Managing asthma can be very simple or very challenging; this will depend on how severe the asthma is.
To doctors, prevention and long-term control are crucial to stop asthma attacks even before they start. Treatment usually involves detecting triggers that may initiate an asthma attack and, of course, avoiding them. Also, patients should keep track of their medications to keep their symptoms under control.
There are various types of treatments for asthma. Still, the right action plan for managing asthma will depend on several factors. For example, age, symptoms, triggers, and responsiveness to treatment. The different types of asthma medicines are the following.
Long-Term Asthma Control Medications
These medications are the cornerstone of asthma treatment. It is a type of treatment that focuses on the prevention and reducing the swelling in the airways that lead to symptoms. Usually, these medications are taken daily and make it less likely that they suffer from an asthma attack. Among the long term medications are the following:
- Inhaled corticosteroids: These medications are very common for asthma management. Patients may need to use these medications for several days to weeks before they reach their maximum benefit. On the bright side, these medications, although being corticosteroids, have a low risk of serious side effects, unlike oral corticosteroids.
- Leukotriene modifiers: Also very common medication like montelukast and zafirlukast. These medications help to relieve symptoms but have been linked to psychological reactions. Nonetheless, this is not the right type of treatment for patients with mild asthma.
- Combination inhalers: These medications, as their name says, combine two different types of medication in one inhaler. Generally, they combine long-acting beta-agonists with corticosteroids.
- Theophylline: Despite being the less common of all treatments, it works for several patients. Theophylline is a pill that helps to keep the airways open by relaxing the muscles that surround them. On the downside, it is a medication that requires regular blood tests to see if there is any affection to the body.
Quick-Relief (Rescue) Medications
These medications help to open airways that are swollen and limit breathing quickly. They are commonly used for rapid, short-term symptom relief during an asthma attack. Doctors may also indicate this type of treatment as a preventive measure for people with exercise-induced asthma. Among the medications are the following:
- Short-acting beta-agonists: The most common type of medication for people with asthma. These medications act within minutes to ease symptoms rapidly. They are taken using a small, portable inhaler or also through a nebulizer. Patients inhale these medications through a face mask or a mouthpiece.
- Anticholinergic agents: These medications are also common and act immediately relaxing the airways, making it easier to breathe. Although these are medications that work in emphysema and chronic bronchitis, asthma also responds to this type of treatment.
- Oral and Intravenous corticosteroids: These medications help reduce airway inflammation in severe asthma cases that do not respond to nebulizer therapy. Nonetheless, if used in the long term, they can cause serious adverse effects.
This type of treatment is especially useful in patients who suffer from allergies. These allergies are a trigger for asthma or worsen the symptoms. Among the medications are the following:
- Allergy shots (immunotherapy): These shots may help reduce the immune system’s reaction to specific allergens over time. Receiving these shots may become a long process, but it may also help in the long term.
- Biologics: This is the last line for treating asthma, and these medications are only and just only for people who have severe asthma.
What are the risk factors for developing Asthma?
Several factors may contribute to developing asthma while being an adult. Nonetheless, the diagnosis can be difficult because the walls of the thorax stiffen with age and may mimic asthma. The following list includes some of the most common risk factors for developing this disease:
- People with a blood relative with a history of asthma. Especially if they are parents or siblings, meaning that there is a chance due to genetics of developing the disease
- By having a previous allergic condition such as atopic dermatitis.
- Overweight or obesity
- By being a passive smoker/Exposure to secondhand smoke
- By being exposed to exhaust fumes or other types of pollution such as burning trash
- The occupational risk involves exposure to chemicals that may generate an inflammatory response
Can adult onset asthma go away?
Sadly, no. There is no cure available nowadays for asthma, and unlike children, asthma will not go away on its own. The only exception for adults who have asthma is the ones with asthma-related to work. This type of asthma can be stopped if the patient identifies the trigger and removes it. Also, the patient may remove himself from the work to prevent exposure to this allergen.
How to prevent Asthma?
There is no possible way to prevent acquiring asthma. However, by working with your doctor, both of you may design a plan to live with this condition and to avoid asthma attacks. Here are some recommendations to avoid asthma attacks:
- Follow the plan that your doctor designed with you. This disease needs constant follow-up; if something does not work for you, notify your doctor about it.
- Get vaccines for Influenza and Pneumonia.
- Identify and avoid, if possible, your asthma triggers. There are a lot of allergens out there that may flare up your asthma. The range is very wide, going from cold air to pollen or cats, so be very wary about it.
- Take your medications on time and as the doctor prescribes them.
- Take note if you have been using your quick-relief inhaler more than usual and notify your doctor about it.
Do you have symptoms of this disease?
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.