Asthma: A fight for breath

Yet often well-controlled

10/20/2017, 11:12 a.m.
It is estimated that 25 million people in this country have asthma. Although it is a very serious disease, it ...

The cause of asthma is unclear. It is probably a combination of environmental as well as genetic factors. Asthma tends to run in families; it is not uncommon for multiple family members to be affected. Additionally, in some cases it is part of a triad that it shares with allergies and eczema.

In asthma the airways maintain a level of inflammation, but exposure to certain substances or conditions called triggers can increase the inflammation, resulting in an attack. Dust mites, mold, rodents and cigarette smoke are examples. Although triggers vary from person to person, one or two invariably are on most lists. One particularly common trigger is change in weather, especially when the weather changes from hot to cool in the fall. September is one of the worse months for asthma attacks, according to Holder-Niles. In the spring there is exposure to seasonal allergies and frequent viruses in the winter.


Triggers are substances or conditions that make asthma worse. They differ from person to person. Examples of triggers are listed below.

  • Respiratory infections, like colds, flu or sinus infections
  • Smoke from cigarettes, cigars and fireplaces
  • Weather, including pollen and air pollution, cold weather
  • Animals with fur or feathers, such as dogs, cats and birds
  • Pests, such as rodents, cockroaches
  • Dust mites
  • Mold and moisture
  • Strong odors, such as hairsprays and cleaning products
  • Medicines, such as aspirin and NSAIDS, beta blockers for heart disease
  • Medical conditions, such as acid reflux
  • Exercise
  • Strong emotions, such as stress, anger, fear

The trick is figuring out just what those triggers are. The best way is to begin a series of queries to find out what has changed. Did you move into a new apartment? Do you have a pet? Does the attack occur when you go outside? Do they happen when you are running and playing or during gym at school? These are all examples of questions to narrow the source of the offending agent. Boston Children’s Hospital provides home visits to make the home “asthma friendly.”

Several medications for asthma are available. Some reduce inflammation, while others relax the airways. Still others target allergies. The two main categories of medications are preventive, which are taken every day for persistent asthma, and rescue medications for intermittent symptoms during a flare-up. “Even people on daily medication will require rescue medication,” explained Holder-Niles. “At any time a person can have increased asthma symptoms with coughing, wheezing or chest tightness. It is important to always have your rescue inhaler available for emergencies at home, school and after-care.”

Preventive medications are modified according to each person’s response. If symptoms persist, medications can be increased, but they can also be reduced if a person is well-controlled for a period of time.


Living with and managing asthma

Source: National Heart, Lung, and Blood Institute

Source: National Heart, Lung, and Blood Institute

In spite of the availability of these medicines, asthma attacks still persist. The CDC found in its national prevalence of asthma attacks report of 2015, that almost 47 percent of persons with asthma reported having one or more asthma attacks, and over 439,000 were admitted to a hospital.