What Is Asthma? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Asthma is a common chronic (long-term) lung disease in which the lungs’ bronchial tubes, or airways, become inflamed.

This inflammation causes the airways to become sensitive to?environmental triggers, such as dust, smoke, pet dander, or cold air.

In reaction to these triggers, an asthma attack can occur. The muscles around the bronchial tubes tighten, the lining of the airways becomes inflamed, and the airways overproduce?mucus, making it difficult to breathe.

Want to know more about asthma? Read on to learn what experts know about this breathing disorder, why some people develop it and others don’t, lifestyle changes that can help you manage asthma, and how to avoid complications linked to the condition.

Do You Know What Type of Asthma You Have?

Asthma is a disease that affects your airways, which carry air in and out of your lungs. The type of asthma you have depends on your specific triggers.

Thanks to advances in asthma research, doctors have been able to identify the different types of asthma. The most common types of asthma are: exercise-induced bronchospasm?(EIB), allergic asthma, nonallergic asthma, cough-variant asthma, occupational asthma, and nocturnal or nighttime asthma. EIB occurs after physical exertion. It’s not always easy to determine which type of asthma you have. Proper diagnosis and regular communication with your doctor can help you to determine the best course of action.

Asthma is a chronic lung disease, so it’s important to receive treatment as soon as possible to ensure that your condition doesn’t worsen.

Learn More About the Types of Asthma

How to Tell if Your Asthma Is Severe

Doctors differentiate severe asthma from other, milder forms of asthma according to the frequency and intensity of a person’s symptoms.

For starters, severe asthma is persistent, which doctors define as asthma that causes symptoms more than twice a week, explains Patricia Takach, MD, an associate professor of clinical medicine in the section of allergy and immunology at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia. For many severe asthma sufferers, symptoms occur daily.

Also, people with severe asthma require a mixture of medications that includes a high-dose inhaled corticosteroid or a systemic (oral) corticosteroid.

?Around the world, about 4 to 5 percent of people with asthma have severe asthma.

Also, and somewhat confusingly, severe asthma is not the same as a “severe acute asthma” attack or episode. This term refers to an asthma attack that is so severe that it requires immediate medical attention.

Learn More About Severe Asthma and How to Manage It

Signs and Symptoms of Asthma

Coughing??Wheezing? Chest pain? If these symptoms sound familiar, it might be asthma, a chronic disease that inflames the airways (bronchial tubes) that carry air in and out of the lungs.

When something triggers your asthma symptoms, the membrane lining your airways swells, the muscles around the tubes constrict, and the airways fill with mucus. As these tubes narrow it becomes more difficult to breathe, causing symptoms such as wheezing and coughing, congestion, shortness of breath, and chest tightness or pain. If you have asthma, performing normal daily activities can be strenuous, and it may take longer to recover from a respiratory infection, such as a cold or flu.

An asthma attack or flare-up is a sudden worsening of these symptoms, including severe wheezing, uncontrollable coughing, rapid breathing, sweating, and anxiety. These symptoms require immediate medical attention.

But not everyone experiences asthma in the same way. Symptoms vary from person to person, can change with age, differ between attacks and may intensify during exercise, with a cold, or under periods of elevated stress.

Learn More About Signs and Symptoms of Asthma

Illustrative graphic titled How Asthma Affects the Body shows Trouble Breathing, Wheezing, Coughing, Chest Tightness. Everyday Health logo
Asthma causes these main symptoms, which may be present some or all of the time and vary in severity.?

Causes and Risk Factors of Asthma and Asthma Attacks

It’s unknown what exactly causes asthma, but scientists believe that both genetic and environmental factors play a role in the development of the disease.

Why Do You Have Asthma?

Asthma tends to run in families, suggesting there’s an?inherited component to the disease.

You’re more likely to have asthma if your parents have it.
You’re also more likely to have asthma if you have atopic syndrome, or atopy — a predisposition toward certain allergic hypersensitivity reactions, such as atopic eczema and hay fever (allergic rhinitis).

Asthma and?allergies?often go hand in hand.
normal, asthmatic, and asthma attack airways
Having asthma causes the membrane lining in the airways to swell. During an asthma attack, the swelling increases, the muscles around the airways constrict, mucus fills the airways, and breathing becomes more difficult.Shutterstock

Having certain respiratory infections during infancy or early childhood is another risk factor for asthma. These infections can cause inflammation in the lungs and can damage lung tissue, affecting lung function later in life.

Similarly, research suggests that early contact with airborne allergens, irritants, and certain viral infections — in infancy or early childhood, before the immune system is fully developed — raises your risk of developing asthma.

What Triggers an Asthma Attack?

Numerous triggers can cause asthma attacks, including:

Tobacco Smoke While smoking is unhealthy for anyone, it’s particularly dangerous for people with asthma. If you smoke, you should quit. Secondhand smoke can also trigger an asthma attack. Avoid situations in which people around you smoke. Also don’t let people smoke in a place where you spend a lot of time, such as your home or car — even if you’re not present when they smoke.

Smoke From Wood or Grass Even though it may seem “natural,” smoke from these sources contains harmful gases and particles. Avoid burning wood in your home. If you live in an area where wildfires occur, monitor air quality forecasts and try to stay inside when particle levels are at their worst.

Outdoor Air Pollution Emissions from factories, cars, buses, lawn mowers, leaf blowers, and snow blowers can all trigger an asthma attack. Try to avoid exposure to these sources whenever possible.

It’s also a good idea to check air quality measurements related to pollution in your area, such as ozone and small particles, and to stay inside as much as possible when they’re elevated.

Certain Foods and Food Additives While almost any food can cause an allergic reaction, a few additives (like sulfites and other preservatives) are widely believed to cause adverse reactions in some people. Acid reflux can also trigger an asthma attack in some people, so any food that aggravates this condition may also be responsible for symptoms.

Respiratory Infections These include influenza (flu), the COVID-19 virus, the common cold, respiratory syncytial virus (RSV), and sinus infections.

Strong Emotional States Negative emotions like stress, anxiety, depression, or fear can cause an attack, often by causing hyperventilation (heavy, fast breathing).

Certain Medications While different people have different triggers, common culprits include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve).

Learn More About Causes of Asthma and Asthma Attacks: Common Risk Factors, Genetics, and More

How Is Asthma Diagnosed?

If you notice yourself having trouble breathing, wheezing, or having chest tightness, let your doctor know so he or she can determine if you have asthma or if something else is wrong. In some cases your primary care provider will refer you to a specialist for a diagnosis.

Diagnosing asthma typically involves your doctor taking your personal and medical history (asking you questions about your symptoms, asking you about your health history, and asking you about your family history); a physical exam (during which the doctor will listen to you breathe); and a pulmonary function test (a type of breathing test to evaluate your lung function).

Your doctor may run additional tests to help determine the type of asthma you have and to determine the severity of it. The type of asthma and its severity will help the doctor come up with an appropriate treatment plan for you.

In rarer cases, your doctor may also use a breath test called a fractional exhaled nitric oxide (FeNO) test to assess the level of inflammation in your lungs if it’s not clear whether you have asthma based on the results of other tests.

In younger children, doctors may diagnose asthma based on only symptoms, a family history, and a physical exam. Though in children 5 years old and older, the steps taken to diagnose asthma tend to be the same as in adults.

Learn More About Diagnosing Asthma: Tests and Screenings, Early Diagnosis, and Your Doctors

Duration of Asthma

For adults with asthma, the condition is usually chronic — meaning they will have it for the rest of their life. A 2015 study found that only 3 percent of adults who had developed asthma experienced a remission of their symptoms during 12 years of follow-up.

The prognosis for asthma is different for children than for adults.

Some kids who develop asthma “lose” it as they grow older.

While asthma may return later in life for some of them, many never have an asthma recurrence.

But for others, especially kids with severe asthma, the condition may not ever go away.

For all these reasons, the long-term prognosis for someone with asthma varies a lot. Some people get better over time — though their symptoms never fully go away — while others get worse, says Emily Pennington, MD, a pulmonologist and asthma specialist at the Cleveland Clinic in Ohio.

Fortunately, by working closely with a doctor to manage symptoms — with medication, and also by avoiding asthma triggers — most people with asthma can live a normal, healthy life free of asthma-related complications.

Treatment and Medication Options for Asthma

There is no cure for asthma, but you can alleviate and prevent your symptoms through quick-relief and long-term control medication. Long-term control medication works to reduce inflammation to make your airways less sensitive to asthma triggers. It’s usually taken daily through an inhaler or as an oral pill. Quick-relief medicines help to relieve symptoms when they happen, relaxing the tight muscles around your airways and easing the flow of air.

The asthma management guidelines, updated in December 2020 by the National Asthma Education and Prevention Program, recommend using one inhaler containing an asthma medication that combines an inflammation-reducing corticosteroid plus the drug formoterol to open airways for people ages 12 and older — teens and adults whose moderate to severe persistent asthma is not well controlled with their current medication. This combination therapy is called single maintenance and reliever therapy (SMART).

The updated guidelines also recommend a type of drug called a long-acting muscarinic antagonist to improve symptoms as an alternative for these age groups when standard combination therapy cannot be used. And for young children (up to age 4) who wheeze only when they have a respiratory tract infection (regardless of whether or not they’ve been diagnosed with asthma), the new guidelines recommend a short course of inhaled corticosteroids plus a rescue inhaler as needed. This can prevent worsening of breathing problems and forestall the need for corticosteroid pills.

Most asthma medications are breathed in through the use of an inhaler or nebulizer. There are two main types of inhalers; a metered dose inhaler (MDI), which uses a pressurized medicine-filled canister, and a dry powder inhaler (DPI), containing medicine in powdered form. A nebulizer uses a mask and delivers medication as a mist. It’s important to learn the different techniques for using these devices to ensure the medicine reaches your lungs.

There are few evidence-backed natural remedies for asthma, particularly if your case is severe. But lifestyle changes, like controlling stress, and some complementary therapies, like acupuncture, may help manage symptoms.

If your asthma is triggered by allergies, doing all you can to reduce your exposure to your trigger allergen — such as pollen, pet dander, dust mites, or cockroaches and rodents — may help. Allergy shots may help, too.

Learn More About Treatment for Asthma: Medication, Alternative and Complementary Therapies, and More

Prevention of Asthma

Doctors aren’t sure why asthma develops in the first place. The condition seems to stem from a mixture of genetic and environmental factors. That said, there are established risk factors for asthma. Avoiding them may lower your risk for developing the disease.

Breathing in air pollution and airborne allergens, irritants, or toxins can raise a person’s risk for developing asthma.

It’s possible that avoiding airborne pollens, mold, chemicals, and traffic-related pollution may lower your risk of developing asthma in the future.

Obesity is also a major risk factor for asthma. Again, doctors aren’t sure exactly how obesity contributes to the development of asthma. Research from 2020 found that obesity promotes systemic inflammation, which could contribute to asthma.

But more research is needed to firm up these links. Regardless, maintaining a healthy weight through diet and exercise can reduce your risk of developing asthma.
If you already have asthma and you’re hoping to prevent symptoms or flare-ups, there are a number of effective ways to go about this:

  • Follow your doctor’s instructions when it comes to taking your medication and avoiding your asthma triggers.

  • Get vaccinated. Viruses and infections can trigger flare-ups. You can lower your odds of developing one of these triggers by getting your seasonal flu shot and other scheduled vaccinations.
  • Monitor your asthma.?Keeping tabs on your condition using a peak airflow meter can help you spot and head off impending flare-ups.
  • Keep an eye out for warning signs.?A cough or frequent inhaler use are two signs that a bad flare-up is in the cards. Recognizing these sorts of red flags can help you take steps to prevent a bad attack.

Complications of Asthma

For most people with asthma, using medications (like inhaled corticosteroids) and making certain lifestyle changes (like quitting smoking and maintaining a healthy weight) will allow them to manage their symptoms and avoid most short- and long-term complications.

But poorly managed or poorly treated asthma can result in additional problems. In the short-term those problems can include severe asthma attacks, disruption to normal activities, and increased risk of pneumonia and other lung infections. Farther down the line, problems can include permanent airway damage, mental health problems, weight gain, and increased risk of other chronic illnesses.

Learn More About the Complications of Asthma: How It Affects Your Body in the Short and Long Term

Research and Statistics: How Many People Have Asthma?

In 2020, more than 25 million people in the United States — or 7.8 percent of the population — had asthma, according to the Centers for Disease Control and Prevention (CDC).

More than 21 million of these people were adults age 18 or older.

About 41 percent of people with asthma reported having at least one asthma attack in 2020.

In 2020, asthma attacks resulted in about 1.2 million emergency room visits and 4,145 deaths in the United States.

On a global scale, about 262 million people have asthma, according to the World Health Organization.

BIPOC Communities and Asthma

Though asthma can affect people of all races and backgrounds, in the United States asthma is more likely to affect racial and ethnic minority groups, and outcomes are worse for these individuals. Children and adults who are Black, Hispanic (particularly people of Puerto Rican descent), and of Indigenous descent develop asthma more often, experience more severe and life-threatening asthma-attack emergencies, and have higher asthma-related death rates than white people and other racial and ethnic groups in America.

The causes driving these disparities are multifactorial.

One study from 2019 showed that Black children, teens, and adults with asthma were twice as likely as white Americans with asthma to visit the emergency room for an asthma emergency, owing to socioeconomic differences that made access to healthcare and asthma treatments more difficult for Black families.

Until recently there has been a lack of research into the biology and genetics of asthma in Black, Indigenous, and People of Color (BIPOC) groups, which has led to widespread one-size-fits all asthma treatment. For example, a study from 2018 found that albuterol, a widely used asthma drug that opens air passages, is significantly less effective in people of African descent than in people of other racial backgrounds.

And a 2020 report from the Asthma and Allergy Foundation of America (AAFA) — a comprehensive overview that looked closely at 15 years of national data about asthma cases, severity, and deaths — concluded that systemic racism, discriminatory housing policies, and environmental injustice also all contribute to these disparities in asthma prevalence and outcomes.

“Poverty, exposure to pollution, and limited access to medical care play a big role in racial disparities in asthma,” says Kenneth Mendez, AAFA’s president and CEO.

“These factors are interrelated and intergenerational,” he explains. Discriminatory housing policies, for example, have caused long-lasting residential segregation, in which poverty is concentrated in Black and Hispanic communities, which then perpetuates a cycle of limited access to education, employment, and quality healthcare services, he says. This residential segregation is also responsible for the disproportionate proximity of minority populations to sources of pollution, such as industrial centers, major roadways, oil and gas refineries, distribution hubs, and traffic-related pollution, which can put people at higher risk for asthma and having worse outcomes, Mendez explains.

AAFA’s report found that while rates of developing and dying from asthma declined in many BIPOC communities in the past decade, enormous disparities persist that need immediate attention from healthcare practitioners, researchers, and the American healthcare system. The AAFA report uses federal health data from several sources, including the National Vital Statistics System, National Health Interview Survey, National Hospital Discharge Survey, and others. The data comes from the CDC and from the U.S. Department of Health and Human Services. The findings include:

  • While the asthma rate among white Americans is about 7.6 percent, according to the AAFA report, it’s 10.6 percent among Blacks and 14.9 percent among Puerto Ricans — the highest rate among all racial and ethnic groups.
  • The number of asthma deaths per one million people is highest for Black Americans, at 23.9, followed by Puerto Ricans at 21.8, Hispanic Americans at 8.4 and white Americans at 7.4.
  • Emergency-room visits for asthma — a sign of asthma that’s not well-controlled — were five times higher for Black Americans compared with white Americans in 2017. The rate was 164.3 ER visits per 10,000 people for Black Americans, compared with 33.9 for white Americans. According to the U.S. Department of Health and Human Services Office of Minority Health, Hispanic Americans are twice as likely to visit the ER for asthma compared with non-Hispanic white Americans.

  • There’s little data on asthma’s effects in indigenous communities in the United States, but the AAFA report states that “tribal nations have among the highest rates of asthma prevalence, morbidity, and mortality.”

Conditions Related to Asthma

Asthma can be associated with several other conditions and health problems. In some cases, asthma can increase the likelihood of certain illnesses, like:

  • Bronchitis
  • Pneumonia

Additionally, there are some illnesses and health conditions that appear to be linked to asthma in that people with one are more likely to have the other, like:

  • Allergies
  • COPD
  • Emphysema
  • Sleep apnea

Common Questions & Answers

What are some of the main causes of asthma?
The exact cause of asthma is unknown, although it tends to run in families, suggesting a genetic component. Exposure to allergens also triggers symptoms of asthma. Some of the most common asthma triggers include pollen, air pollutants, smoke, foods, respiratory infections, and medications.
Can you die from having an asthma attack?
If you don’t get immediate treatment during an asthma attack, your lungs can tighten up so much that you will develop a blue color to your lips, signifying a lack of oxygen in your blood. This can lead to a loss of consciousness and death. Asthma deaths can be prevented with better routine care.
Is it possible to develop asthma later in life?
Asthma is common in children, but you can develop it at any point in your life. People who develop asthma as adults have what’s known as adult onset asthma. Adults generally have persistent symptoms and require daily medication to manage the condition.
How do you treat asthma?
Asthma treatments vary from oral medications to inhalers to injections to medication delivered in a breathing machine or nebulizer. Your medication will depend on the type of asthma you have and whether you are looking for immediate relief to control an asthma attack or need something to prevent symptoms from occurring.
Are there any good home remedies to treat asthma?
You should always take medications as prescribed by your doctor, but there are some remedies you can check out at home. Try a hot steam bath, which can clear up nasal congestion and airway irritation.?Some tout herbs with anti-inflammatory properties, such as garlic, ginger, licorice root, turmeric, and honey — but it’s important to always speak with your doctor before trying any herbal remedy,?as it may interact with prescribed medications.

Resources We Trust

  • Mayo Clinic: Allergies and Asthma: They Often Occur Together
  • Cleveland Clinic: Childhood Asthma
  • American Academy of Allergy, Asthma & Immunology:?Asthma and Pregnancy
  • American Lung Association: Asthma Treatment
  • Asthma and Allergy Foundation of America:?Asthma Triggers
Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. What Is Asthma? National Heart, Lung, and Blood Institute.
  2. Most Recent National Asthma Data. Centers for Disease Control and Prevention.
  3. International ERS/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma. European Respiratory Journal.
  4. What Is Severe Asthma? Asthma and Lung UK.
  5. Acute Severe Asthma Defined. American Academy of Allergy, Asthma & Immunology.
  6. The Atopic Disorders and Atopy … “Strange Diseases” Now Better Defined! Allergy and Asthma Proceedings.
  7. Asthma: Symptoms and Causes. Mayo Clinic.
  8. Asthma Triggers. Asthma and Allergy Foundation of America.
  9. Common Asthma Triggers. Centers for Disease Control and Prevention.
  10. Common Asthma Triggers. Centers for Disease Control and Prevention.
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  12. 2020 Focused Updates to the Asthma Management Guidelines: A Report From the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. The Journal of Allergy and Clinical Immunology.
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  25. Asthma and Hispanic Americans. U.S. Department of Health and Human Services Office of Minority Health.

Resources

  • What Is Asthma??National Heart, Lung, and Blood Institute.?March 24, 2022.
  • Most Recent National Asthma Data.?Centers for Disease Control and Prevention. December 13, 2022.
  • Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS?Guidelines on Definition, Evaluation and Treatment of Severe Asthma.?European Respiratory Journal.?February 2014.
  • What Is Severe Asthma??Asthma and Lung UK.?November 2022.
  • Acute Severe Asthma Defined.?American Academy of Allergy, Asthma & Immunology.
  • Bellanti JA, Settipane RA. The Atopic Disorders and Atopy … “Strange Diseases” Now Better Defined!?Allergy and Asthma Proceedings. July–August 2017.
  • Childhood Asthma: Symptoms and Causes. Mayo Clinic. April 5, 2023.
  • Asthma Triggers.?Asthma and Allergy Foundation of America. October 2019.
  • Common Asthma Triggers.?Centers for Disease Control and Prevention. December 12, 2022.
  • Asthma Diagnosis.?Asthma and Allergy Foundation of America. June 2022.
  • Tuomisto L, Ilmarinen P, Niemela O, et al.?A 12-Year Prognosis of Adult-Onset Asthma: Seinajoki?Adult-Onset Asthma Study.?European Respiratory Journal. September 2015.
  • Asthma in Infants and Young Children.?Asthma and Allergy Foundation of America.
  • Asthma: Outlook/Prognosis.?Cleveland Clinic. January 19, 2022.
  • Asthma: Symptoms and Causes.?Mayo Clinic. March 5, 2022.
  • Asthma Causes and Risk Factors.?American Lung Association. April 19, 2023.
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  • Asthma Action Plan.?American College of Allergy, Asthma & Immunology.
  • National Center for Health Statistics: Asthma.?Centers for Disease Control and Prevention. January 24, 2023.
  • Asthma.?World Health Organization. May 4, 2023.
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Jon E. Stahlman, MD

Medical Reviewer

Jon E. Stahlman, MD, has been a practicing allergist for more than 25 years. He is currently the section chief of allergy and immunology at Children’s Healthcare of Atlanta's Scottish Rite campus and the senior physician at The Allergy & Asthma Center in Atlanta. He served as the president of the Georgia Allergy Society, has been named a Castle Connolly Top Doctor, and was listed as a Top Doctor by Atlanta magazine. His research interests include new therapies for asthma and allergic rhinitis as well as the use of computerized monitoring of lung function.

He received his bachelor's and medical degrees from Emory University. He completed his pediatric residency at Boston Children’s Hospital and his fellowship in allergy and clinical immunology at Harvard University’s Boston Children’s Hospital and Brigham and Women’s Hospital. After his training, Dr. Stahlman conducted two years of clinical research at Boston Children’s Hospital and was part of the faculty at Harvard Medical School, where he taught medical students and allergy and immunology fellows.

Stahlman is board-certified and recertified in allergy and clinical immunology. He served as a principal investigator on phase 2 through 4 studies that are responsible for most of the U.S. Food and Drug Administration–approved therapies for allergies and asthma available today.

Outside of the office, he centers his interests around his wife and three daughters, coaching soccer for many years, and his hobbies include cycling and triathlons.

Joseph Bennington-Castro

Author

Joseph Bennington-Castro is a science writer based in Hawaii. He has written well over a thousand articles for the general public on a wide range topics, including health, astronomy, archaeology, renewable energy, biomaterials, conservation, history, animal behavior, artificial intelligence, and many others.

In addition to writing for Everyday Health, Bennington-Castro has also written for publications such as Scientific American, National Geographic online, USA Today, Materials Research Society, Wired UK, Men's Journal, Live Science, Space.com, NBC News Mach, NOAA Fisheries, io9.com, and Discover.

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