Asthma is a very common respiratory illness impacting over 300 million people worldwide and 22 million adults in the United States. The symptoms are due to inflammation and an exaggerated response in the airways. This response can be life threatening and require intensive care level monitoring and treatment. The most common symptoms are wheezing and shortness or breath however patients may also experience chest tightness and cough. Common triggers for asthma include cold weather, exercise, animal dander, pollen, occupational exposures, foods and medications. The physical exam may reveal wheezing but it may be normal which can help to exclude alternative diagnoses. In some situations, a diagnostic test called spirometry is performed. During this specialized breathing tests, the volume and flow of air is measured during inhalation and exhalation. Variations on this test can include measuring these parameters after receiving an inhaled bronchodilator or alternatively measuring the parameters following exposure to a medication that can elicit an asthmatic response. Based on spirometry results as well as symptoms, the severity of the asthma is assessed and guides treatment. Typically, treatment begins with avoidance of the trigger that provokes the asthma. Frequently, patients will have an inhaled bronchodilator such as albuterol to use when needed (rescue inhalers). However, in more severe cases, patients may require controller inhalers. During acute exacerbations of asthma, patients may require steroid treatment.
Kerlin MP. In The Clinic: Asthma. Ann Intern Med. 2014. Mar 4; 160 (5)