Bronchial asthma; Wheezing - asthma - adults
Asthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness of breath, chest tightness, and coughing.
Asthma is caused by swelling (inflammation) in the airways. An asthma attack occurs when the lining of the air passages has become swollen and the muscles surrounding the airways become tight. This narrowing reduces the amount of air that can pass through the airway.
Asthma symptoms can be caused by breathing in substances called allergens or triggers, or by other causes.
Common asthma triggers include:
Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.
Asthma symptoms vary from person to person. For example, you may have symptoms all the time or mostly during physical activity.
Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days. An asthma attack may start suddenly or develop slowly over several hours or days. It may become dangerous if airflow is severely blocked.
Symptoms of asthma include:
Emergency symptoms that need prompt medical help include:
The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. The provider will take your medical history and ask about your symptoms.
Tests that may be ordered include:
The goals of treatment are to:
You and your provider should work as a team to manage your asthma symptoms. Follow your provider's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.
MEDICINES FOR ASTHMA
There are two kinds of medicines for treating asthma:
These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take these medicines every day for them to work. Take them even when you feel OK.
Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your provider will prescribe the right medicine for you.
These are also called rescue medicines. They are taken:
Tell your provider if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control. Your provider may change the dose or your daily asthma control medicine to reduce the use of quick-relief medicines.
Quick-relief medicines include:
A severe asthma attack requires a checkup by a provider. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).
ASTHMA CARE AT HOME
You can take steps to decrease the possibility of asthma attacks:
Asthma action plans are written documents for managing asthma. An asthma action plan should include:
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
There is no cure for asthma, although symptoms sometimes improve over time. With proper self-care and medical treatment, most people with asthma can lead a normal life.
The complications of asthma can be severe, and may include:
Contact your provider for an appointment if asthma symptoms develop.
Contact your provider right away if:
Go to the emergency room right away if these symptoms occur:
You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.
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Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF Jr, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update From the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301-2317. PMID: 33270095 pubmed.ncbi.nlm.nih.gov/33270095/.
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Marcdante KJ, Kliegman RM, Schuh AM. Asthma. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 78.
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BACK TO TOPReview Date: 1/22/2023
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Internal review and update on 02/10/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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