Asthma Triggers and Management

If you have asthma, you can minimize your symptoms and improve your quality of life by avoiding your asthma triggers and working with your allergist/immunologist, often referred to as an allergist, to develop a treatment plan.

Triggers

People with asthma have recurrent episodes of airflow limitation, often from inflamed airways that become narrowed, making it more difficult to move air in and out of their lungs. This can cause wheezing, cough, chest tightness and shortness of breath.

It is important to understand what triggers your symptoms and what makes them go away. Common asthma triggers include:

• Tobacco smoke, which is an irritant that often aggravates asthma. No one should smoke around you in your home or your car. Your asthma may also be irritated by strong odors or fumes, weather changes or air pollution.
• Viral and bacterial infections such as the common cold and sinusitis.
• Strenuous exercise or exposure to cold, dry air.
• Acid reflux, even if you do not experience heartburn. This diagnosis can be hard to make and treatment is different from most asthma medications, so talk to your allergist.
• Some medications can cause or worsen asthma. These include aspirin or other non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen; and beta-blockers (used to treat heart disease, high blood pressure, migraine headaches or glaucoma).
• Even eating certain foods can trigger wheezing in some people. If any foods seem to trigger an asthma attack, avoid eating them and talk to your allergist.
• Emotional anxiety may also increase your asthma symptoms and trigger an attack. Proper rest, diet and exercise are important for your overall health and can help in managing asthma.
• Many people with asthma have allergies, which can trigger asthma symptoms. Common allergens include house dust mites, animal dander (dead skin flakes), molds, pollen, cockroach droppings or foods. Your allergist can identify what you are allergic to and recommend ways to avoid exposure to your triggers.

Treatment and Management

Asthma has different causes in different people, and therefore individualized therapy is wise. Personalized plans for treatment may include:

• Environmental control measures to avoid your asthma triggers Medication
• An asthma action plan
• A partnership between you, your family, your allergist and other healthcare providers

You and your allergist can work together to ensure that your asthma is well-managed, so that you can participate in your normal activities.

Since asthma is a chronic disease, it requires ongoing management. This includes using proper medications to prevent and control your asthma symptoms and to reduce airway inflammation. There are two general classes of asthma medications, quick-relief and long-term controller medications. Your allergist may recommend one or a combination of two or more of these medications.

Rescue Medications

Quick-relief medications are used to provide temporary relief of symptoms. They include bronchodilators and oral corticosteroids.

Bronchodilators, generally called "rescue medications," open up the airways so that more air can flow through. Bronchodilators include beta-agonists and anticholinergics, and come in inhaled, tablet, liquid or injectable forms.

There are some corticosteroids designed for short-term use that are swallowed or given by injection, and work a bit more slowly to help treat particularly bad inflammation in your airways.

Long-Term Control Measures

Long-term controller medications are important for many people with asthma, and are taken on a regular basis (often daily) to control airway inflammation and treat symptoms in people who have frequent asthma symptoms.

Inhaled corticosteroids (there are many different ones), cromolyn or nedocromil and leukotriene modifiers can help control the inflammation that occurs in the airways of most people who have asthma. One medication may work better for you than another. Your allergist can help guide you.

Inhaled long-acting beta 2-agonists are symptom-controllers that open your airways and may have other beneficial effects, but in certain people they may have some risks. Current recommendations are for them to be used only along with inhaled corticosteroids.

Methylxanthines provide modest opening of the airways and may have a mild anti-inflammatory effect. Theophylline is the most frequently used methylxanthine. Leukotriene modifiers are also used for airway opening.

Omalizumab is an injectable antibody that helps block allergic inflammation. It is used in patients with persistent allergic asthma.

Your asthma medications may need to be adjusted as you and your asthma change, so stay in close touch with your allergist. The better informed you are about your asthma triggers and management, the better your asthma symptoms will be. Together, you and your allergist can work to ensure that asthma interferes with your daily life as little as possible.

Healthy Tips

• Your asthma symptoms can be triggered by allergens, tobacco smoke, colds or sinus infections, exercise, reflux disease, medications, weather changes or emotions and occasionally, foods.
• Each person has their own triggers and avoidance of these triggers can help improve your asthma.
• Quick-relief medications provide temporary relief of asthma symptoms, while long-term controller medications are taken on a regular basis to control airway inflammation or prevent frequent asthma symptoms.
• Work with your allergist to ensure that your asthma is well-controlled and interferes with your daily life as little as possible.