Asthma is a common but potentially life-threatening condition. According to the Centers for Disease Control and Prevention, about 1 in 13 people in the United States live with asthma. 

Knowing what asthma is, seeking a diagnosis and using an asthma action plan are crucial to managing this potentially deadly disease.

What is asthma, and what causes it?

Asthma is a chronic condition that inflames and narrows the airways in and out of the lungs. A person’s defense system usually helps fight off infection, but for some, it reacts by creating inflammation. Inflammation causes the airways to become too sensitive or hyperresponsive. This swelling and narrowing create more mucus and cause the muscles to tighten, making breathing harder and potentially leading to a severe flare-up or asthma attack.

Asthma often starts during childhood and extends into the teen years. For some people, asthma can improve over time and into adulthood. While it doesn’t actually “go away,” asthma can become inactive. In some people, asthma can extend well into adulthood or flare up from time to time.

What do asthma symptoms look like?

Asthma symptoms may vary for each person and age. They may follow a pattern, like worsening at night or in the morning or coming and going. 

Common symptoms include:

• Coughing, wheezing and shortness of breath.
• Chest tightness.
• Increased production of mucus.
• Trouble sleeping or waking often due to coughing or wheezing.
• Fatigue or tiring quickly due to difficulty breathing.

Asthma can also be categorized into different types depending on a person’s triggers, including: 

• Indoor or outdoor environmental allergies.
• Physical activity or exercise.
• Viruses or infections.
• Certain medications.
• Breathing in cold air or being in a damp environment.
• Pet allergies.
• Breathing too fast from laughing or crying.

For babies and young children, call 911 or go to the emergency room if they:

• Are unusually drowsy, confused, or have a change in mental status.
• Have a bluish tint to their skin or lips.
• Have an unusually fast heartbeat.
• Can’t speak due to shortness of breath while seated.
• Show signs of severe difficulty breathing: Nostril flaring, clavicle or ribs sticking out.
• Are not responding to a rescue inhaler, or if you have run out of medication.

Download our Asthma Control Test to see if your symptoms are well controlled.

How is asthma diagnosed?

Several variables must be considered when diagnosing, including age, family history, preexisting conditions, known allergies or eczema and symptoms.

“I will often begin with family history because asthma tends to run in families,” says internal medicine and pediatrics physician Rachel Johnson, MD. “People with eczema are also at higher risk. We look at all the factors, perform lung function tests, and put the puzzle pieces together to make a diagnosis.” 

Lung function tests

Pulmonary or lung function tests are often performed in a pulmonary lab. They are typically a doctor's primary tool for diagnosing asthma. 

One or more of these tests may be used:

• Spirometry tests help determine how much air is flowing in (oxygen), how much air is flowing out (CO2) of your lungs and how fast.
• Peak expiratory flow, or PEF, tests measure how fast you can blow air out.
• Bronchodilator responsiveness tests measure how much air you can blow after inhaling a fast-acting bronchodilator (like albuterol). This shows how your lung function responds, after which another spirometry test is performed to see if breathing has improved. 

More nuanced diagnostic breathing tests can be tried if a diagnosis is unclear.

“In adults, we try to rule out any conditions other than asthma that may be causing problems,” says Dr. Johnson. “But with young children, we often have to begin with symptoms like coughing, wheezing and shortness of breath. If a child responds to medication treatment, we’re likely looking at asthma.”

Management is essential: Follow an asthma action plan 

An asthma action plan is a personalized guide crafted by your doctor. It will help you manage the condition and medications, recognize symptoms worsening, know when to seek help and prevent asthma triggers from leading to an asthma attack. The plan will typically use traffic-colored signs or zones to make it easy to tell how severe your symptoms are and what to do in each zone.

Dr. Johnson offers advice for parents just beginning to manage their child’s asthma:

• Following the treatment plan and being consistent with medication is incredibly important and can save your child’s life.
• Use medications correctly. Know which inhaler is the controller (used daily) and which is the rescue (used to treat asthma attacks). Medications help control inflammation which is vital for short- and long-term health. 
• Understand triggers and manage them. Take steps to address and control allergies and other triggers in and out of the home.
• If you don't understand something about your asthma action plan, don’t hesitate to ask your health care team for clarification. 
• Get your refills early so you don’t risk running out.