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Asthma

What is asthma?

Asthma is a chronic (long-term) lung disease. It affects your airways, the tubes that carry air in and out of your lungs. When you have asthma, your airways can become inflamed and narrowed. This can cause wheezing, coughing, and tightness in your chest. When these symptoms get worse than usual, it is called an asthma attack or flare-up.

What causes asthma?

The exact cause of asthma is unknown. Genetics and your environment likely play a role in who gets asthma.

An asthma attack can happen when you are exposed to an asthma trigger. An asthma trigger is something that can set off or worsen your asthma symptoms. Different triggers can cause different types of asthma:

  • Allergic asthma is caused by allergens. Allergens are substances that cause an allergic reaction. They can include
    • Dust mites
    • Mold
    • Pets
    • Pollen from grass, trees, and weeds
    • Waste from pests such as cockroaches and mice
  • Nonallergic asthma is caused by triggers that are not allergens, such as
    • Breathing in cold air
    • Certain medicines
    • Household chemicals
    • Infections such as colds and the flu
    • Outdoor air pollution
    • Tobacco smoke
  • Occupational asthma is caused by breathing in chemicals or industrial dusts at work
  • Exercise-induced asthma happens during physical exercise, especially when the air is dry

Asthma triggers may be different for each person and can change over time.

Who is at risk for asthma?

Asthma affects people of all ages, but it often starts during childhood. Certain factors can raise your risk of having asthma:

  • Being exposed to secondhand smoke when your mother is pregnant with you or when you are a small child
  • Being exposed to certain substances at work, such as chemical irritants or industrial dusts
  • Genetics and family history. You are more likely to have asthma if one of your parents has it, especially if it's your mother.
  • Race or ethnicity. Black and African Americans and Puerto Ricans are at higher risk of asthma than people of other races or ethnicities.
  • Having other diseases or conditions such as obesity and allergies
  • Often having viral respiratory infections as a young child
  • Sex. In children, asthma is more common in boys. In teens and adults, it is more common in women.
What are the symptoms of asthma?

The symptoms of asthma include

  • Chest tightness
  • Coughing, especially at night or early morning
  • Shortness of breath
  • Wheezing, which causes a whistling sound when you breathe out

These symptoms can range from mild to severe. You may have them every day or only once in a while.

When you are having an asthma attack, your symptoms get much worse. The attacks may come on gradually or suddenly. Sometimes they can be life-threatening. They are more common in people who have severe asthma. If you are having asthma attacks, you may need a change in your treatment.

How is asthma diagnosed?

Your health care provider may use many tools to diagnose asthma:

  • Physical exam
  • Medical history
  • Lung function tests, including spirometry, to test how well your lungs work
  • Tests to measure how your airways react to specific exposures. During this test, you inhale different concentrations of allergens or medicines that may tighten the muscles in your airways. Spirometry is done before and after the test.
  • Peak expiratory flow (PEF) tests to measure how fast you can blow air out using maximum effort
  • Fractional exhaled nitric oxide (FeNO) tests to measure levels of nitric oxide in your breath when you breathe out. High levels of nitric oxide may mean that your lungs are inflamed.
  • Allergy skin or blood tests, if you have a history of allergies. These tests check which allergens cause a reaction from your immune system.
What are the treatments for asthma?

If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include

  • Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
  • Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
  • Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.

If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.

Your provider may adjust your treatment until asthma symptoms are controlled.

Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway's ability to tighten and allows you to breathe more easily. The procedure has some risks, so it's important to discuss them with your provider.

Cough

Coughing is a reflex that keeps your throat and airways clear. Although it can be annoying, coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with a cold, flu, or acute bronchitis. Chronic coughs last longer than 2 to 3 weeks. Causes of chronic cough include

  • Chronic bronchitis
  • Asthma
  • Allergies
  • COPD (chronic obstructive pulmonary disease)
  • GERD (gastroesophageal reflux disease)
  • Smoking
  • Throat disorders, such as croup in young children
  • Some medicines

Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. Children under four should not have cough medicine. For children over four, use caution and read labels carefully.

Lung Diseases

When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.

The term lung disease refers to many disorders affecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and many other breathing problems. Some lung diseases can lead to respiratory failure.

Dept. of Health and Human Services Office on Women's Health

Lung Transplantation

A lung transplant removes a person's diseased lung and replaces it with a healthy one. The healthy lung comes from a donor who has died. Some people get one lung during a transplant. Other people get two.

Lung transplants are used for people who are likely to die from lung disease within 1 to 2 years. Their conditions are so severe that other treatments, such as medicines or breathing devices, no longer work. Lung transplants most often are used to treat people who have severe

  • COPD
  • Cystic fibrosis
  • Idiopathic pulmonary fibrosis
  • Alpha-1 antitrypsin deficiency
  • Pulmonary hypertension

Complications of lung transplantation include rejection of the transplanted lung and infection.

NIH: National Heart, Lung, and Blood Institute

Oxygen Therapy

What is oxygen?

Oxygen is a gas that your body needs to work properly. Your cells need oxygen to make energy. Your lungs absorb oxygen from the air you breathe. The oxygen enters your blood from your lungs and travels to your organs and body tissues.

Certain medical conditions can cause your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, or confused. It can also damage your body. Oxygen therapy can help you get more oxygen.

What is oxygen therapy?

Oxygen therapy is a treatment that provides you with extra oxygen to breathe in. It is also called supplemental oxygen. It is only available through a prescription from your health care provider. You may get it in the hospital, another medical setting, or at home. Some people only need it for a short period of time. Others will need long-term oxygen therapy.

There are different types of devices that can give you oxygen. Some use tanks of liquid or gas oxygen. Others use an oxygen concentrator, which pulls oxygen out of the air. You will get the oxygen through a nose tube (cannula), a mask, or a tent. The extra oxygen is breathed in along with normal air.

There are portable versions of the tanks and oxygen concentrators. They can make it easier for you to move around while using your therapy.

Who needs oxygen therapy?

You may need oxygen therapy if you have a condition that causes low blood oxygen, such as

  • COPD (chronic obstructive pulmonary disease)
  • Pneumonia
  • COVID-19
  • A severe asthma attack
  • Late-stage heart failure
  • Cystic fibrosis
  • Sleep apnea
What are the risks of using oxygen therapy?

Oxygen therapy is generally safe, but it can cause side effects. They include a dry or bloody nose, tiredness, and morning headaches.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. If you use oxygen tanks, make sure your tank is secured and stays upright. If it falls and cracks or the top breaks off, the tank can fly like a missile.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBOT) is a different type of oxygen therapy. It involves breathing oxygen in a pressurized chamber or tube. This allows your lungs to gather up to three times more oxygen than you would get by breathing oxygen at normal air pressure. The extra oxygen moves through your blood and to your organs and body tissues. HBOT is used to treat certain serious wounds, burns, injuries, and infections. It also treats air or gas embolisms (bubbles of air in your bloodstream), decompression sickness suffered by divers, and carbon monoxide poisoning.

But some treatment centers claim that HBOT can treat almost anything, including HIV/AIDS, Alzheimer's disease, autism, and cancer. The U.S. Food and Drug Administration (FDA) has not cleared or approved the use of HBOT for these conditions. There are risks to using HBOT, so always check with your primary health care provider before you try it.

NIH: National Heart, Lung, and Blood Institute