Asthma affects more than 23 million Americans. It is also one of the most common chronic diseases of childhood, affecting close to 10 percent of all children.
Asthma is a lung disease that inflames and narrows the airways that carry air into and out of your lungs. Unpredictable attacks of wheezing alternate with periods of relatively normal breathing.
In an asthma attack, muscles of the bronchial tree tighten and the linings of air passages become swollen. Reduced airflow produces wheezing.
Asthma can develop at any age but it most often starts in childhood.
Children who are more at risk of developing asthma frequently have a parent with asthma or signs of allergies (including eczema). Children with asthma also tend to wheeze even when they don’t have a cold or other infection.
Children who will develop it usually do so before the age of five. Some seem to "outgrow" the illness, but underlying conditions can remain without symptoms.
The first signs of asthma may be a lingering cough and wheezing after a viral infection. Physicians advise that if this occurs, you should ask your child's doctor about the possibility of asthma.
The condition, which can be life-threatening, often goes underdiagnosed and undertreated. Asthma is one of the most frequent causes of hospitalization and missed school days.
According to Michael Cohen, MD, director of respiratory care services at John Muir Health, "The goal would be to stay out of the hospital and the ER by consistently taking prescribed medications."
Allergies to substances such as molds, animal dander, or house dust mites are often involved. Flare-ups can also occur spontaneously or be triggered by respiratory infections, exercise, cold air, smoke or other air pollutants, and food or drug allergies.
Even stress or anxiety can cause a sudden attack. And inherited genes can play a role. Smoking cigarettes doesn't cause asthma, but it makes it worse.
"Recent data reveals that the rates of emergency room visits for asthma have increased, with the greatest increase in children 10 to 17. Children under five accounted for the highest rates of emergency room visits," says pulmonologist Richard Kops, MD, director of respiratory care at John Muir Health.
Physicians diagnose asthma by taking a medical history, listening to the chest, and performing a lung function test (spirometry), which measures airflow and how fast you can blow air out of your lungs. Your doctor may give you asthma medicine and test you again to see if there is improvement.
If your lung function appears normal with spirometry, but your symptoms persist, your doctor may have you inhale a mild asthma trigger to determine whether or not you have the condition.
Since there is no cure for asthma, the goal of treatment is to control it. Treatment involves monitoring your asthma, developing a partnership with your doctor and other health care professionals to manage it, avoiding known allergens, and using medications to control symptoms.
Doctors prescribe two main types of medications. Inhaled anti-inflammatory ("long term control") medicines help prevent symptoms. Bronchodilators ("quick relief medications") help prevent asthma attacks.
A peak flow meter is an inexpensive device that may be used to monitor airway function at home by testing the speed of air leaving the airways. Doctors find that daily use of a peak flow meter may help to determine the need to adjust medications.
"It's important for patients, loved ones, and their families to become educated about asthma," Dr. Kops emphasizes. "All should thoroughly understand asthma and have an action plan for when to call a physician or seek emergency care.”
“Individuals with asthma must learn to manage this condition themselves, as they may have it for life," says Dr. Kops.
He adds that a doctor or other health care professional should educate patients as to how these medications work, when to use them, and how to properly use inhalers, which deliver the medicine. He cautions, "If you have asthma, you should always have your medications with you."
Looking toward the future, many physicians are optimistic that current genetic research may lead to new classes of medications, and even the possibility of preventing asthma.