Q: What is asthma?
Asthma is a disease that is characterized by chronic inflammation (swelling) and remodeling (restructuring) of the airways (breathing tubes) and can lead to symptoms of shortness of breath, wheezing (a whistling sound in the chest), chest tightness or coughing.
Q: How common is asthma and who gets it?
Asthma is a very common disease that currently affects 25 million people in the United States (8 percent of the population) and 300 million people worldwide. People of all ages and all races are affected. The diagnosis of asthma is five times more likely to be made before age 20 than after, although older people can develop it. If you are over age 50 and experiencing symptoms of cough, wheezing, chest tightness or breathlessness for the first time, you should be evaluated by a lung specialist.
Q: What causes asthma?
The exact cause of asthma has not been identified but it is believed that genetic and environmental factors are involved. Asthma runs in families. Environmental factors such as exposure to allergens (i.e., dust mites, mold spores and cockroaches), air pollution, viral infections and tobacco smoke, have been identified as causative factors. Lifestyle factors such as frequent antibiotic use, obesity, and growing up in an urban environment are also important. The critical window for developing asthma seems to be prenatally when the immune system is developing and the airways are growing and during the first year of life.
Q: What are the most common asthma symptoms?
The most common asthma symptoms include wheezing, coughing with or without phlegm, shortness of breath, and chest tightness. Symptoms range from mild to severe and the severity can vary within the same individual at different times.
Q: What triggers asthma symptoms?
The following is a list of some of the most common triggers:
- Weather extremes – hot, cold, humid or abrupt change in weather conditions
- Exercise (particularly in cold, dry air)
- Strong fumes (car exhaust, tobacco smoke, perfumes, paints, cleaning sprays)
- Allergens (furry pets, dust, mold, grasses, trees, cockroach)
- Strong emotions (laughter, crying)
- Infection (upper respiratory, sinusitis)
- Foods and beverages (nuts, red wine, salad bars with sulfite as a preservative)
- Medications (aspirin, ibuprofen and beta blocker medicines used to treat high blood pressure, migraine headaches and glaucoma).
- Specific occupations – Asthma may develop as a result of exposures specific to the workplace. Exposure to laboratory animals in technicians, to flour in bakers and to latex in hospital workers are some common examples.
Q: Can other conditions make asthma worse?
There are several conditions that may worsen asthma including allergic rhinitis, sinusitis, sleep apnea, GERD (Gastroesophageal Reflux Disease), diabetes, and even high blood pressure.
Q: How will pregnancy affect my asthma?
About one-third of patients with prior asthma have worsening of their lung disease with pregnancy, one-third remains unchanged, and the other third actually improves. Every pregnant patient with asthma should work closely with their obstetrician and an asthma specialist.
Q: How does cigarette smoking affect asthma?
Active smoking in patients with asthma has been linked to more severe symptoms, a lower quality of life, reduced lung function and increased utilization of health care services. It is extremely important that patients with asthma not smoke.
Q: Are there medications that a patient with asthma should avoid?
Some patients with asthma may experience symptoms of wheezing, cough or chest tightness after ingesting certain medications such as beta blockers, aspirin and non-steriodal anti-inflammatory drugs, and cholinergic stimulators such as pilocarpine. It is important to remind your physicians that you have asthma when they are giving you new medication or if you are to have surgery under general anesthesia.
Q: Can people with asthma have pets?
Furry pets (i.e., cats, dogs, hamsters and guinea pigs), can often trigger asthma by initiating an allergic reaction. Specifically, the proteins found in animal dander, urine, and saliva set off a series of chemical reactions that result in chest tightness, wheezing, cough and even throat closure. The most effective measure in controlling allergy due to animal dander is not to keep animals in the house.
Q: What is the relationship between exercise and asthma?
Exercise-induced asthma symptoms occur in up to 80 percent of patients with asthma and may be an indication of reduced asthma control. Symptoms generally start once the patient stops exercising and usually reach their peak at 10-15 minutes after exercise termination. There are techniques used by professional and non-professional athletes alike, which can reduce exercise-induced asthma symptoms. This includes “warming up” prior to exercise and “cooling down” afterwards. Patients with asthma should not avoid exercise since it may have beneficial effects on the disease and on health, in general. Several medications are available which can be taken prior to exercise to ameliorate asthma symptoms. Patients are encouraged to discuss the role of regular exercise in asthma with their physician. If you are over 40 years old, have other health conditions or are overweight, you should speak with your doctor before beginning an exercise program. Patients should advise their physician if they have shortness of breath or chest discomfort during exercise since these symptoms may be indicative of heart disease rather than asthma.
Q: Can diet influence asthma?
There are many potential ways that diet can play a role in asthma. One area of interest is the role of vitamins, particularly ones with antioxidant properties such as vitamin C, E, and beta-carotene (a form of vitamin A). An antioxidant is a chemical that can prevent the formation of free radicals, substances that can damage cells in the body. Vitamin D deficiency has been associated with worsening asthma in some studies. Your physician will advise you whether you should be tested for vitamin deficiency and whether you would benefit from meeting with a nutritionist.
It has been clearly established that being obese is a risk factor for asthma and that obesity can also worsen asthma control. Weight loss is associated with improvement in asthma. The Asthma Program team will work with you to address issues related to weight and will refer you to experts who specialize in healthy weight loss strategies.