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Asthma at the Asthma Institute at UPMC

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Asthma Overview

Asthma is a chronic inflammatory disease of the lungs which can make it hard to breathe. The airways become sensitive and obstructed, making it difficult to move air in and out.

The disease affects the large tubes of the lung called the bronchial tubes. In people with asthma, the bronchial tubes are hyper-responsive, causing overreactions to allergens and irritants. This results in the tube lining becoming inflamed and the muscles surrounding the bronchial tubes squeezing the airways, narrowing the passages.

As the disease persists, the inflammation of the bronchial tube lining can become worse and worse, leading to increased mucus production and further narrowing of the airways. Over time, without treatment, the damage to the bronchial tubes can become irreversible, leading to a permanent loss of lung function.

Asthma Causes

Asthma can develop in both children and adults, and the exact cause is often unclear. It appears that asthma is the result of a combination of factors, including genetics and environment. Individuals whose parents have asthma have a higher risk of developing asthma.

Allergies also play an important role for a large number of asthmatics. It is estimated that asthma is related to allergies in up to 90% of children and 50% of adults. Allergies to dust mites, animals (cats, dogs), mold, grasses, and cockroaches have been strongly associated with asthma.

Signs and Symptoms

The main symptoms of asthma are:

  • Difficulty breathing – a feeling of breathlessness, or being unable to get enough air in or out of your lungs
  • Chest tightness – a feeling of something squeezing or sitting on your chest
  • Wheezing - a high-pitched whistling or squeaky sound when you breathe
  • Coughing - a dry, nonproductive, cough that often gets worse at night or early in the morning

Symptoms can vary from person to person, and not every asthmatic will experience all of these symptoms. Should one or more of the above occur, whether mild or extreme, contact your board-certified allergist for an evaluation.

Diagnosis

Peak Flow Monitoring

During a visit to the Asthma Institute, our physicians may use a peak flow meter to measure how well air moves out of your lungs. The peak flow rate can be used to find out if there is narrowing of the airways.

Your personal best number is the highest peak flow number you can achieve over a two-week period, when your asthma is under good control. Once you know your personal best, your doctor can adjust your treatment plan based on your numbers.

The severity of your asthma is mainly determined by how often you have symptoms, your breathing test results, the type and amount of medications you use daily, and how often you have to use your rescue inhaler. Our team uses the Asthma Control Questionnaire, which asks you questions such as these, to determine how severe your asthma is and if it is or has been under control. Our goal for asthma patients is to have as few symptoms as possible.

Treatment

Our experts at the Asthma Institute use a multidisciplinary approach to help you manage your asthma. While there is no one cure for the disease, it can be treated using medication and lifestyle management.

Asthma Medications

There are two primary types of medicine to treat asthma: long-term control medicines (controllers) and quick relief medicines (rescue medicines).

Long-term control medicines prevent symptoms and treat the disease process and inflammation. These medicines are taken daily, even if you feel well. Quick relief (rescue) medicines work quickly to open up narrowed airways and are taken when shortness of breath or other acute asthma symptoms occur suddenly.

Avoiding Asthma Triggers

Triggers are factors that can bring on an asthma attack. Controlling your environment by reducing or stopping exposure to your triggers is an important part of treatment.

Every person with asthma has different triggers. The following are common asthma triggers: dust mites, animal dander, pollens, indoor molds, cockroaches, tobacco smoke, infections, strong odors, stress, exercise, respiratory infections, and hormones.

You do not have to avoid exercise if you have asthma; in fact, exercise is strongly encouraged. Premedicating with an inhaler before exercise can help reduce the risk of an asthma attack.

Goals of Asthma Treatment

The goals of our asthma treatments are to prevent chronic and troublesome symptoms, reduce the use of rescue medicine such as albuterol, maintain near-normal pulmonary function, maintain normal activity levels, and meet patients’ expectations of and satisfaction with their asthma care.

We also work to prevent recurrent exacerbations, minimize the need for emergency room visits or hospitalizations, and prevent progressive loss of lung function and reduced lung growth in children.

The University of Pittsburgh - Athsma Institute home page
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