Symptoms of Asthma
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times, such as when exercising, or have symptoms all the time.
- shortness of breath,
- chest tightness or pain,
- wheezing when exhaling, which is a common sign of asthma in children
- trouble sleeping caused by shortness of breath, coughing or wheezing,
- coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu.
- typical Asthma signs and symptoms that are more frequent and bothersome,
- increased difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter),
- the need to use a quick-relief inhaler more often.
- Exercise-induced Asthma: may be worse when the air is cold and dry.
- Occupational Asthma: triggered by workplace irritants such as chemical fumes, gases, or dust.
- Allergy-induced Asthma: triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander).
When to Contact your Doctor
If you think you have Asthma: if you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of Asthma, see your Doctor or Primary Healthcare Provider. Treating Asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.
To monitor your Asthma after diagnosis: if you know you have Asthma, work with your Doctor or Primary Healthcare Provider to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening attack.
If your Asthma symptoms get worse: contact your Doctor or Primary Healthcare Provider right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often.
Don't take more medication than prescribed without consulting your Doctor or Primary Healthcare Provider first. Overusing asthma medication can cause side effects and may make your asthma worse.
To review your treatment: Asthma often changes over time. Meet with your Doctor or Primary Healthcare Provider regularly to discuss your symptoms and make any needed treatment adjustments.
When to Seek Emergency Medical Assistance
- rapid worsening of shortness of breath or wheezing,
- no improvement even after using a quick-relief inhaler,
- shortness of breath when you are doing minimal physical activity.
It isn't clear why some people get Asthma and others don't, but it may be due to combination of environmental and inherited (genetic) factors.
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of Asthma and can include:
- airborne allergens such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste,
- respiratory infections, such as the common cold,
- physical activity,
- cold air,
- air pollutants and irritants, such as smoke,
- certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve),
- strong emotions and stress,
- sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine,
- Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat.
Diagnosis of Asthma
Your Doctor or Primary Healthcare Provider will perform a physical exam to rule out other possible conditions, such as a respiratory infection or Chronic Obstructive Pulmonary Disease (COPD). They will also ask you questions about your signs and symptoms and about any other health problems.
You may be given lung function tests to determine how much air moves in and out as you breathe.
Spirometry: this test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
Peak flow: a peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign that your lungs may not be working as well and that your asthma may be getting worse. Your Doctor or Primary Healthcare Provider will give you instructions on how to track and deal with low peak flow readings.
Lung function tests often are done before and after taking a medication to open your airways, called a bronchodilator. If your lung function improves with use of a bronchodilator, it's likely you have Asthma.
- methacholine challenge,
- imaging tests,
- allergy testing,
- nitric oxide test,
- sputum eosinophils,
- provocative testing (exercise and cold-induced Asthma).
There are several risk factors that are suspected to increase your chances of developing Asthma including:
- having a blood relative with asthma, such as a parent or sibling,
- having another allergic condition, such as atopic dermatitis which causes red, itchy skin or hay fever, which causes a runny nose, congestion, and itchy eyes,
- being overweight,
- being a smoker,
- exposure to second-hand smoke,
- exposure to exhaust fumes or other types of pollution,
- exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing.
- Signs and symptoms that interfere with sleep, work and other activities.
- Sick days from work or school during Asthma flare-ups.
- A permanent narrowing of the tubes that carry air to and from your lungs (bronchial tubes), which affects how well you can breathe.
- Emergency room visits and hospitalizations for severe Asthma attacks.
- Side effects from long-term use of some medications used to stabilize severe Asthma.
- Follow your Asthma Action Plan.
- Get vaccinated for Influenza and Pneumonia.
- Identify and avoid Asthma triggers.
- Monitor your breathing.
- Identify and treat Asthma attacks early.
- Take your medication as prescribed.
- Pay attention to increasing quick-relief inhaler use.
Prevention and long-term control are key to stopping Asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid triggers, and tracking your breathing to make sure your medications are keeping symptoms under control. In case of an Asthma flare-up, you may need to use a quick-relief inhaler.
Speak with your Doctor or Primary Healthcare Provider about creating an “Asthma Action Plan”, which outlines when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. This document should include a list of your specific triggers and the steps you need to take to avoid them.
Your Doctor or Primary Healthcare Provider may also recommend tracking your Asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your Asthma.
Your treatment should be flexible and based on changes in your symptoms. Your Doctor or Primary Healthcare Provider should ask about your symptoms at each visit. Based on your signs and symptoms, your treatment can be adjusted accordingly.
The right medications for you depends on several factors including your age, symptoms, Asthma triggers, and what works best to keep your Asthma under control.
Preventive, long-term control medications reduce the swelling (inflammation) in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.
Long-term Asthma control medications, generally taken daily, are the cornerstone of Asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack.
- inhaled corticosteroids,
- leukotriene modifiers,
- combination inhaler,
Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an Asthma attack. They may also be used before exercise if your doctor recommends it.
- short-acting beta agonists,
- anticholinergic agents,
- oral and intravenous corticosteroids.
If you have an Asthma flare-up, a quick-relief inhaler can ease your symptoms right away. However, you shouldn't need to use your quick-relief inhaler very often if your long-term control medications are working properly. Keep a record of how often you use your quick-relief inhaler each week. If you use it more often than recommended, contact your Doctor or Primary Healthcare Provider to discuss adjusting your long-term control medication.
Allergy medications may also help if your Asthma is triggered or worsened by allergies. These can include allergy shots (immunotherapy) and biologics.
Lifestyle and Home Remedies
Although many people with Asthma rely on medications to prevent and relieve symptoms, there are several things that you can do to maintain your health and lessen the possibility of Asthma attacks.
Avoid Your Triggers
Taking steps to reduce your exposure to Asthma triggers is a key part of asthma control.
Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep your windows closed during pollen season.
Minimize dust that may worsen nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses, and box springs in dust-proof covers. Avoid using down-filled pillows and blankets. Throughout the house, remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds.
If you live in a damp climate, talk to your doctor about using a dehumidifier.
Clean damp areas in the bathroom, kitchen and around the house to keep mold spores from developing. Get rid of moldy leaves or damp firewood in the yard.
If you're allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed may also reduce the amount of dander in your surroundings.
Clean your home at least once a week. If you're likely to stir up dust, wear a mask or have someone else do the cleaning. Wash your bedding regularly.
If your asthma is worsened by cold or dry air, wearing a face mask can help.
- Asthma Canada
- Asthma – Preventing and Managing Chronic Disease – Ministry of Health and Long-Term Care
- Asthma – Resources and Support – Children’s Hospital of Eastern Ontario (CHEO)
- Breathe – Asthma – The Canadian Lung Association
- Creating Asthma Friendly Environments – Healthy Schools Healthy Communities
- Health Quality Ontario – Asthma in Adults
- OASIS – Ontario Asthma Surveillance Information System