How can I tell if I might have asthma?

Many people think that having asthma means constantly wheezing or being short of breath, and requiring frequent hospitalization. This is not the case -- usually symptoms are less dramatic but persistent:

  • Chronic dry, nonproductive cough
  • Cough with laughter
  • Night cough
  • Cough or chest tightness with exercise
  • Coughing for weeks or months after respiratory infections
  • Feeling like an elephant is sitting on your chest
  • Feeling you cannot take a full breath
  • Wheezing (a musical or squeaky sound in the chest on exhalation)

Is there anything I can do on my own to manage asthma?

Yes, although we wouldn't recommend trying to manage severe shortness of breath or wheezing without seeing your physician. The most common trigger for asthma is exertion, so if you are prone to exercise-induced asthma symptoms, it may help to warm up slowly prior to running, and slow down to a walk if you start to cough or feel short of breath. If you seem to be reacting to certain allergy triggers, such as pets or dust, avoidance may reduce your asthma symptoms.

For more severe symptoms, it is best to treat early with safe prescription medications that target the problem areas quickly and prevent further inflammation of the airways. You will end up with less medication in the long run if you are treated early and effectively, rather than waiting for symptoms to become chronic and debilitating.

But once I start taking asthma medications, won't I need them forever?

Not necessarily. If asthma triggers are eliminated or reduced, the need for medications may be lessened. That is why it is important to identify these triggers -- a chronic infection, allergies, gastric reflux, etc. Also, if allergic asthma is treated with immunotherapy ("desensitization" or "allergy shots"), a lasting immunity can be built against the airborne allergens that are now triggering your asthma.

What are common triggers of asthma?

By far the most common trigger for asthma is the common cold. Babies with wheezing or labored breathing triggered during respiratory infections are said to have "reactive airways". This may improve with age, but if bronchial inflammation is allowed to become chronic, asthma may be further triggered by:

  • exercise (especially running for extended periods of time)
  • respiratory infections
  • allergens such as pet dander, dust mite, molds, or pollens
  • cold air
  • acid reflux ("heartburn")
  • airborne irritants (smoke, fumes, strong odors)

What would happen if I came in for asthma evaluation?

A careful history is most helpful in identifying likely triggers for your symptoms, and examination of the chest may help the doctor in choosing the appropriate diagnostic work needed. A computerized breathing test called "spirometry" can give us a good idea of whether air flow rates and lung volumes are as they should be, or if there is obstruction of the airways suggesting asthma. Other studies may be helpful in determining whether there is an underlying infection or allergies are present.

I would rather just live with it -- I am used to feeling this way

Not really a great idea. Why? Because symptoms generally reflect airway inflammation, which left untreated can lead to irreversible changes in the airway lining. That means the longer you wait to treat your asthma, the more difficult it will be to achieve a successful outcome.

We always strive to minimize the amount of medication needed to control asthma. However, what asthma experts consider "good control" may be more ambitious than you were thinking: symptoms occurring only one day per month or less. It is wise to know your treatment options, and to monitor asthma with your doctor over time, adjusting medications as you improve.