What Is The Main Cause Of Asthma

Why Do People Get Asthma

Research has yet to show a definitive cause of asthma. However, researchers have determined several risk factors that can lead to asthma development.

Family History and Genetics

Children of mothers with asthma are three times more likely to suffer from asthma, and 2.5 times more likely if the father has asthma. More than 30 genes have been linked to asthma so far, and gene-gene interactions, gene-environment interactions and epigenetic modifications also play a part. Genetic differences also play a role in differences in response to treatment.

Allergies

People are more likely to have asthma if they have certain types of allergies, such ones which can affect the eyes and nose. However, not everyone who has allergies will get asthma and not everyone who has asthma is affected by allergies. Respiratory allergies and some types of asthma are related to an antibody called immunoglobulin E , which the immune system produces in response to allergens. To protect the body, the IgE causes allergic reactions that can affect the eyes, nose, throat, lungs and skin.

Premature Birth

Children born before 37 weeks are at increased risk of developing asthma later in life.

Lung Infections

Babies or small children may be at risk of developing asthma later in life if they had certain lung infections at a very early age.

Occupational Exposures

Hormones

Women can develop adult-onset asthma during or after menopause.

Environment Air Quality

Obesity

How Do You Monitor Asthma Symptoms

You should keep track of your asthma symptom. Its an important piece of managing the disease. Your healthcare provider may ask to use a peak flow meter. This device measures how fast you can blow air out of your lungs. It can help your provider make adjustments to your medication. It also tells you if your symptoms are getting worse.

Know When To Get Help

Warning signs of a potential asthma attack include:

• Needing more rescue inhaler medication .
• A cough that gets worse.
• Feeling like you canât breathe or like someoneâs sitting on your chest.
• Waking up at night feeling like you canât breathe.
• Not being able to be active or exercise without getting winded or wheezing.

Use your asthma rescue inhaler medication as soon as you start to feel an attack come on. If it doesnât seem to work and you feel like you still canât breathe, call 911 so you can get to an emergency room right away.

If you have a steroid medicine at home , you can take it on your way to the ER.

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How Can You Tell If You Have Asthma

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.

During a checkup, a doctor will ask if you cough a lot, especially at night. He or she will also ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then ask about chest tightness, wheezing, and colds lasting more than 10 days. He or she will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems. Finally, the doctor will ask questions about your home and whether you have missed school or work or have trouble doing certain things.

The doctor may also do a breathing test, called spirometry, to find out how well your lungs are working by testing how much air you can breathe out after taking a very deep breath before and after you use asthma medicine.

How Long Does Asthma Take To Develop

There is no fixed period of time in which asthma can develop. Asthma as a disease may develop from a few weeks to many years after the initial exposure. Analysis of the respiratory responses of sensitized workers has established three basic patterns of asthmatic attacks, as follows:

Immediate â typically develops within minutes of exposure and is at its worst after approximately 20 minutes recovery takes about 2 hours.

Late â can occur in different forms. It usually starts several hours after exposure and is at its worst after about 4 to 8 hours with recovery within 24 hours. However, it can start 1 hour after exposure with recovery in 3 to 4 hours. In some cases, it may start at night, with a tendency to recur at the same time for a few nights following a single exposure.

Dual or Combined â is the occurrence of both immediate and late types of asthma.

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Proposed Human Exposome Project

The idea of a Human Exposome Project, analogous to the , has been proposed and discussed in numerous scientific meetings, but as of 2017, no such project exists. Given the lack of clarity on how science would go about pursuing such a project, support has been lacking. Reports on the issue include:

• a 2011 review on the exposome and by and Stephen Rappaport, “Exposure science and the exposome: an opportunity for coherence in the environmental health sciences” in the journal .
• a 2012 report from the “Exposure Science in the 21st Century: A Vision and A Strategy”, outlining the challenges in systematic evaluations of the exposome.

Identifying Asthma Triggers With Allergy Testing

Determining what triggers a personâs asthma is often difficult.

Allergy testing is appropriate when there is a suspicion that some avoidable substance is provoking attacks. Skin testing Skin testing Allergic reactions are inappropriate responses of the immune system to a normally harmless substance. Usually, allergies make people sneeze the eyes water and itch… read more can help identify allergens that may trigger asthma symptoms. However, an allergic response to a skin test does not necessarily mean that the allergen being tested is causing the asthma. The person still has to note whether attacks occur after exposure to this allergen. If doctors suspect a particular allergen, a blood test that measures the level of antibody produced in response to the allergen can be done to determine the degree of the person’s sensitivity to the allergen.

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What Is An Asthma Attack

When you breathe normally, muscles around your airways are relaxed, letting air move easily and quietly. During an asthma attack, three things can happen:

• Bronchospasm: The muscles around the airways constrict . When they tighten, it makes your airways narrow. Air cannot flow freely through constricted airways.
• Inflammation: The lining of your airways becomes swollen. Swollen airways dont let as much air in or out of your lungs.
• Mucus production: During the attack, your body creates more mucus. This thick mucus clogs airways.

When your airways get tighter, you make a sound called wheezing when you breathe, a noise your airways make when you breathe out. You might also hear an asthma attack called an exacerbation or a flare-up. Its the term for when your asthma isnt controlled.

How Can We Control Work

Although there are medical treatments that may control the symptoms of asthma, it is important to stop exposure wherever possible. If the exposure to the substance is not stopped, treatment will be needed continuously and the breathing problems may become permanent. People may continue to suffer from work-related asthma even after removal from exposure.

The best way to prevent work-related asthma is to replace substances with less harmful ones. Where this is not possible, exposure should be minimized through engineering controls such as ventilation and enclosures of processes. Information on a safety data sheet should list any health hazards, as well as safe handling and control steps.

Preventing further exposure might involve administrative controls such as medical screening and surveillance program for at-risk workers and a change of job or tasks.

Education of workers is also very important. Proper handling procedures, avoidance of spills and good housekeeping reduce the occurrence of asthma.

Masks or respirators can also help to control workplace exposure. Personal protective equipment is considered the last option for control measures. In order to be effective these protective devices must be carefully selected, properly fitted and well maintained as part of a full personal protective equipment program.

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What Should I Know About Covid

If you have asthma that is moderate-to-severe, or if your asthma symptoms arent well controlled, youre at greater risk of having to be hospitalized if you get COVID-19. Therefore, you should wear a mask if you go to indoor spaces with other people, get vaccinated and avoid exposure to people who have the virus.

A note from Cleveland Clinic

Many people live fulfilling lives with asthma. Some professional athletes with asthma have set records in their sports. Your healthcare provider can help you find the best way to manage your asthma. Talk to your healthcare provider about how to control your symptoms.

Last reviewed by a Cleveland Clinic medical professional on 01/19/2022.

References

Monitoring Asthma At Home

Some people use a handheld peak flow meter to evaluate their breathing and determine when they need intervention, before their symptoms become severe. People who experience frequent, severe asthma attacks should know how to reach help quickly.

Peak expiratory flow can be measured using a small handheld device called a peak flow meter. This test can be used at home to monitor the severity of asthma. Usually, peak flow rates are lowest between 4 AM and 6 AM and highest at 4 PM. However, more than a 30% difference in rates at these times is considered evidence of moderate to severe asthma. People with moderate to severe asthma, particularly those who need daily treatment to control symptoms, often use a peak flow meter to take measurements and compare them to their personal best to help identify signs of worsening asthma or the onset of an asthma attack.

All people with asthma should have a written treatment action plan that was devised in collaboration with their doctor. Such a plan allows them to take control of their own treatment and has been shown to decrease the number of times people need to seek care for asthma in the emergency department.

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Exposure To Substances At Work

Occupational asthma is a type of asthma caused by certain things found in the workplace, such as chemicals or dust from flour or wood.

If you havent had asthma before and then get it because of the work you do, and if your symptoms improve when youre not at work, you probably have occupational asthma. See your GP as soon as possible for advice. If they think there is an occupational cause for your asthma they should refer you to a specialist.

Occupational asthma is a common cause of adult-onset asthma.

Find out more about occupational asthma.

Side Effects Of Relievers And Preventers

Relievers are a safe and effective medicine, and have few side effects as long as they are not used too much. The main side effects include a mild shaking of the hands , headaches and muscle cramps. These usually only happen with high doses of reliever inhaler and usually only last for a few minutes.

Preventers are very safe at usual doses, although they can cause a range of side effects at high doses, especially with long-term use.

The main side effect of preventer inhalers is a fungal infection of the mouth or throat . You may also develop a hoarse voice and sore throat.

Using a spacer can help prevent these side effects, as can rinsing your mouth or cleaning your teeth after using your preventer inhaler.

Your doctor or nurse will discuss with you the need to balance control of your asthma with the risk of side effects, and how to keep side effects to a minimum.

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Asthma Symptoms Can Mimic Other Illnesses Or Diseases Especially In Older Adults For Example:

• Hiatal hernia, stomach problems, heart failure, or rheumatic arthritis can create asthma-like symptoms.
• Chronic obstructive pulmonary disease has many of the same symptoms as asthma. COPD, which includes emphysema and chronic bronchitis, is very common in older adults especially those who are or have been smokers.

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.

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What Asthma Treatment Options Are There

You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:

• Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen and are used for intermittent and chronic asthma.
• Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms of chronic asthma.
• Biologic therapies for asthma: These are used for severe asthma when symptoms persist despite proper inhaler therapy.

You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or another type of asthma inhaler. Your healthcare provider may prescribe oral medications that you swallow.

Why Is My Asthma Worse At Night

Asthma that gets worse at night is sometimes called nighttime asthma or nocturnal asthma. There are no definite reasons that this happens, but there are some educated guesses. These include:

• The way you sleep: Sleeping on your back can result in mucus dripping into your throat or acid reflux coming back up from your stomach. Also, sleeping on your back puts pressure on your chest and lungs, which makes breathing more difficult. However, lying face down or on your side can put pressure on your lungs.
• Triggers in your bedroom and triggers that happen in the evening: You may find your blankets, sheets and pillows have dust mites, mold or pet hair on them. If youve been outside in the early evening, you may have brought pollen in with you.
• Medication side effects: Some drugs that treat asthma, such as steroids and montelukast, can affect your sleep.
• Air thats too hot or too cold: Hot air can cause airways to narrow when you breathe in. Cold air is an asthma trigger for some people.
• Lung function changes: Lung function lessens at night as a natural process.
• Asthma is poorly controlled during the day: Symptoms that arent controlled during the day wont be better at night. Its important to work with your provider to make sure your asthma symptoms are controlled both day and night. Treating nighttime symptoms is very important. Serious asthma attacks, and sometimes deaths, can happen at night.

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What You Need To Know About Your Childs Asthma

There are many things to think about and plan for when your child has asthma. It is important to learn as much as you can about the condition. Your doctor and pharmacist are there to help you. Talk to them about any concerns you may have about your childs asthma. To manage your childs asthma effectively, it is important to know:

• the pattern of their asthma
• their asthma medications what they do and how to help your child take them properly
• what to do if they have an asthma attack know and follow asthma first aid.

Make sure you have an updated written asthma action plan and understand how to use it.

Asthma Action Plans For Children

An asthma action plan is a clear written summary of instructions for when your childs asthma symptoms change. Everyone with asthma should have a personalised asthma action plan written by their doctor.

Your childs asthma action plan will tell you:

• how to recognise when your childs asthma is getting worse or an attack is developing, and the steps you should take to manage it
• symptoms that are serious, indicating a need for urgent medical help
• your childs asthma triggers.

Make sure you understand and can follow the asthma action plan from your doctor.

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What Causes Airway Inflammation For People With Asthma

The inflammation process starts when airway cells called dendritic cells identify an allergen. Dendritic cells break it down into small pieces and display the pieces on their surface. Immune cells called T cells then recognize the allergen pieces. For people with asthma, this transforms T cells into active type 2 helper T cells.4

We do not yet know why people with asthma have this inflammation response. Experts think it involves an imbalance between type 1 and type 2 helper T cells. An immune response that involves mostly type 2 helper T cells is linked to conditions like asthma.5

Genetic factors and environmental exposures increase the risk of developing asthma. They may do so by influencing the balance of types of immune cells. This may make some people more likely to have a type 2 inflammatory response. Some risk factors include:1,2,6

• Family history of asthma