Pulmonologist offers tips to manage asthma

Asthma is a condition where airways narrow and swell, possibly producing extra mucus and other symptoms. While asthma affect adults, it's the most common long-term disease in children. More than 262 million people globally are affected by asthma and more than 461,000 have died from it, according to the World Health Organization.

There's no cure for asthma, and for somepeople, asthma is a minor nuisance. For others, it can interfere withdaily activitiesand may lead to life-threateningasthma attacks. Having good day-to-day control of asthma is key to keeping symptoms at bay and preventing asthma attack, says John Costello, M.D., a pulmonologist at Mayo Clinic Healthcare in London.

Symptoms of asthma include shortness of breath, chest tightness, wheezing when exhaling, trouble sleeping caused byshortness of breath, coughing or wheezing, and coughing or wheezing attacks worsened by a respiratory virus.

Asthma is usually an intermittent condition worsened by a respiratory virus, an allergy or another trigger.It is not clear why some people get asthma and others do not. For some people, asthma signs and symptoms flare up in certain situations, such as during exercise. Cold weather and even thunderstorms can trigger asthma.

"There's a very big genetic component to asthma as there is to allergy, but the absolute definition of the genes involved is still under investigation and still much debatable," Dr. Costello says. "So the prevention of asthma as a condition is quite difficult. What you can prevent is the frequency and severity of attacks by the use of regular treatment."

Children with asthma may not be able to articulate the symptoms they're feeling. Parents will often notice that the child has more frequent chest infections than their siblings, or they'll hear frequent wheezing. The family also may have a history of cough, wheezing, breathlessness, asthma or allergy―all factors that point to a diagnosis of asthma.

Asthma often improves in the early teen years. But why it improves―whether hormonal or otherwise―isn't clear, Dr. Costello says. However, once a person is diagnosed with it, there's always the tendency for it to return later in life, given the right circumstances.

People with asthma and theirhealth care providerscan consult local and international treatment guidelines to design a stepwise plan for living with their condition, preventing asthma attacks and recognizing when it is out of control. Inhalation therapy is the treatment of choice, though patients with severeasthmamay need corticosteroids that are given orally or by IV.

"And if the patient's not responding, then admission to the hospital (is needed) to make sure that these medicines are administered efficiently," Dr. Costello says.

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