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Introduction to Asthma

About one in 15 people has asthma, a chronic condition whose symptoms are attacks of wheezing, breathlessness, chest tightness, and coughing. There is no cure for asthma, but most people can control the condition and lead normal, active lives.

Different things set off asthma attacks in different people. Smoke from cigarettes or a fire, air pollution, cold air, pollen, animals, house dust, molds, strong smells such as perfume or bus exhaust, wood dust, exercise, industrial chemicals--all can trigger an attack.

What Causes Asthma?

All people with asthma have the same underlying problem: an immune system that overprotects the lungs. Cells that defend the body stay gathered in the airways and produce mucus, a moist substance that keeps the airways free of dust. But if an irritant, such as smoke, pollution, or cold air, comes along, these defense cells overreact: They make too much mucus. The mucus clogs the breathing passages. At the same time, the muscles lining the passages contract, squeezing and narrowing the airways. The result is that less air is able to flow in and out of the lungs.

Doctors aren't sure what causes these cells to stay gathered in a person's airways in the first place, but they do know that the problem tends to run in families. If one of your parents has asthma, the odds that you will have it are higher. You are even more likely to have asthma if both your parents have it. Asthma shows up before the age of 18 for about half of the people who develop the condition. But it can appear at any age, even when a person is in his sixties or older.

How to Prevent an Attack

There are three keys to taking control of your asthma: faithfully using your prescribed medication, periodically checking your breathing at home, and avoiding the things that set off your symptoms. With these keys, you can prevent attacks rather than just treating them.

Using medication:

Certain anti-inflammatory drugs can ward off attacks or lower the number of attacks you have. Most often, you breathe in the medication using an inhaler. These drugs keep the defense cells that stay in your airways from overreacting and causing an attack.

Your doctor will tell you how many times a day to use your inhaler and how many puffs to take each time, based on how bad your asthma is. You must follow this schedule for the inhaler to work. And it's important to remember that using anti-inflammatory drugs won't help during an attack.

It's a good idea to rinse your mouth out with water after using the inhaler. This will help prevent an infection in the mouth, a rare side effect of the drug.

Anti-inflammatory drugs also come in pill form, but usually only people with severe asthma need to take pills. In pill form, the medicine goes directly into the bloodstream and stays in the body longer, having a more lasting effect than an inhaled drug does.

Anti-inflammatory drugs are sometimes called corticosteroids. However, they have nothing to do with the muscle-building hormone that many people think of when they hear the term steroids.

Monitoring breathing:

You might have to check your breathing from time to time at home with a device called a peak flowmeter. This small, hand-held instrument measures the amount of air that you are able to blow out. The measurement gives you a better idea of the clearness of your breathing passages than you can sense on your own. Using the flowmeter regularly will help you and your doctor work out the best possible treatment plan. If you keep getting good results, meaning you're breathing easily, you may not have to use the inhaler as often--or at all.

A dip in the flowmeter's reading, showing that you are able to exhale less air than usual, can warn you that an asthma attack is coming.

Avoiding irritants:

Stay away from the things that brought on your asthma symptoms in the past. Keep a diary for jotting down the details of each attack. This will help you see patterns and learn what triggers your symptoms. If smoke is the cause, don't go into smoky places or sit around campfires. If it's dust, keep your home as clean as possible. Consider getting rid of carpets and curtains and using a plastic cover on your mattress, so there are fewer places for dust to collect.

Be aware that although contact with one irritant may not be enough to trigger an attack, a combination of things may. For instance, if you use hair spray, run to catch the bus, and then sit next to someone wearing perfume, you may experience symptoms.

What to Do If You Have an Attack

You won't always be able to prevent asthma attacks. If you have one, take action immediately.

Have your medicine handy Your doctor will prescribe drugs that relieve the symptoms of asthma should you suffer an attack. These drugs are called bronchodilators. You inhale them, and they quickly work to open up your airways. If your asthma is very mild, the bronchodilator may be the only drug you need.

People often confuse these drugs with inhaled anti-inflammatory medications, which act on the immune system cells in the lungs but will not loosen your breathing passages during an attack.

Check your breathing. Use the flowmeter to see if an asthma attack is responding to your medication. If it's not, get emergency care right away.

Exercise and Asthma

Unlike bothersome substances, exercise is not an irritant that you need to avoid. Although vigorous activity can cause attacks in many people with asthma, there are things you can do to make exercising more comfortable. Experts encourage adults and kids to go for it--to participate in pretty much whatever sports or activities they like. There have even been Olympic athletes with asthma.

Asthma symptoms can appear during your workout or after you finish exercising. The symptoms are thought to be caused by changes in the temperature and moisture of the air you breathe. Usually an exercise flare-up reaches a peak in five to ten minutes and then goes away by itself in 30 minutes to an hour.

Here are some things you can do to avoid asthma symptoms while you work out.

Start slow. Spending a few minutes warming up before you go all out can help prevent the symptoms.

Be prepared. To lessen the negative effect of physical activity, your doctor may tell you to take a couple of puffs from your brochodilator inhaler about ten minutes before you start exercising.

Check the air quality. While exercise itself rarely brings on a bad attack, exercise in combination with another irritant can create a serious problem. If you are sensitive to air pollution or pollen, for example, and you run on a day when the air is smoggy or pollen counts are high, you may have trouble. A better choice on such a day is to exercise indoors.

Check the air temperature. Like physical activity, cold air brings on asthma symptoms in many people. The same bike ride, walk, or roller-skating outing that you can handle in mild weather may be tougher in the winter.

Work out when you're healthy. You're more likely to experience a flare-up during exercise if you have a virus. Make sure you're over a cold or the flu before going back to your routine. 

A stuffy nose can also create problems. Your nose warms and moistens the air you inhale. But when you have to breathe through your mouth, colder, drier air goes into your airways, causing asthma symptoms. If you often have a stuffy nose from allergies, ask your doctor about treatment.


American Lung Association 800/586-4872. This number automatically connects you with regional representatives who can answer questions about asthma, refer you to classes in your area, and send written information.

National Jewish Center for Immunology and Respiratory Medicine, 800/222-5864. Request written information or speak with a Lung Line representative.