Asthma is a treatable disease that works like an allergic reaction: environmental triggers cause airway inflammation. Asthma causes difficulty breathing until the inflammation is treated and reduced. This is a very common disease. There are approximately 334 million people worldwide, including 25 million in the United States who have asthma. If you think you have asthma, there are signs and symptoms, risk factors, and diagnostic tests that can help you confirm it.
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Part 1 of 4: Knowing the Risk Factors for Asthma
Step 1. Consider a combination of sex and age factors
In the US, boys under 18 have a 54% higher risk of asthma than girls. However, at the age of 20 years, female asthmatics outnumber boys. At 35 years of age, this gap changes to 10.1% for women and 5.6% for men. After menopause, this value decreases for women and the gap narrows but does not completely disappear. Experts have several theories about why gender and age seem to influence asthma risk:
- Increased atopy (predisposition to allergic sensitivity) in adolescent boys.
- Smaller airways in boys than girls.
- Sex hormone fluctuations during premenstrual, menstrual, and menopausal years in women.
- Studies reintroducing hormones in postmenopausal women improve newly diagnosed asthma.
Step 2. Look at your family history of asthma
Experts have found more than 100 genes associated with asthma and allergies. Research on families, especially twins, shows that asthma is caused by shared heredity. A 2009 study found that family history is actually the strongest predictor of whether or not a person will develop asthma. When comparing families with normal, moderate, and high genetic risk for asthma, subjects at moderate risk were 2.4 times more likely to develop asthma, while subjects at high risk were 4.8 times more likely to develop it.
- Ask your parents and relatives if there is a history of asthma in your family.
- If you were adopted, your biological parents may have given your family history to your adoptive family.
Step 3. Take note of any allergies
Research has linked an antibody to an immune protein called "IgE" with the development of asthma. If your IgE level is high, you are more likely to inherit a tendency to develop allergies. If your blood contains IgE, the body experiences an inflammatory allergic reaction that causes narrowing of the airways, rash, itching, watery eyes, wheezing, etc.
- Take note of your allergic reactions that may be common triggers, including food, cockroaches, animals, mold, pollen and dust mites.
- If you have allergies, your risk of developing asthma also increases.
- If you have a severe allergic reaction but can't identify the trigger, ask your doctor for an allergy test. The doctor will apply a number of patches to your skin to find out if your allergy changes.
Step 4. Avoid exposure to secondhand smoke
When we inhale particles into the lungs, the body reacts to expel them through coughing. These particles can also trigger an inflammatory response and asthma symptoms. The more you are exposed to secondhand smoke, the greater your risk of developing asthma. If you are addicted to smoking, talk to your doctor about strategies and medications you can use to quit. Common solutions include chewing gum and nicotine patches, reducing smoking gradually, or taking medications such as Chantix or Wellbutrin. Even if you have trouble quitting smoking, don't smoke around other people. Consistent exposure to second-hand smoke can lead to the development of asthma in those around you.
Smoking during pregnancy will cause wheezing when the fetus is in childhood, increase the risk of food allergies and inflammatory proteins in the blood. The effect is even greater if the child continues to be exposed to secondhand smoke after birth. Talk to your OBGYN before you take oral medications to help quit smoking
Step 5. Lower your stress level
Many studies have shown that high levels of stress hormones can lead to asthma symptoms, increased allergen sensitivity, and constriction of the lungs. Identify the most stressful things in your life, and work out ways to deal with the triggers.
- Practice relaxation techniques such as deep breathing, meditation, and yoga.
- Exercise regularly to release endorphins which relieve pain and reduce stress levels.
- Improve your sleep habits: go to bed when you're tired, don't sleep with the TV on, don't eat before bed, avoid caffeine at night, and keep your sleep schedule the same every day.
Step 6. Stay away from air pollution in your environment
Most asthma in children is caused by exposure to air pollution from factories, construction, vehicles, and industrial plants. Just as tobacco smoke irritates the lungs, air pollution triggers an inflammatory reaction that causes damage and narrowing of the lungs. While you can't eliminate air pollution, you can reduce your body's exposure to it.
- If possible, avoid breathing air around major roads or highways.
- Make sure your child is playing in an area away from roads or construction.
- If you are moving to the US, look for areas with the best air quality on the EPA air quality index guidelines.
Step 7. See the effect of the drug you are taking on the body
If you are taking certain medications, pay attention to whether your asthma symptoms have improved when you started taking them. If so, consult your doctor before stopping, reducing the dose, or changing medications.
- Studies show that aspirin and ibuprofen can cause constriction of the lungs and airways in asthmatic patients who are sensitive to these drugs.
- ACE inhibitors used to treat blood pressure do not cause asthma but rather a dry cough that can be misinterpreted. However, excessive coughing due to the use of ACE inhibitors can irritate the lungs and trigger asthma. Common ACE inhibitors include ramipril and perindopril.
- Beta blockers are used to treat heart disease, high blood pressure, and migraines. Beta blockers can narrow the airways of the lungs. Some doctors may prescribe beta blockers even if you have asthma, and only watch for changes in you. Common beta blockers include metoprolol and propranolol.
Step 8. Maintain your ideal weight
Many studies have found a link between increased body weight and an increased risk of asthma. Obesity makes it difficult for the body to breathe or pump blood. Obesity also increases the amount of inflammatory proteins (cytokines) in the body, making you more at risk for inflammation and narrowing of the airways.
Part 2 of 4: Recognizing Mild and Moderate Signs and Symptoms
Step 1. See a doctor even if your symptoms are mild
Initial symptoms are not enough to interfere with your normal activities or daily life. However, as the condition begins to worsen, you may find it difficult to carry out normal activities. Other people usually continue to have early, but more severe, symptoms.
If left undiagnosed or treated, these mild early symptoms of asthma can worsen, especially if you don't recognize and avoid triggers
Step 2. Watch for excessive coughing
If you have asthma, your airways can become blocked due to narrowing or inflammation caused by the disease. Your body will respond by trying to clear the airways through coughing. Although coughs during bacterial infections are wet, mucus-y asthmatic coughs tend to be dry, with very little mucus.
- If the cough starts or gets worse at night, this may be a symptom of asthma. A common symptom of asthma is a cough at night or a cough that keeps getting worse after you wake up.
- In more severe conditions, the cough will continue for a day.
Step 3. Listen to the sound when you exhale
People with asthma usually hear a high-pitched wheezing or whistling when they exhale. It is caused by narrowing of the airways. Listen to this voice. If there is a sound at the end of the breath, it is an early sign of mild asthma. If the condition begins to worsen from mild to moderate symptoms, you will experience wheezing or hear whistling when you breathe.
Step 4. Note any unusual shortness of breath
Exercise-induced bronchoconstriction is a type of asthma seen in people who have recently engaged in strenuous activities, such as exercise. Narrowing of the airways will make you tired and breathless more quickly, and you may also need to stop exercising more quickly. Compare how long you usually exercise when fatigue and shortness of breath hold you back.
Step 5. Watch for rapid breathing
The body increases the rate of breathing so that more oxygen enters the lungs. Place your palms on your chest and count how many times your chest expands and contracts in one minute. Use a timekeeper or clock that is equipped with a second count so that the time you get is accurate. The normal respiratory rate is 12-20 breaths in 60 seconds.
In moderate asthma, the respiratory rate is 20-30 breaths per minute
Step 6. Don't ignore cold or flu symptoms
Although an asthmatic cough is different from a cough due to a cold or flu, bacteria and viruses can trigger asthma. Watch for signs of infection that can cause asthma symptoms: sneezing, runny nose, sore throat, and stuffy nose. If the mucus looks dark, green, or white when you cough, it's likely bacteria causing the infection. If the mucus is light or white, it may be viral.
- If you notice these symptoms of infection plus a sound when you breathe and your body is panting, you may have asthma triggered by an infection.
- Go to the doctor to find out exactly what happened.
Part 3 of 4: Recognizing Severe Symptoms
Step 1. Seek medical attention if you can't breathe, even when you're not exerting yourself
Usually, shortness of breath caused by activity will subside when people with asthma rest. However, when symptoms are severe or you have an asthma attack, shortness of breath can occur even when you are resting because asthma triggers activate the inflammatory process. If the inflammation is serious enough, you may suddenly feel very short of breath or try to breathe deeply.
- You may also feel like you can't fully exhale. Because the body needs oxygen from inhalation, breathing will be shorter in order to get oxygen more quickly.
- You may feel like you can't say a full sentence, but instead use short words while gasping for air.
Step 2. Check your breathing rate
Severe asthma attacks are worse than mild and moderate asthma which makes you breathe fast. The constriction in the airways prevents enough fresh air from flowing into the body, making the body "hungry" for oxygen. Fast breathing is the body's attempt to get as much oxygen as possible to fix this problem before it gets damaged.
- Place your palms on your chest and watch how many times your chest rises and falls in one minute. Use a timekeeper or clock that is equipped with a second count so that the time you get is accurate.
- In severe attacks, the respiratory rate will be more than 30 breaths per minute.
Step 3. Watch the pulse
In order to carry oxygen to the tissues and organs of the body, blood picks up oxygen from the air in the lungs and carries it to various parts of the body. During a severe attack, if not enough oxygen is carried, the heart must pump blood faster to carry as much oxygen as possible to the tissues and organs. You may feel your heart pounding without realizing that a severe attack has occurred.
- Hold your hands with your palms facing up.
- Place the tips of the index and middle fingers of the other hand on the outside of the wrist, under the thumb.
- You will feel a rapid pulse from the radial artery.
- Count heart rate by counting the number of times your heart beats in one minute. The normal heart rate beats less than 100 beats per minute, but in severe asthma symptoms, this number can be more than 120 times.
- Some smartphones are now equipped with heart rate monitors. Use it if available.
Step 4. Look for a bluish tinge to the skin
Blood is bright red when it carries oxygen; otherwise the color is much darker. When blood is exposed to the air outside, the oxygenated blood will turn bright so you may not notice this. During a severe asthma attack, you may experience "cyanosis" which is caused by oxygen-deprived dark blood traveling through your arteries. This causes the skin to appear bluish or grayish, especially on the lips, fingers, nails, gums, or the thin skin around the eyes.
Step 5. Pay attention to whether your neck and chest muscles are tense
If you are breathing heavily or are in respiratory distress, accessory muscles (which are not normally associated with breathing) are involved. The muscles used for breathing in this situation are the sides of the neck: the sternocleidomastoid and scalene muscles. Look for deep lines in the neck muscles if you have trouble breathing. In addition, the muscles between the ribs (intercostals) are pulled inward. These muscles help lift the ribs during inhalation. In serious cases, you may be able to see it pulled between the ribs.
Look in the mirror the obvious neck muscles and the pulled muscles between the ribs
Step 6. Feel tightness or pain in your chest
If you try to breathe too much, the muscles involved in the breathing process will be overworked. This causes muscle fatigue that feels like tightness and pain in the chest. This pain is prolonged, sharp, or stabbing, and can be felt around the middle of the chest (sternal) or slightly from the center (parasternal). It requires emergency medical assistance. Go to the emergency room to avoid heart problems.
Step 7. Listen for sounds that get louder during the breath
In mild and moderate symptoms, whistling and wheezing are only heard when breathing. However, in a severe attack, you can hear sounds both when inhaling and exhaling. This sound is known as "stridor" and is caused by the narrowing of the throat muscles in the upper respiratory tract. Wheezing tends to occur in breathing caused by constriction of the muscles in the lower respiratory tract.
- Noise on inhalation can be a symptom of asthma or a severe allergic reaction. You need to be able to tell the difference so you can treat the cause appropriately.
- Look for hives or a red rash on the chest, indicating an allergic reaction, not an asthma attack. Swelling of the lips or tongue is also a sign of an allergy.
Step 8. Treat asthma symptoms as soon as possible
If you have a severe attack that is making it difficult for you to breathe, call 118 or 119, and go to the ER immediately. If you have an emergency inhaler, use it.
- The Albuterol inhaler pump should only be used 4 times a day, but in severe attacks you can use it every 20 minutes for 2 hours.
- Take deep and slow breaths, count to three and then inhale and exhale. This can help reduce stress and breathing rate.
- Avoid the trigger if you can identify it.
- Asthma gets better if you use steroids prescribed by a doctor. This medication can be inhaled through a pump, or taken as a tablet. Mix the medicine or tablet with water. This drug is effective within a few hours, but will be able to control asthma symptoms.
Step 9. For severe asthma symptoms, call the emergency number
These symptoms indicate you are having an acute attack and your body is struggling to draw in enough air to function. It is considered a medical emergency which can be fatal if not treated immediately.
Part 4 of 4: Getting a Diagnosis
Step 1. Give your doctor your medical history
The information you provide must be accurate so that your doctor can get an overall picture of the problems that affect you. Prepare all of the following information in advance so you don't have to bother remembering it when you see a doctor:
- Asthma signs and symptoms (cough, shortness of breath, sounds when breathing, etc.)
- Past medical history (previous allergies, etc.)
- Family history (history of lung disease or allergies in parents, siblings, etc.)
- Social history (tobacco use, diet and exercise, environment)
- Medications you are currently taking (such as aspirin) and supplements or vitamins you are taking
Step 2. Perform a physical examination
The doctor may examine some or all of the following during the test: ears, eyes, nose, throat, skin, chest and lungs. Examination includes using a stethoscope on the front and back of the chest to listen for breath sounds or the absence of lung sounds.
- Since asthma is linked to allergies, doctors will also watch for signs of a runny nose, red eyes, watery eyes and skin rashes.
- Finally, the doctor will check for swelling in your throat and your ability to breathe, as well as abnormal sounds that may indicate narrowed airways.
Step 3. Ask the doctor to confirm the diagnosis with a spirometry test
During this test, you will breathe into a mouthpiece connected to a spirometer to measure the rate of airflow and how much air you can inhale and exhale. Take a deep breath and exhale as hard as you can while the device measures it. A positive result means asthma, but a negative result does not mean there is no asthma.
Step 4. Run a peak air flow test
This test is similar to spirometry which measures how much air you can exhale. Your doctor or lung specialist may be able to recommend this test to help confirm the diagnosis. To take this test, place your lips against the tool opening and set the tool to the zero position. Stand up straight and take a deep breath, then blow as hard and fast as you can in one breath. Repeat several times so that the results are consistent. Take the largest number, that's your peak flow. When asthma symptoms occur, repeat the test and compare the current airflow with the previous peak flow.
- If your score is more than 80% of the best peak flow, you are in a safe range.
- If your score is 50-80% of the best peak flow, your asthma is not being managed properly and your doctor may adjust your medication accordingly. You are at risk for an asthma attack in this range.
- If your score is less than 50% of the best peak flow, your respiratory function is severely impaired which may need to be treated with medication.
Step 5. Ask your doctor to do a methacholine challenge test
If you have no symptoms when you go to the doctor, it will be difficult for your doctor to diagnose you accurately. Your doctor may recommend a methacholine challenge test. Your doctor will give you an inhaler that you can use to inhale methacholine. Methacholine will cause airway constriction if you have asthma, and the triggering symptoms can be measured by spirometry and peak airflow tests.
Step 6. Test your response to asthma medications
Sometimes doctors ignore this test and just give you asthma medication to see if you get better. If your symptoms subside, you likely have asthma. The severity of the symptoms will help the doctor choose which medication to use, but a complete history and physical examination will also influence this decision.
- A common medication is the albuterol/salbutamol inhaler pump, which is used by pursed lips at the opening and then pumps the medication into your lungs as you inhale.
- Bronchodilators help open the narrowed airways by widening them.
