Introduction?
Do you know any of the suggested causes of asthma? While scientists are doing lots of research to determine this, the exact causes of asthma, unfortunately, remain unknown. Asthma impacts the lives of more than 22 million people and some 6 million children.
What Happens To An asthmatic patient
No matter what the cause of asthma, asthma symptoms will usually include one or more of the following:
• Wheezing
• Chest tightness
• Shortness of breath
• Chronic cough
Wheezing
Wheezing Is A Common Asthma Symptom for Adults
Wheezing is one of the common asthma symptoms and is often the reason many people seek care. With wheezing you will hear a high-pitched whistle sound as you breathe through your mouth or nose.
While most commonly heard as you exhale, or breathe out, wheezing may also occur when inhaling or breathing in. Wheezing results from the airways of the lungs narrowing as a result of inflammation, making it more difficult for air to flow through the lung.
The inflammatory response that is part of asthma is the reason this inflammation occurs. Not all wheezing is asthma since diseases like pneumonia, COPD, or certain vocal cord problems may lead to wheezing.
What Does It Mean If I Hear Wheezing?
Do you ever hear this sound when breathing? This is what wheezing sounds like when a doctor listens to your chest with a stethoscope. Wheezing is never normal and should not be ignored. Wheezing is one of the classic symptoms associated with asthma. Based on your history and some or all of these other symptoms, your doctor may make a diagnosis of asthma:
• Chronic cough, especially at night
• Chest tightness
• Shortness of breath
When Should I Contact A Doctor?
If the wheezing is new
If wheezing is not new, but getting worse
If your your wheezing is a new problem and you do not have a diagnosis of asthma, you should definitely see a doctor as many different things can cause wheezing.
When you visit the doctor, you will be asked many questions about your history, symptoms, and if the symptoms are associated with any of these triggers. Triggers are things that "set off" your asthma. You can learn how to identify and avoid these common triggers to help get better control of your asthma.
If you are already being treated for asthma and still wheezing significantly, your treatment may not be working or you may not be taking the treatment correctly. When your asthma is under good control, you should not wheeze. Improving communication with your doctor and asking for a health information prescription may help you gain the information and skills you need to get better control of your asthma.
If you use an Asthma Action Plan, make sure you follow the instructions for wheezing. If you don't have one, you need to make discussing one with your asthma doctor a priority.
Chest Tightness
Chest tightness frequently occurs in asthma patients, either alone or with the other classic symptoms of asthma:
• Wheezing
• Shortness of breath
• Chronic cough
As your airways become more inflamed, filled with mucus, and the smooth muscles in your airways constrict, chest tightness may be experienced as the inability or perception of not being able to move air in and out of your lungs.
This feeling may also increase your anxiety and further worsen the sense of not being able to move air through your lungs. The inflammation, mucus, and muscle tightness may occur after exposure to a trigger, a specific irritant in occupational asthma, or even as a result of exercise in the case of exercise-induced asthma.
What It Means
Like the other classic symptoms of asthma, chest tightness should not be ignored, especially if you do not have a previous history of asthma. Ignoring a symptom like chest tightness may lead to a asthma attack if you do not follow your asthma care plan appropriately.
Make sure you discuss this symptom with your doctor because a number of other diseases such as heart disease, COPD, and pulmonary embolism can also be associated with chest tightness. If you are unsure of what your symptoms may mean or just want more information, consider using About.com's symptom checker to see what may be causing your symptoms.
When Should I Call a Doctor?
You need contact a physician if you experience chest tightness and have not previously been diagnosed with asthma. Keeping track of your symptoms may help your doctor decide what to do next. In keeping a symptom diary, you can record the answers to the following questions:
• How often do you get the chest tightness?
• What you are doing when the chest tightness occurs?
• What makes the chest tightness go away?
• Do other classic asthma symptoms occur with the chest tightness?
• What makes the chest tightness get better?
• What does the chest tightness exactly feels like?
Additionally, your doctor may order a whole series of tests. Some will be to help with a diagnosis of asthma and some will be to make sure you do not have one of the previously mentioned serious causes of shortness of breath. This tests may include:
• Pulse oximetry
• Peak flow
• Complete blood count (CBC)- blood test to check for anemia
• Chest x-ray
• Spirometry
• Complete pulmonary function testing
• Cat scan
• Electrocardiogram (ECG)
• Echocardiogram
• Stress test- to look for possible coronary artery disease or blockages in the heart
If you already have a diagnosis of asthma, chest tightness may indicate poor control or worsening symptoms that could escalate into an asthma attack if you do not follow your asthma action plan.
Make sure you understand what to do when you experience symptoms and ask your doctor specific questions if you do not understand.
Shortness of breath
Shortness of breath is one of the classic asthma symptoms people experience before being diagnosed with asthma or when their asthma is poorly controlled.
Shortness of breath refers to feeling breathless or having difficulty breathing. Your doctor may refer to shortness of breath using the medical term dyspnea. There is no strict medical definition for shortness of breath. Patients will often describe this trouble breathing differently. You may hear shortness of breath described as:
• "Being air hungry"
• "Unable to catch my breath"
• "Gasping for breath"
• "Suffocation" or "smothering"
• "Unable to complete usual activities"
Young children, and even some adults, may have difficulty in describing what shortness of breath feels like. Some adults will also describe shortness of breath as "feeling tired" or a decreased ability to do their normal activities.
Young children who are not yet verbal may experience shortness of breath as feeding problems while older children may describe tiredness, fatigue, or just not be able to keep up with other kids their age.
Shortness Of Breath-What It Means
Like all the other common symptoms, you may experience shortness of breath alone or, more likely, in combination with the other asthma symptoms.
If you have not been diagnosed with asthma previously, make sure you mention this symptom to your doctor because a number of other diseases such as heart disease, COPD, and pulmonary embolism can cause shortness of breath. Consider using the symptom checker to see what may be causing your shortness of breath.
If you have not been diagnosed with asthma, you need to see a doctor to make sure it is not one of the other serious causes of shortness of breath. Your doctor will likely ask you a series of questions trying to narrow down what may be causing your symptoms and may order a number of tests to rule out a more serious cause of your shortness of breath. The tests may include:
• Pulse oximetry
• Peak flow
• Complete blood count (CBC)- blood test to check for anemia
• Chest x-ray
• Spirometry
• Complete pulmonary function testing
• Cat scan
• Electrocardiogram (ECG)
• Echocardiogram
• Stress test- to look for possible coronary artery disease or blockages in the heart
If you already have an asthma diagnosis, shortness of breath may signal poor control or worsening symptoms that could escalate into an asthma attack if you do not follow your asthma action plan. If the shortness of breath is due to your asthma, it is not likely to get better without treatment so keeping a rescue inhaler like albuterol with you at all times and using it soon after developing symptoms is very important.
Chronic Cough
Chronic cough is common among patients developing asthma symptoms and is also a sign of poorly controlled asthma.
What a Chronic Cough Means
Chronic cough is a common reason why patients seek care from a doctor and also one of your body's normal defense mechanisms. While a chronic cough can be a sign of infection or asthma, a cough is appropriate as your body tries to expel infection, mucus and other foreign material from your body.
Cough is not always a sign that something is wrong, but any chronic cough -- lasting more than 3 weeks -- should be investigated. The most common reasons for a non-smoking person to develop chronic cough are:
• Asthma
• Post nasal drip
• GERD
However, there are a number of other less common causes of chronic cough including:
• Pneumonia
• Pertusis
• Chronic bronchitis
• COPD
• Sinusitis
Chronic cough related to asthma commonly occurs at night (coughing at night is not normal and should almost always be investigated) and its frequency is one of the factors used to determine how well your symptoms are controlled. A cough with asthma may be made worse by viral infections and cold air.
When a cough occurs with other common asthma symptoms like wheezing, chest tightness, and shortness of breath or when someone has a significant nighttime cough, asthma should be suspected and you may need to undergo tests to diagnose asthma.
Treating Chronic Cough
The first step in treating a chronic cough is to make sure you have the correct diagnosis. After taking a history, asking about medications and allergies, your doctor may order a number of tests like a chest x-ray or spirometry. If you have never been diagnosed with asthma, your doctor may begin treatment or change your treatment if your doctor feels the cough is a sign of worsening asthma.
Your doctor may prescribe medications if your chronic cough is due to asthma. These could include inhaled steroids such as:
• Aerobid
• Alvesco
• Asmanex
• Azmacort
• Flovent
• Pulmicort
• Qvar
Your doctor may also prescribe medications for acute symptom control of chronic cough. These could include short acting inhalers such as:
• Albuterol
• Proventil
• Ventolin
• Xopenex
• Maxair
When Should I Call a Doctor About Chronic Cough?
You need to make sure you contact a physician if you experience any of the following symptoms:
• Chronic cough lasting more than 3 weeks
• Nighttime coughing or trouble sleeping
• If you cough up blood
• Significant pain with a cough
• Passing out when you cough
You may want to track your chronic cough symptoms with a symptom diary. This will help you identify and avoid your asthma triggers and cause of chronic cough. Make sure you follow your asthma action plan
Could My Chronic Cough Be Something Else Besides Asthma?
If you think your chronic cough could be something else besides asthma, why not go to the symptom checker and see what else might be causing your symptoms.
Lets take a look at some possible asthma causes.
Theories on the Causes Of Asthma
What exactly leads some people to develop inflammation in their lungs and not others is not yet known. However, one of the popular theories regarding the causes of asthma believes that it is an interplay between your genetics and certain environmental exposures that occur early in life. Scientists have offered a number of theories regarding the causes of asthma.
• Your Immunity and the Hygiene Hypothesis
The hygiene hypothesis suggests that one of the causes of asthma could be our super-clean world. Such extreme cleanliness deprives our immune system of the ability to distinguish between harmless and potentially harmful irritants. The hygiene hypothesis posits that it is exposure to germs that actually prevents asthma.
• Genetics- As one of the causes of asthma, there is not anything we can do about this. Either asthma runs in our family or not.
• Gender
Asthma is more common in young boys compared to young girls, until puberty hits. After puberty, asthma becomes more common in girls. But how the hormonal changes that occur during puberty affect asthma is unknown.
• Certain Respiratory Infections, Like RSV
While the hygiene hypothesis says exposure to germs is a good thing, some respiratory infections have been shown to increase risk of asthma.
• Obesity
Being overweight may lead to increased levels of certain types of cells (and their products) that cause inflammation, such as mast cells.
• Vitamin D deficiency
A number of different studies have shown that parts of the world with lower vitamin D intakes have more asthma and that vitamin D has potent anti-inflammatory properties. However, these associations do not necessarily mean that vitamin D is one of the causes of asthma.
• Air Pollution
Frequent outdoor exercise in communities with high levels of ozone has been associated with increased asthma rates among school-age children. As a result, some researchers suggest air quality may be associated with the development of asthma. Wile we don't often think about it, indoor air pollution can also make your asthma worse.
Behind all the potential causes of asthma is the pathophysiology of asthma, or the underlying processes that occur in your body and lead to asthma and its complications. No matter which of the causes of asthma have lead to your symptoms, your asthma is the result of inflammation that leads to both hyperresponsiveness of the lungs and inflammation of the lungs.
FAQs- Causes of Asthma
• Can My Asthma Be Treated Even Though There Is No Cure?
• Are Your Other Medications Leading to Worsening Asthma?
• What Is the Buteyko Technique?
• Is Exercise One of the Causes of Asthma?
Question: Can My Doctor Cure Asthma?
Answer:
The short answer is unfortunately NO.
Why Is There No Asthma Cure?
For an asthma cure to be available, doctors and scientist have to know the cause. In asthma, while we know a lot about the relationship between the immune system and asthma, for example, we do not know why this process occurs in particular individuals.
Asthma Cure Versus Asthma Control
Asthma is a chronic disease. This means that while there is no asthma cure, asthma control is possible. With good asthma control you will experience less:
• Wheezing
• Chest tightness
• Shortness of breath
• Chronic cough
With good asthma control you will also:
• Need less rescue medication
• Maintain good lung function
• Remain active and participate in normal activities
• Sleep better
• Prevent asthma attacks
Asthma Pathophysiology & Asthma Treatment
Asthma is an inflammatory process. While many of the medications used to treat asthma decrease inflammation, none actually cure the inflammation.
While there is no asthma cure currently, asthma can be controlled with proper treatment. Medications can prevent or relieve asthma symptoms. Asthma care plans can help you learn what to do in an asthma attack, when you need to adjust your medication, and when you need to call your doctor. You can also also can learn to identify your asthma triggers and avoid them.
Research: Hope For An Asthma Cure
Research will be the way an asthma cure is eventually found. Stay up to date with the research looking for an asthma cure and learn how you might participate in a clinical trial.
• Bronchial Thermoplasty
• Do Asthma Specialists Improve Quality Care in Asthma?
• What Is the Relationship Between Asthma and GERD?
• Find An Asthma Clinical Trial
With education regarding triggers, medications and your specific asthma management strategy, most people can effectively control asthma and live a normal, active life.
Question: Are Your Other Medications Leading to Worsening Asthma?
Answer:
If you are doing everything your doctor has recommended to control your asthma but are still experiencing bouts of severe or worsening asthma, it could be a medication you are taking for another health condition.
While it is not clearly understood how this happens, doctors suspect it is akin to an allergic reaction. Meaning, you have an unusual reaction to medication, which subsequently causes the release histamine, a trigger for inflammation. It's important that you discuss with your doctor all the medications you are taking and if your asthma seems to be worse. Le us take a look at which drugs are most frequently associated with this problem:
Anti-Inflammatories Like Motrin: This class of drugs includes many common medications for aches and pains such as, Motrin, Advil, and Aleve. Asthma patients should use caution taking NSAIDS because reactions causing worsening of asthma may occur with repeated use. In fact, about 10 to 20% of asthma patients using NSAIDS can experience an exacerbation. Why a drug that normally decreases inflammation causes worsening asthma is not completely understood.
Certain Heart Disease Drugs: Some of these drugs used for conditions such as heart failure, heart attacks or high blood pressure can cause bronchconstriction in your lungs. Depending on your health history, your doctor may want to put you on one of these medications. If so, be sure to tell him or her about your asthma history. You want to avoid "non-specific" beta blockers:
• Inderal (propranolol)
• Coreg (carvedilol)
• Normodyne (labetalol)
• Corgard (nadolol)
If your doctor feels you would really benefit from a beta blocker, the "specific" beta blockers are a better choice because they affect the lungs less and so are less likely to cause bronchconstriction and worsen asthma symptoms. Examples include:
• Tenormin (atenolol)
• Lopressor (metoprolol)
• Zebeta (bisoprolol)
• Sectral (acebutolol)
Certain Glaucoma Drugs: Beta blocker eye drops are also use to treat glaucoma of the eye and have been known to worsen asthma.
It is not known exactly how many asthmatics experience problems related to taking beta blockers. No matter what, you need to watch carefully if you are prescribed these medications. If you develop wheezing or your asthma worsens on either a "specific" or "non-specific" beat-blocker, make sure you discuss with your doctor immediately.
Angiotensive Converting Enzyme Inhibitors (ACE inhibitors): ACE inhibitors can cause problems for asthmatics. Up to 10% of all patients taking these medications for conditions like hypertension or congestive heart failure may develop a troublesome cough. The cough can be confused with asthma or potentially trigger an asthma attack.
Question: What to Expect When Beginning the Buteyko Technique?
Answer:
Before beginning any new treatment such as the Buteyko technique, it is important to understand what to expect both in terms of potential benefits and side effects. According to Asthma Care Ireland's website, a comprehensive asthma treatment program, including the Buteyko technique, can decrease the following asthma symptoms by as much as 50% within 2 weeks:
• Wheezing
• Chest tightness
• Shortness of breath
• Chronic cough
Known Risks?
As with other medical treatments and medications, there are some potential side effects. Certain people should not preform the Buteyko technique. Also, the Buteyko technique has not been rigorously studied in traditional medical settings. Proponents report some people preforming the Buteyko technique may experience additional benefits, such as increased energy, as well as additional symptoms, such as increased fatigue or headaches. However, these risks and benefits have not been independently verified.
Question: How Is Exercise Induced Asthma Diagnosed?
Answer: In known asthma patients or patients with typical symptoms during or after exercise, your physician will often make a presumptive diagnosis of exercise induced asthma by discussing your symptoms with you. Many times your doctor will not conduct further diagnostic tests unless your symptoms persist, or they are not prevented by other measures such as taking albuterol 30 minutes before exercise.
If you do not have an asthma diagnosis but develop chest tightness, coughing, shortness of breath, or wheezing during or after exercise, further investigation by your doctor is necessary to make sure the symptoms are not due to some other condition, like heart disease.
Most often, spirometry before and after physical activity is used to confirm a diagnosis of exercise induced asthma. Generally, you will exercise on a treadmill or stationary bicycle until you reach 85% of your expected maximum heart rate.
You are considered to have exercise induced asthma if your FEV1 falls more than 10% with exercise. Some asthma care providers may recommend a bronchoprovocation challenge test, but this is not specific to exercise induced asthma diagnosis. Similarly, measuring peak flows pre- and post-exercise is not recommended to diagnose exercise induced asthma, as results are often inaccurate.
Other causes of shortness of breath, chest tightness, and cough occurring with exercise also need to be considered. This is especially important if you have no other asthma symptoms and do not benefit from recommended preventive measures. Other diagnoses your doctor may consider include:
• Vocal cord dysfunction
• Heart failure
• Coronary heart disease
• Gastroesophageal reflux disease