Asthma is a common condition that can be managed with the right strategies and treatment. Piedmont Healthcare Pulmonologist Vijay Patel, MD, FCCP, discusses the most common questions he hears from his patients. 1. Q: What is asthma? A: Asthma is a chronic lung disease; it’s not something that will likely totally disappear. It affects the airways because they become inflamed, which then causes them to get more narrowed or swollen. They also will make a lot of extra mucus. These changes cause obstruction in the lungs, so they don’t move air as well and therefore cause trouble breathing. 2. Q: What causes asthma? A: We don’t know what exactly causes asthma to develop, but we do know there are different triggers that can make asthma symptoms worse. There are also different types of asthma, so for example, with allergic-type asthma, symptoms are triggered from environmental factors like pollen or animal dander, dust mites, cockroaches, and mold. Then there’s non-allergic type asthma: that can be triggered by changes in weather, fragrances, viral infections, or irritants, like smoke from cigarettes or a fire. There’s also a specific type of asthma that’s triggered only by exercise, called exercise-induced asthma. Avoiding your triggers, once you identify them, is important to manage asthma and keep symptoms down. 3. Q: How does asthma change over time? A: Often, people who had asthma in childhood will not quite outgrow it, but they will experience much fewer symptoms as they become adults. But there’s a tendency for some patients to have a recurrence of their asthma in their 30s, 40s, and even 50s. It may be milder and not as bad as it was when they were children, and it happens whether they were good or bad at managing it. 4. Q: How is asthma typically treated? A: We have different grades of asthma, so treatment depends on how severe your asthma is. The more severe the symptoms, the more therapy we add. Some people have what we call intermittent asthma, where they just have a sporadic asthma episode once or twice a year, and we’ll put them on a short-term treatment like a rescue inhaler and they’ll be fine. They don’t need continuous treatment all the time. Then there’s also mild persistent, moderate persistent, and severe persistent asthma; all of these require continuous treatment. Controller medications are taken continuously to keep symptoms under control and prevent asthma exacerbations, also known as asthma attacks. They are typically inhaled steroids and they reduce inflammation in your airways. You have to take them once or twice a day, depending on how severe your asthma is. There are also medicines called long-acting bronchodilators that we use as everyday therapy. They relax airway muscles so they’re not so constricted. And sometimes we mix inhaled steroids with longer-acting medications for some patients’ asthma. There are also tablets and pills that we use for patients with mild to moderate asthma. They’re anti-inflammatory and reduce inflammation in the airways so it’s easier to breathe. The most important part of asthma treatment is following your doctor’s instructions and taking your medications the right way at the right time. 5. Q: What’s an asthma attack? A: An asthma attack or exacerbation happens when something triggers your asthma symptoms to get worse. For example, you could get a cold, and your bronchial tubes get inflamed and swollen and become very narrow. So you get short of breath; you wheeze and cough more than usual. You’ll have to use your emergency rescue inhaler to treat that, and a common one is called albuterol. An asthma attack can be short or can last for days. If you’re taking your rescue inhaler every two hours but symptoms still aren’t getting better, then you should go to the emergency room or urgent care. 6. Q: Can people with asthma exercise? A: Exercise is important for everyone, including asthmatics. If someone has pretty bad asthma symptoms, they shouldn’t exercise until they’re getting treatment to bring their symptoms down. And some people have exercise-induced asthma, so they should talk to their doctor about exercising. But most asthmatics, if their asthma is under control, can and should be active. I tell my patients they have no limitations for exercise, as long as their asthma is well controlled. If they’re taking the minimum medications and they’re breathing fine with no symptoms, they can do whatever exercise they want to do, whether it’s running, biking, swimming, etc.