What Causes Asthma?
Asthma patients know all to well the suffering from being short of breath, having a tight chest and cough, and the wheezing noises. Why do these problems come and go? Can’t they just stay away?
The term ‘trigger' is often used for a reason that asthma gets worse. Triggers can be obvious but often are not. For instance, all asthmatics have certain genetic issues that set them up to have asthma to begin with. You can’t do anything about your DNA, but you can deal with the other things that affect your asthma! Let’s go through some of the most common asthma triggers.
Allergies are present in up to 80% of asthmatics! Allergy exposure makes asthma worse in two distinct ways.
A). Acute allergic triggers: an example of an acute exposure would be visiting a friend’s house who has a few cats and noting that within 15 minutes your chest gets tight, you're wheezy, short of breath, and cough. In addition, you have itchy eyes, itchy nose, and you start sneezing. The end result is that you realize this isn’t good and you leave.
B). Chronic allergic triggers: with many months of exposure to an allergy, asthma progressively gets worse. In the end, you just get used to the asthma and adapt. You don't run or laugh as much, use your albuterol reliever more often, and mis out on the fun. Then, more and more medications are needed to counteract this. Cold air, exercise, and infections can really set off the asthma for these patients. The dust mites in your beds and carpets, the dog or cat you love, and the outdoor mold season can all be to blame.
What can we do? For some, avoidance helps. Immunotherapy, mainly allergy shots, can help you become far less allergic so the exposures don’t bother you nearly as much. Both avoidance and allergy shots are a gradual, no medication way, to improve your asthma.
Most asthmatics find that after a long period of sustained, hard aerobic exercise they have asthma symptoms. This can happen even with laughter for some! The poorer the asthma control, the quicker this happens.
The answer isn’t to quit exercise! Rather, having the best day to day control and the use of a bronchodilator like albuterol about 15 minutes before the exercise can help.
Almost every asthmatic gets worse when they catch a common cold. Other viruses also trigger asthma flares--influenza being infamous. Viral triggered asthma can be severe and the effects often go on for months. It is rare for bacteria to flare the asthma and that is why antibiotics rarely help asthma. Getting your flu shot is an important thing you can do to lessen asthma problems! Hand washing is another important intervention.
Cigarette smoke, dust, air pollution, strong fumes, and cold air may irritate the lining of the bronchial tubes. At times workplace exposures can be a problem. Possibilities include flour, cedar saw dust, and numerous chemicals. Reducing exposures, when possible, can help.
Some people develop severe asthma attacks after taking aspirin or aspirin-like drugs including ibuprofen, indomethacin, naproxen, and others. Many of these people also have nasal polyps (small, non-cancerous tumors in the nose). While avoidance is the normal treatment, some patients undergo aspirin desensitization to help.
Working together with your entire care team can lead to greatly improved asthma control. Your Allergist can identify the worst triggers, plan interventions that work, and coordinate your asthma program.