Asthma is a treatable disease that behaves like an allergic reaction: certain environmental factors trigger inflammation of the airways, consequently breathing problems develop which subside only when the inflammation is treated and reduced. This disorder is very common and affects approximately 334 million people worldwide, including 25 million in the United States alone. If you are concerned that you have asthma, you may notice some signs and symptoms, analyze risk factors, and undergo diagnostic tests to know for sure.
Steps
Part 1 of 4: Knowing the Risk Factors
Step 1. Take into account the combination of gender and age
In the United States, for example, there are 54% more cases of asthma among boys under 18 than girls. But from the age of 20 onwards, girls suffer from it more than boys. After the age of 35 this gap increases further and 10.1% of women suffer from asthma, compared to 5.6% of men. After menopause this percentage is reduced in women and the gap decreases, even if it does not completely disappear. Experts have some theories as to why gender and age seem to affect the risks of suffering from asthma:
- An increase in atopic syndrome (a predisposition to allergic sensitivity) in adolescent males.
- A reduced airway volume in adolescent boys compared to girls.
- Hormonal fluctuations during the premenstrual phase, during menstruation and in the menopausal years in women.
- Studies have found that postmenopausal women who have undergone hormone replacement therapy have increased the number of new asthma cases.
Step 2. Check family history
Researchers have found that there are more than 100 genes associated with asthma and allergies. Research carried out on families, especially on twins, has shown that asthma is caused by hereditary factors. From a 2009 study, in particular, it was deduced that a previous history of asthma in the family is the major risk factor in the development of this disorder. Comparing families with normal, moderate, and high genetic risk to each other shows that moderate-risk individuals are 2.4 times more likely to develop the disorder, while high-risk individuals are 4.8 times more likely to develop the disorder..
- Ask parents or other relatives if there is a genetic predisposition to asthma in your family.
- If you have been adopted, your biological parents may have provided your medical history to the adoptive family.
Step 3. Pay attention to any signs of allergy
Some studies have associated immunoglobulin called "IgE" with the development of asthma. If you have high levels of IgE in your body, you are more likely to have a hereditary allergy. If you have this immunoglobulin in your blood, your body triggers an inflammatory allergic reaction that causes constriction of the airways, rashes, itchy, watery eyes, wheezing, and so on.
- Check for an allergic reaction to certain triggers, such as food, cockroaches, animals, mold, pollen, and dust mites.
- If you have allergies, you run a higher risk of developing asthma.
- If you suffer from several allergic reactions but cannot identify the trigger, ask the doctor who prescribes the allergy test. Small pads containing different allergens will be placed on your skin to control the reaction and changes in the skin.
Step 4. Don't expose yourself to cigarette smoke
When particles are inhaled into the lungs, the body reacts with a cough. These smoke particles may also be responsible for the body's inflammatory response and asthma symptoms. The more you are exposed to tobacco smoke, the more you risk developing asthma. If you are a heavy smoker and can't get rid of this habit, talk to your doctor to find out about smoking cessation programs and medications. Popular methods include chewing gum and nicotine patches, gradually reducing the number of cigarettes or even taking medications such as Chantix or Wellbutrin. However, even if you have a hard time quitting, avoid smoking around other people, as secondhand smoke can cause asthma in other individuals as well.
Women who smoke during pregnancy can cause babies to feel short of breath, increasing the risk of food allergies and the release of inflammatory proteins into the blood. The effect is even greater if the baby continues to be exposed to secondhand smoke even after birth. Talk to your gynecologist before taking any oral medications to try to quit smoking
Step 5. Reduce your stress levels
Many studies have found that high levels of stress hormones can cause an asthma crisis, increased sensitivity to allergens and a feeling of chest tightness. Try to identify the factors that put you under pressure the most and work to get rid of them.
- Try relaxation techniques such as deep breathing, meditation, or yoga.
- Exercise regularly to release endorphins, thereby relieving pain and reducing stress levels.
- Improve your sleep habits: Go to bed when tired, don't sleep with the TV on, don't eat before bed, avoid caffeinated drinks in the evening, and maintain a regular sleep schedule every day.
Step 6. Do not expose yourself to environmental pollutants in the air
A significant percentage of asthma cases in children are caused by polluted air from factories, construction sites, vehicles and industrial plants. Just as tobacco smoke irritates the lungs, polluted air triggers inflammatory reactions that cause lung damage and chest tightness. While you can't eliminate pollutants, you can still try to reduce their exposure.
- If you can, avoid staying too long in busy areas and near highways.
- If children play outdoors, keep them away from highways or construction sites.
- If you have the possibility to move and change locations, contact the ARPA of your region or the one you wish to go to to find out the data on the air quality of the different locations.
Step 7. Consider your medications
If you are taking certain medications, check to see if your asthma symptoms have worsened since the start of therapy. If so, consult your doctor before you think about stopping treatment, reducing your dosage, or changing your medication.
- Some research has shown that aspirin and ibuprofen can cause lung constriction in asthmatic patients sensitive to these drugs.
- ACE inhibitors prescribed to control high blood pressure do not cause asthma, but they do cause a dry cough that can be mistaken for it. However, excessive coughing from these medications can irritate the lungs and trigger an asthma crisis. The most common ACE inhibitors are ramipril and perindopril.
- Beta blockers are taken to treat heart problems, high blood pressure and migraines; these too can cause a constriction of the pulmonary passages. Some doctors may prescribe these drugs even in the presence of asthma; the important thing is to monitor any changes or symptoms. The most common beta blockers are metoprolol and propranolol.
Step 8. Maintain a normal weight
Research has confirmed a correlation between weight gain and an increased risk of asthma. Excess weight makes breathing more difficult and increases the effort of the heart to pump blood around the body. This causes an increase in inflammatory proteins (cytokines) in the body, facilitating the development of inflammation of the airways and chest constriction.
Part 2 of 4: Recognizing Mild and Moderate Symptoms
Step 1. Contact your doctor, even if your symptoms are mild
The first symptoms are usually not particularly severe to interfere with normal activities or everyday life. However, when the disorder begins to progress, you notice greater difficulty in carrying out ordinary daily activities. In most cases the symptoms do not change, but only become more intense and disabling.
If not diagnosed or treated, these early, mild symptoms of asthma get worse over time. This is especially true if you fail to recognize the triggers and avoid them
Step 2. Pay attention to excessive coughing
With asthma, the airways are blocked due to constriction or inflammation; the body then reacts by trying to clear the respiratory passages by coughing. In the case of a bacterial infection, coughs are greasy with a lot of mucus, while in the presence of asthma they tend to be dry, with very little phlegm.
- If the cough starts or gets worse during the night, it could actually be asthma; in fact, night cough or cough in the morning as soon as you wake up is a typical symptom of this disorder.
- As asthma progresses and worsens, the cough also extends throughout the day.
Step 3. Listen to the noise you make as you exhale
Asthmatics often hear a high-pitched hiss or whistle during the exhalation phase, which is caused by the reduction in the diameter of the air passages. Be careful when you hear this sound; if it occurs in the last phase of exhalation it is an early sign of asthma. When the problem escalates from light to moderate, hissing is heard throughout the exhalation.
Step 4. Take note of unusual shortness of breath
Exercise-induced bronchoconstriction, or exertional asthma, is a type of asthma that occurs in those who have just done some particularly demanding activity, such as exercise. The constriction of the airways causes a feeling of tiredness and leaves you breathless earlier than normal; as a result, you may be forced to quit the business sooner than you wish. Try to compare how long you can train normally and how many times you feel tired and out of breath.
Step 5. Pay attention to rapid breathing
In order to try to assimilate more oxygen through the narrowed respiratory channels, the body instinctively breathes faster. Place a palm on your chest and count how many times your chest rises in one minute. Use a stopwatch or a watch that indicates the seconds to make an accurate count. In normal breathing, you should typically count between 12 and 20 breaths in 60 seconds.
In case of moderate asthma, the breaths in one minute are about 20-30
Step 6. Don't overlook cold or flu symptoms
Although cough from asthma is different than cough caused by a cold or flu, bacteria or viruses can still trigger asthma. Look out for symptoms of infections that can cause this disorder: sneezing, runny nose, sore throat, and congestion. If you expel dark, green, or white mucus, the infection can be bacterial; if it is transparent or white, it can be viral.
- If these symptoms are associated with noise when exhaling or wheezing when you breathe, the infection probably triggered asthma.
- Visit your doctor for an accurate diagnosis.
Part 3 of 4: Recognizing the Severe Symptoms
Step 1. See your doctor if you can't breathe even without exercising
In asthmatics, shortness of breath or shortness of breath caused by exercise usually improves with rest. However, when symptoms are severe or an asthma attack is in progress, you may suffer from wheezing even at rest due to the inflammatory process that induced the seizure. When the inflammation is quite severe, you suddenly feel out of breath or gasp with air hunger.
- You may also experience the sensation of not being able to exhale fully. When the body needs oxygen and inhales air, it tends to reduce the exhalation phase so that it absorbs oxygen more quickly.
- You may also find that you cannot pronounce a complete sentence, but that you can only use short words and phrases between gasps.
Step 2. Check your breathing rate
During mild or moderate asthma attacks, breathing may be accelerated, but in a severe seizure this pace can become even faster. Constrained airways prevent a sufficient supply of fresh air to the lungs, resulting in a shortage of oxygen. Faster breathing is the body's natural reaction to take in as much oxygen as possible and remedy the situation before suffering more serious problems.
- Place your palm on your chest and count how many times your chest rises and falls in one minute. Use a stopwatch or watch that also appreciates seconds, so you can record data more accurately.
- In the event of a severe attack, the rate exceeds 30 breaths per minute.
Step 3. Measure your heart rate
Blood absorbs the oxygen that organs and tissues need from the air in the lungs, distributing it throughout the body. During a severe attack, when the blood fails to ensure an adequate supply of oxygen to the body, the heart has to pump faster in an attempt to make up for this deficiency. So, during a severe attack, you may feel that your heart rate speeds up without any real reason.
- Extend your hand with the palm facing up.
- Place the index and middle fingers of the other hand on the outside of the wrist, under the thumb.
- You should feel a rapid pulse throbbing from the radial artery.
- Calculate your heart rate by counting the beats per minute. In a normal situation it should be less than 100 per minute, but in the presence of severe asthma symptoms it can also be over 120.
- There are some smartphone apps that can measure your heart rate. If you are interested, you can download some.
Step 4. Check if the skin appears bluish
Blood is bright red only when it carries oxygen, otherwise it is much darker. We can only see it when it is outside the body, where it comes into contact with oxygen again and returns to a bright color; this is why we are not used to thinking it of other colors. During a severe asthma attack, however, you may become "cyanotic" due to the dark, oxygen-starved blood flowing through your arteries. The skin appears bluish or grayish, especially on the lips, fingers, nails, gums or around the eyes where it is thin.
Step 5. Check if you are contracting your neck and chest muscles
When you have difficulty breathing or are in respiratory failure, activate accessory muscles (those that are usually not essential for breathing). These are the muscles on the sides of the neck: the sternocleidomastoid and the scalene. See if your neck muscles are swollen when you realize you are short of breath. Also pay attention to the intercostal muscles, because in moments of air hunger they are contracted inwards. These are the muscles that help lift the rib cage on inhalation, and you may notice that they retract between the ribs when the situation is severe.
Look in the mirror to check the muscles on both sides of the neck if they are very outlined and if the intercostal ones are retracted
Step 6. Pay attention to chest pain and tension
When you have a lot of difficulty breathing, the chest muscles that work to ensure breathing have to work under strain. As a result, they tire and cause pain and tension. The pain may feel dull, sharp, or stabbing and may occur around the mid-chest area (sternum area) or slightly outside (parasternal area). If you experience this pain you should go to the emergency room immediately to rule out any heart problems.
Step 7. See if the breathing noise gets worse
When symptoms are mild or moderate, whistling and wheezing are noticeable only on exhalation. However, in the case of more severe asthma, you can also feel them when inhaling. The whistling sound during inhalation is called "stridor" and is caused by constriction of the throat muscles in the upper respiratory tract. Dyspnea, on the other hand, occurs more often during exhalation and is caused by constriction of the muscles in the lower respiratory tract.
- The noise you hear while breathing in can be caused by both asthma and severe allergic reactions. It is important to be able to distinguish between them, in order to find the appropriate type of treatment.
- Check for signs of hives or red rashes on the chest, as these indicate an allergic reaction and not an asthma attack. Edema of the lips or tongue are also indicative of allergies.
Step 8. Treat your asthma symptoms as soon as possible
If you have a severe asthma attack that makes it difficult for you to breathe, you need to call 911 and go to the nearest emergency room right away. If you have never been diagnosed with this disorder before, you probably won't have a life-saving inhaler with you. If not, though, use it.
- Salbutamol inhalers should only be used 4 times a day, but during an attack you can use them as often as needed every 20 minutes for 2 hours.
- Take slow, deep breaths, mentally counting to 3 on both the inhale and exhale phases. By doing this, you can reduce stress and respiratory rate.
- Avoid exposing yourself to triggers if you can spot them.
- Your asthma can be reduced if you take steroids that your doctor prescribes. These drugs can be inhaled through a pump or taken orally. Spray the medicine or take it as a tablet with water. It will take a few hours for it to start working, but it can keep the symptoms under control.
Step 9. Seek immediate medical attention for severe symptoms
In this case it means that you are experiencing a dangerous asthma attack and the body is struggling to assimilate enough air. You must go to the emergency services right away, as the problem can become very serious if not treated promptly, even to the point of being fatal.
Part 4 of 4: Getting a Diagnosis
Step 1. Provide your doctor with your entire medical history
Try to be as precise and accurate as possible so that the doctor can get a general idea of the problems you are suffering from. You should prepare your arguments in advance so that you don't have to think too much about these questions when you visit his studio:
- Any signs or symptoms of asthma (cough, wheezing, noises while breathing, etc);
- Previous medical history (previous allergies, etc.);
- Family medical history (lung problems or allergies of parents, siblings, etc.);
- Your lifestyle habits (use of tobacco, diet and physical activity, surrounding environment, etc.);
- Any medications (such as aspirin) and any supplements or vitamins you take.
Step 2. Get a medical examination
During the exam, doctors may check some or all of these parts of the body: ears, eyes, nose, throat, skin, chest, and lungs. He may also use the stethoscope on the front and back of the chest to listen for breathing sounds or even note the absence of sound in the lungs.
- Since asthma is related to allergies, the doctor may also check for rhinorrhea, conjunctival hyperaemia, lacrimation, and skin rashes.
- Finally he will also examine your throat to see if it is swollen and to determine your ability to breathe; it will also take note of any abnormal sounds, which could indicate a constriction of the airways.
Step 3. Let the doctor confirm the diagnosis by performing the spirometry test
During the test you have to breathe into a tube connected to a spirometer that measures your airflow and how much air you can inhale and exhale. Take a deep breath and exhale forcefully for as long as possible as the device calculates the power. Although, in the event of a positive result, the presence of asthma is certain, a negative result does not automatically rule it out.
Step 4. Do the peak expiratory flow test
This test is similar to spirometry and measures how much air you can exhale. Your doctor or pulmonologist may recommend this test to help you get a clear diagnosis. To take the test, you need to put your lips on the opening of a device that is zero-calibrated. Stand upright and take a deep breath, then blow as hard and as fast as you can in a single exhalation. The procedure must be repeated a few times, in order to obtain consistent results. To obtain valid results for the test, the largest value detected, which is the peak respiratory flow, must be considered. When you feel that asthma symptoms are arising, repeat the test and compare this airflow to the previously detected peak flow.
- If the value is more than 80% of the best peak flow detected, you are in a safe range.
- If the reading is between 50 and 80% of the best peak flow found under normal conditions, you are not following adequate treatments for asthma and your doctor will need to find other more suitable medications. If you fall within this range, you have a moderate risk of suffering from an asthma attack.
- If the resulting value is less than 50% of the best peak flow, it means that you have a severe respiratory disease that needs to be treated with medication.
Step 5. Ask your doctor to perform the methacholine bronchial challenge test
If you don't have obvious symptoms when you go to the doctor, it may be difficult to diagnose asthma. If that's the case, it's worth doing this test, where your doctor will give you an inhaler containing methacholine. This substance causes the airways to constrict if you have asthma, and triggers symptoms that can be measured with peak airflow tests and spirometry.
Step 6. Check the body's response to asthma medications
Your doctor doesn't always decide to undergo these tests and may simply give you medications to improve your condition. If your symptoms subside, you are likely to have asthma. The severity of symptoms, a previous history of asthma episodes, and the results of physical tests are the main factors that a doctor considers when choosing a drug.
- A very popular device is the albuterol / salbutamol-based inhaler which is used by placing the lips on the opening and spraying the drug, which is then inhaled into the lungs.
- Bronchodilator drugs help open the constricted airways thanks to their dilating action.
