Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Unlike many other conditions that cause difficulty breathing and are not reversible, oral or inhaled medications can make breathing easier in almost all patients with asthma.
Asthma can be managed and treated so you can live a normal, healthy life, according to the American Lung Association. However, it is a serious illness that causes more than 1.8 million emergency room visits and 439,000 hospital stays (averaging 3.6 days) with asthma as the primary diagnosis, according to the Centers for Disease Control and Prevention (CDC). Each year approximately 3,600 Americans die from asthma.
Call 911 immediately when you experience these conditions:
  • Prescribed medicines do not relieve an asthma attack
  • Trouble walking and talking because you're out of breath
  • Blue lips or fingernails

You should seek medical attention when these signs indicate your asthma is not under control: 
  • Symptoms start to occur more often, are more severe, or bother you at night and cause you to lose sleep
  • You limit normal activities or miss school or work because of your asthma
  • Peak flow number is low compared to your personal best or varies a lot from day to day
  • Asthma medicines do not seem to work well anymore
  • You have to use your quick-relief inhaler more than two days a week

Asthma affects people of all ages, but it most often starts during childhood. At Houston Methodist, our highly trained pulmonologists work with patients to determine the best course of treatment. They closely examine the following asthma-related areas: 
  • Symptoms
  • Causes
  • Triggers of attacks
  • Diagnosis
  • Treatments

Common signs of asthma vary:
  • Coughing from asthma (with and without sputum or mucus) is often worse at night or early in the morning, making it hard to sleep
  • Wheezing, whistling or squeaky sound, that occurs when you breathe because the airways are narrowed
  • Chest tightness, or feeling like something is squeezing or sitting on your chest
  • Shortness of breath, feeling like you cannot get air into or out of your lungs or both

Sometimes symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms worsen. When symptoms get more intense, you are having an asthma attack (also called a flare up or an exacerbation). Treating symptoms when you first notice them will help prevent a severe attack that may require emergency care or can be fatal.
The exact cause of asthma is not known. Researchers think some genetic and environmental factors interact to cause the condition, most often early in life. Common causes of asthma may include:
  • An inherited tendency to develop allergies, called atopy
  • Parents who have asthma
  • Certain respiratory infections during childhood
  • Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing

Not all people with asthma have these symptoms. Likewise, having all these symptoms does not always mean you have asthma.
If you start wheezing or coughing during exercise or if exercise makes it hard to breathe, you may have exercise-induced asthma (also called exercise-induced bronchoconstriction).
Triggers of Attacks
Many things can trigger or worsen asthma symptoms, including:
  • Allergens from dust, animal fur, cockroaches, mold, and pollens from trees, grasses and flowers
  • Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products and sprays (such as hairspray)
  • Medicines such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
  • Sulfites in foods and drinks
  • Viral upper respiratory infections, such as colds

Asthma is different for each person. Some of the triggers listed above may or may not affect you. Other health conditions, including osteoporosis and sleep apnea, can make asthma harder to manage. These conditions need treatment as part of an overall asthma care plan.

The best way to diagnose asthma is a lung function test called spirometry, which can detect asthma before symptoms become severe. It is a simple, non-invasive breathing test that measures the amount of air a person can blow out of the lungs (volume) and how fast they can blow it out (flow).
A bronchoprovocation test uses repeated spirometry to determine how reactive or sensitive your airways are to increasing doses of cold air or other provocation. Your doctor may recommend other tests to rule out other causes of your symptoms.

Your doctor may ask you to use a peak flow meter (a spirometry device) each morning and keep a record of your results. The highest number you get during a two- to three-week period when your asthma is well controlled is your personal best FEV1. You can compare this number to future numbers to manage your asthma.
The peak flow meter can help warn you of an asthma attack before you notice symptoms. If your score shows your breathing is getting worse, you should take quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked.
Asthma has no cure. Even when you feel fine, you still have the disease and it can flare up at any time. According to the American Lung Association, there is no best medicine for all people with asthma.

You and your health care providers will develop an asthma action plan built around your needs. An asthma action plan provides guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms and seeking emergency care when needed.
Most people with asthma need two kinds of medicine:
  • Quick-relief or rescue bronchodilators (inhaled medications that expand the passageways into the lungs (the bronchi), allowing more air in and out and improving breathing)
  • Long-term or controller medicines are taken every day to prevent symptoms and attacks
  • Immunotherapy (allergy shots) can also be helpful for some people with asthma
  • Bronchial thermosplasty for patients who have severe, persistent asthma that is not well controlled with standard medications alone.

Corticosteroids and bronchodilators are powerful drugs that can be dangerous when not taken as prescribed.

Asthma is complex and requires a comprehensive approach by specialists devoted to its evaluation and management. The experienced pulmonologists, respiratory therapists and other health care professionals at Houston Methodist pulmonary services are devoted to care and research for patients with chronic cough.


Our physicians at Houston Methodist specialize in managing asthma at the following convenient locations.