What You Should Know About Asthma Exacerbation

Asthma is a chronic disease that affects a person's airways and makes breathing difficult. More than 25 million Americans¹ suffer from asthma, and there is currently no cure for this condition. People with asthma need to work closely with their doctors to manage the symptoms and keep asthma exacerbations to a minimum.

Let's look at what it means to have an asthma exacerbation and what treatment options are available for relief.

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What is an asthma exacerbation?

When exposed to certain triggers like allergens or chemicals, a person with asthma can have an asthma exacerbation, also known as an asthma attack. When this happens, the muscles around the bronchial tubes begin to constrict, and this causes the air passages to become narrow, making it very difficult to breathe. This can feel like a heavy weight on your chest or a tightening sensation in your lungs.

Episodes can vary in severity and last from a few minutes to hours or even days. This experience can be scary, but there are fast-acting treatment options that can help to stop an episode quickly and effectively.

Asthma in adults

Adults with asthma should discuss their condition with their healthcare provider at least once a year to control their symptoms. When an adult is diagnosed with asthma, they're more likely to have persistent symptoms that need to be closely monitored.

If you have adult-onset asthma, you may need to take daily medication to manage your symptoms and avoid having an asthma exacerbation.

Asthma in children

Asthma is the most common chronic disease in childhood, and it affects 8.3%² of children in the US. Most young children diagnosed with asthma develop the condition from a viral infection, and it's believed that 80% of cases are diagnosed before a child turns six.

It's crucial that your child's asthma is closely monitored by their doctor and that you've got a treatment plan in place. That way, if an episode occurs, you've got a fast-acting medication on hand that can be administered immediately.

Signs and symptoms of an asthma exacerbation

If you have asthma, it's important to pay attention to your triggers and watch out for warning signs that may indicate you're about to have an asthma exacerbation.

Symptoms

If you've been exposed to one of your triggers, you may begin to develop unpleasant symptoms. These symptoms can quickly worsen without the right intervention, leading to a medical emergency.

These symptoms include:

  • A dry cough

  • Shortness of breath

  • Wheezing

  • Tightening of the chest

  • Difficulty exercising or talking

If you notice any of these symptoms, especially if your shortness of breath wakes you at night, it's important to use medication so you can find relief.

Triggers

If you have asthma, you will begin to recognize the triggers that cause your airways to constrict, leading to an asthma exacerbation. These triggers can be environmental or physical, and each person has their own unique sensitivities that can lead to an asthma attack.

Some environmental triggers include:

  • Pollen

  • Certain trees

  • Grass

  • Weeds

  • Cockroaches

  • Dust mites

  • Animal dander

  • Extreme weather conditions

  • Smoke (especially cigarette smoke)

  • Chemical fumes

  • Perfume

  • Strong odors

Physical triggers can include:

  • Illnesses like sinusitis, flu, upper respiratory infections

  • Exercise

  • Strong emotional reactions like laughing or crying

  • Stress 

Children with asthma are especially sensitive to allergens, secondhand smoke, weather changes, and strenuous exercise. These triggers can cause an asthma flare-up, leading to an asthma attack.

Risk factors

According to the American Lung Association, several risk factors make a person more likely to develop asthma. They include:

  • Family history: If one parent has asthma, the American Lung Association states that their child is three to six times more likely to develop asthma than if neither parent suffered from the condition.

  • Respiratory problems in childhood: Children who have viral respiratory infections are more likely to develop chronic asthma that will follow them into adulthood.

  • Allergies: If a child or adult has eczema or hay fever, they're more likely to develop asthma.

  • Exposure to environmental triggers: Some environmental triggers like dust, chemical fumes, vapors, and mold can increase your chances of developing asthma, especially if you're exposed to them daily at home or work.

  • Cigarette smoke: Smoking cigarettes and being exposed to secondhand smoke both make it far more likely for a person to develop asthma.

  • Obesity: If you're overweight or obese, you're more likely to develop asthma at some point.

  • Smog: Air pollution is harmful to the lungs, making people who live in urban areas more likely to develop asthma.

  • Other socioeconomic factors: People who live in poverty or have no health insurance are at a far greater risk of developing many medical conditions, including asthma.

If you or your children have several risk factors, it's important to closely monitor your health and communicate with your doctor if you notice any symptoms that could indicate you've developed asthma.

What causes an asthma exacerbation?

When a person has asthma, their body has certain triggers that can cause an asthma exacerbation. If you're exposed to one of your unique triggers, your body will respond by causing inflammation in your airways, and the muscles around your bronchial tubes will begin to constrict. When this happens, your chest can become tight, and breathing can become difficult, signaling that it's time to use your rescue inhaler.

If you notice a persistent cough, wheezing, or other telltale signs of asthma, it's important to visit the doctor for an evaluation and diagnosis.

Diagnosis

Since asthma is so common, doctors can use several methods to test for this condition. He or she will begin by taking a detailed medical history and conducting a physical exam. Then, they will perform a lung function test, like a peak flow test, to determine whether your lungs are working effectively.

You may also need to have a chest or sinus x-ray to determine that everything looks okay. From these results, your doctor can create an individualized treatment plan to help control your symptoms.

Peak flow test

A peak flow test is an easy way for doctors to determine your lung output and to see whether your asthma is under control. In fact, a peak flow meter³ can detect your lung function issues better than a stethoscope. Many doctors recommend using a peak flow meter along with a diary to monitor and manage your symptoms effectively.

A peak flow meter is a small handheld device that measures how well you can push air from your lungs. If you consistently use your peak flow meter, you'll be able to determine your typical readings and can intervene with medication when it indicates a problem.

To use your peak flow meter, follow these steps:

  1. Put the meter in your mouth between your teeth and close your lips around it.

  2. Blow out as hard and fast as you can in a single puff.

  3. Write down the number that's indicated on the meter.

  4. Repeat two more times and record the highest number in your diary.

With your doctor's help, you can determine which numbers mean you're in the green, yellow, and red zone, and what measurements mean that it's time to take action.

Treatment

Doctors can prescribe several treatment plans for people with asthma, based on the severity of their symptoms and the degree to which their condition is under control. In most cases, asthma is controlled by avoiding your triggers and using medication when you've been exposed to one. Let's look at the best asthma exacerbation treatment for most people.

Medical intervention

For quick relief, most people with asthma are prescribed a short-acting, rapid-onset medication, usually in the form of an inhaler. Albuterol (also known as salbutamol) is a common medication that's prescribed for use at the onset of an asthma exacerbation. This type of medication works to quickly relax your airway muscles, allowing you to breathe more easily and deeply.

If your asthma is not properly controlled and your symptoms are persistent and progressing, your doctor may prescribe a steroid to reduce inflammation and relieve your symptoms over several days.

Home remedies

During your visit, your doctor will help you develop an action plan to manage symptoms and take control if an asthma exacerbation occurs. Although medication can help, it's especially important to avoid your triggers as much as possible. You may need to visit an allergist to determine what environmental factors trigger your asthma.

It's also important to remain healthy, including staying active and at a healthy body weight. If you smoke cigarettes, stop, and if you can't, ask your doctor for help.

Managing an asthma exacerbation

An asthma exacerbation can be scary. It can cause panic, making breathing more difficult and causing symptoms to worsen. If you do have an asthma exacerbation, try to remain calm and stick to your action plan.

If you notice that your symptoms are increasing, you're coughing, and your chest is getting tight, it's time to take action. Lie down and do your best to relax. This is the best position for an asthma attack.

According to the American College of Allergy, Asthma, and Immunology,⁴ it's important to stick to your action plan and use your fast-acting inhaler at the first sign of wheezing or trouble breathing. Use your inhaler as directed, and call your doctor immediately if your symptoms persist.

Can you prevent an asthma exacerbation?

If you have asthma, you can prevent many asthma exacerbation episodes by following the treatment plan that you developed with your healthcare provider. That means you'll need to take your prescribed medication daily and use your quick-acting medicine as soon as you begin to notice symptoms of an asthma exacerbation.

It's also crucial to learn your triggers and avoid them as often as possible. That way, you can prevent your body from reacting to them in the first place. With help from your healthcare provider and an allergist, you can learn to avoid triggers and decrease the instances in which you'll need to use a quick-acting medicine.

Most people with asthma can lead normal lives, especially if they've got an effective treatment plan in place.

When to see a doctor

If you've been diagnosed with asthma, it's important to see your healthcare provider at least once each year. That way, you can effectively manage your condition and maintain a treatment plan that keeps asthma exacerbations at a minimum.

If you have any of the following symptoms, it's important to call your doctor immediately:

  • Feeling faint, dizzy, or weak

  • Trouble doing normal activities like cleaning or walking

  • A persistent cough

  • Wheezing when you breathe, especially if it persists after using your quick-acting inhaler

If you have the following symptoms, it's a medical emergency.

  • Blue nails or lips

  • Flaring nostrils when you inhale

  • The skin between your ribs or near your collarbone stretches each time you breathe

  • Breathing more than 30 times each minute

  • Talking or walking becomes difficult

Working closely with your healthcare provider will allow you to live a normal life that eliminates the most severe symptoms of asthma. Make sure you meet with your doctor at least once a year to maintain a treatment plan that's effective and up to date.

The lowdown

Asthma is a condition that causes a person's airway to swell and become constricted when they're exposed to certain triggers. This can cause chest tightness and trouble breathing.

An asthma exacerbation, also known as an asthma attack, can be very scary, and without a proper treatment plan in place, your condition can get out of control, leading to a medical emergency.

If you or a loved one has asthma, make sure you're working with a medical professional to manage and control asthma so you prevent asthma exacerbations from occurring.

  1. Asthma | Asthma and Allergy Foundation of America

  2. Asthma in children and adults—What are the differences and what can they tell us about asthma? (2019)

  3. Peak flow meters | Asthma and Allergy Foundation of America

  4. Asthma attack | American College of Allergy, Asthma & Immunology

Other sources:

Have you considered clinical trials for Asthma?

We make it easy for you to participate in a clinical trial for Asthma, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
Peter, 64



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