Asthma is commonly thought to be a childhood disease, but people can develop asthma at any age. In fact, nearly 23 million adults in the United States have asthma, so it’s important to understand what asthma is, its symptoms, and how it’s treated.
What Is Asthma?
Asthma is a chronic lung disease that causes narrowing, swelling, and inflammation of the airways, sometimes with excess mucus. It can vary in severity from person to person and may change over time. Symptoms include:
- Shortness of breath
- Wheezing
- Chest pain or tightness
- Coughing
Some people have asthma attacks only when exercising, or when exposed to certain allergens.
Adult Asthma Vs. Childhood Asthma
Some of the symptoms of asthma are the same in children and adults, but young children may also have flaring nostrils and poor eating and sleeping habits. In adults, asthma attacks occur more regularly while in children, asthma may flare up intermittently.
Childhood asthma is more common in males than females, but adult-onset asthma is more common in females. Adults are more likely to die from asthma than children.
Two specific types of asthma are more common in adults.
- Eosinophilic asthma is a severe type of asthma caused by an excess of white blood cells called eosinophils in the airways. These cells fight infections, but an excess of them can cause inflammation in the body including the lungs and swelling in the airways.
- Aspirin-exacerbated respiratory disease (AERD) is a condition that includes asthma, sinus disease with nasal polyps, and sensitivity to aspirin and NSAIDs.
Adult-Onset Asthma Risk Factors
The cause of adult-onset asthma is largely unknown, but several risk factors have been identified including:
- Being female, often due to hormonal changes
- Family history
- Having allergies
- Smoking
- Obesity
- Gastroesophageal Reflux Disease (GERD)
- A history of RSV or the flu
- Living in a polluted environment
- Working in an environment with allergens or chemicals
Treating Adult Asthma
Asthma cannot be cured, but it can be controlled in several different ways.
Long-Term Asthma Control Medications
Long term medications are taken daily to control asthma. They include:
- Inhaled corticosteroids including fluticasone propionate, budesonide, ciclesonide, beclomethasone, mometasone, and fluticasone furoate. They work to prevent inflammation thus reducing swelling and mucus.
- Leukotriene modifiers are oral medications that include montelukast, zafirlukast, and zileuton. They work by inhibiting leukotrienes, which are inflammatory modifiers.
- Combination inhalers including fluticasone-salmeterol, budesonide-formoterol, formoterol-mometasone, and fluticasone furoate-vilanterol. Each is a combination of a long acting beta antagonist and a corticosteroid.
- Theophylline is an oral medication that relaxes the muscles around the airways, keeping them open.
Quick-Relief Medications (Rescue Medications)
Rescue medication are used when an asthma attack occurs, and sometimes before exercise. They include:
- Short-acting beta agonists are bronchodilators taken by inhaler and relieve asthma symptoms quickly.
- Anticholinergic agents are bronchodilators that include ipratropium and tiotropium. They immediately relax the airways.
- Oral and intravenous corticosteroids including prednisone and methylprednisolone work by relieving airway inflammation. They are mainly used for severe asthma.
Allergy Medications
For those whose asthma is triggered by allergens, certain allergy treatments are used including:
- Immunotherapy which consists of allergy shots that work over time to reduce your immune system’s reaction to specific allergens. Shots are usually given weekly for a few months, then monthly for several years.
- Biologics including omalizumab, mepolizuma, dupilumab, reslizumab, benralizumab, and tezepelumab. Used for severe asthma, biologics target specific parts of the immune system that cause airway inflammation.
Bronchial Thermoplasty
Bronchial thermoplasty is a rarely used treatment for asthma that doesn’t respond to other medications. During the treatment, the inside of your airways are heated with an electrode, which smooths the muscles and keeps the airways from tightening.
Avoiding Triggers
People with asthma generally have certain triggers that lead to asthma attacks. Avoiding these triggers can reduce the frequency of symptoms. Triggers may include:
- Exercise or exertion
- Cold, dry air
- Temperature or weather changes
- Viral respiratory infections
- Allergens including pollen, mold, pet dander, and dust mites
- Strong odors
- Irritants such as chemicals
- Smoke of any kind
- Air pollution, both indoor and outdoor
- Medicines including aspirin, NSAIDs, ACE inhibitors, and beta blockers
- Anxiety or strong emotional reactions
If you don’t know your triggers, keep a diary of your asthma attacks and what preceded them.
Managing Related Conditions
Controlling other conditions like allergies and GERD can also reduce asthma attacks. Getting to and maintaining a healthy weight can also help, as can simply taking care of your overall health.
Have an Asthma Action Plan
An asthma action plan is critical for children to have in place so that school workers and other caregivers know what to do, but it’s also important for adults. Your plan should include signs to watch for and what to do when those signs appear, i.e. taking certain medications or calling your doctor.
In Closing
Asthma can develop at any age, so you should know the symptoms to watch for, and when to see a doctor. At Health Service Alliance, we can diagnose and treat your asthma, regardless of your ability to pay. Give us and call today. We are here to help.
