Asthma: Symptoms, Triggers, Diagnosis, and Treatment

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Asthma is a chronic respiratory condition that affects over 25 million people in the U.S. alone. Characterized by airway constriction and inflammation, asthma could be to blame for symptoms like wheezing, shortness of breath, chest tightness, and persistent coughing. While some manage it with drugs and lifestyle changes, others even develop serious complications when symptoms turn into full-fledged attacks.

In this guide, physicians from Rush University Medical Center and Bayhealth, both part of the AMA Health System Program, discuss what patients should know about asthma diagnosis, treatment, and control

What Is Asthma?

Asthma is a chronic lung disease that results in inflammation and narrowing of the airways," said Dr. Sindhura Bandi, allergist and immunologist at Rush University Medical Center.

According to Dr. Rabab Nasim, a critical care and pulmonologist with Bayhealth in Delaware, asthma symptoms are likely to be caused by airway hyperresponsiveness to typical stimuli. These include:

• Dry cough (especially at night)
• Chest tightness
• Wheezing
• Shortness of breath

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Early Warning Signs of Asthma

Asthma is underdiagnosed, particularly among adults, Dr. Nasim says. She suggests that patients pay attention to these early warning signs:

• Recurring dry cough, especially during the night
• Slowed recovery from respiratory infections
• Reduced exercise tolerance or shortness of breath during exercise
• Persistent chest discomfort or tightness

Triggers of Asthma

Triggers vary from one individual to another but typically include:

• Allergens: Pollen, dust mites, pet dander, and mold
• Irritants: Cigarette smoke, strong odors, air pollution
• Respiratory infections: Colds, flu, or COVID-19
• Exercise: Cold or dry air
• Weather changes: Cold, heat, humidity, or wind
• Cockroaches: Allergen exposure from cockroach feces and exoskeletons

"Triggers for adult-onset asthma are often different from childhood asthma and can be occupational exposures, obesity, or chronic inflammation," Dr. Nasim says.

Asthma Can Happen to Anyone

Globally, over 300 million people have asthma. In America:

• 8% of adults and 10% of children have asthma.
• Adult-onset asthma is on the rise, especially among:
• Women
• People with allergies or acid reflux
• People who have been exposed to air pollution or work irritants
• Overweight people

Asthma Diagnosis

A step-by-step process is required to diagnose asthma:

1. Medical history and symptom tracking

2. Physical examination

3. Lung function tests (spirometry):

• Tests for airflow and responsiveness to bronchodilators
• Tests for airway reversibility

⚠️ Note: A normal lung function test doesn’t always rule out asthma, especially if you’re not currently experiencing a flare-up.

Doctors may also rule out conditions with overlapping symptoms, like COPD or seasonal allergies.

Asthma Treatment Options

Asthma treatment is personalized based on severity and triggers. The most common treatments include:

1. Inhalers

• Rescue inhalers (short-acting beta agonists): Used during flare-ups
• Maintenance inhalers (often corticosteroids): Taken daily to prevent attacks

"Taking your maintenance inhaler regularly helps reduce the need for stronger oral steroids," said Dr. Bandi.

2. Leukotriene Modifiers

Tablets that reduce inflammation in the airways and control allergies

3. Biologic Therapies

• Medications injected into the body to target specific immune systems
• Typically reserved for advanced asthma cases

The Role of Steroids in Treating Asthma

• Inhaled corticosteroids are the cornerstone of managing chronic asthma.
• Reduce inflammation and mucus production
• Prevent flare-ups

Limit the use of oral steroids, which may cause:

•   Weight gain
•   Elevated blood pressure
•   Sleep disturbance

Identifying Your Asthma Triggers

Monitoring your environment and keeping an asthma diary can help identify what induces asthma. Keep notes on symptoms with potential exposures, including:

• Strong perfumes or chemical odors
• Environmental changes
• Outdoor air pollution
• Exertion or exercise

Lifestyle Changes That Help Asthma

Dr. Bandi noted the role of lifestyle interventions in maximizing control of asthma:

• Plant-based diet
• Exercise regularly
• Quit smoking
• Weight loss
• Treat acid reflux or allergies 

Regular follow-ups with your doctor will help with re-evaluating your medication needs based on symptoms and lung function.

Exercise and Asthma: What You Should Know

Exercise can strengthen the lungs and improve immunity, but carefully.

✅ Asthma-friendly exercise tips:

1. Use a rescue inhaler before exercise if needed
2. Warm up and cool down
3. Avoid exercising in polluted or cold air
4. Be consistent with low-impact exercises (e.g., walking, swimming)

"Try for 15–20 minutes of exercise a few times a week to build stamina safely," said Dr. Nasim.

The Role of an Asthma Action Plan

A.Individualized asthma action plan must be present for all asthma patients, and it should record:

• Daily treatment and when to take it (Green Zone)
• What to do for mild flare-ups (Yellow Zone)
• When to contact emergency care (Red Zone)

Templates are available from national asthma organizations, and your doctor can customize one for you.

Final Thought: Asthma Can be Controlled with the Right Approach

Even though asthma has no cure as yet, it is really very well-controlled with the proper combination of:

• Medication
• Lifestyle changes
• Avoiding triggers
• Regular medical monitoring

"Many patients have little to no symptoms and a normal, active life with proper treatment," said Dr. Bandi.

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