By Chris Woolston
CONSUMER HEALTH INTERACTIVE
When a person has asthma, attacks can seem to come out of nowhere. One minute you're feeling fine, the next you're wheezing and gasping for breath. If you look closely, however, there's always a reason for the attack.
If you have asthma, your airways are inflamed, which makes them ultrasensitive. Inflammation can cause airways to swell, hampering your breathing. More often than not, your asthma will be more noticeable when something additional disturbs your airways, which are already inflamed.
Unfortunately, triggers -- agents that bring on an attack --are all around. Many different things, from viruses and dust mites to exercise and emotional distress, can set off an asthma attack. Every case is different, however, and something that causes wheezing in one person may be completely harmless to another. Understanding your personal triggers is a crucial first step toward controlling your disease.
Here's a look at the most common causes of asthma attacks.
Many people with asthma also have allergies to pollen, dust mites, or other things in the air. When they inhale one of these offenders, the allergic reaction can set off an asthma attack. In fact, allergies are the most common cause of asthma attacks in teen-agers and children over age two.
Some typical causes of allergy-related asthma attacks:
Many things can irritate the lining of your airways and set off an attack. One of the worst offenders is tobacco smoke. (For more information, see our primer on Smoking and Asthma .) For instance, children with asthma who live in smoke-filled homes have more episodes of wheezing, need more medications, and take more trips to the emergency room than other asthma patients their age.
Other common irritants:
Illness and infections
A cold or flu virus that invades the airways can easily trigger an asthma attack. Respiratory viruses are the most common cause of asthma attacks in senior citizens and in children under two. Other illnesses that can cause attacks include sinusitis and heartburn (reflux disease).
Aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen can bring on asthma symptoms in some people, especially patients in their 30s who also have nasal polyps. Beta blockers, found in drugs prescribed to lower blood pressure and glaucoma drops, have also been linked to attacks in some people.
Trauma and emotions
Strong feelings of anxiety or depression can trigger asthma attacks and make the disease more difficult to manage. "Whenever I see patients who are having severe attacks, I always ask them 'What's gone wrong [in their emotional lives]?'" says H. James Wedner, chief of allergy and immunology at Washington University School of Medicine in St. Louis.
Emotional distress may trigger attacks by disrupting the normal balance of hormones and brain chemicals. Depression and anxiety can also weaken the immune system, making a person more vulnerable to colds, flu, and other infections that can open the door for asthma. Conversely, treating the depression or emotional distress may ease symptoms of asthma. Interestingly, strong fits of laughter can also trigger asthma symptoms in some individuals. (See our primer on Asthma: The Mind-Body Connection for more information.)
Surprisingly, a good workout -- especially a workout in cold, dry air -- is one of the surest ways to trigger an attack. In fact, many people have "exercise-induced asthma," which means they have asthma only when they exercise. Even people with persistent or constant asthma may notice breathing problems primarily when they exercise.
However, this is no reason to stop exercising. With a few precautions, such as keeping an inhaler within reach at all times, practically anyone with asthma can enjoy their sport or activity of choice. (See our primer on Sports and Asthma for more details.)
-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.
American Academy of Allergy, Asthma, and Immunology
American Lung Association
800-LUNG USA http://www.lungusa.org
Asthma and Allergy Foundation of America
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Reviewed by Martha Vetter White, M.D., director of research at the Institute for Asthma and Allergy in Washington, D.C.
Last updated August 24, 2009
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