Many people do not know they have asthma, especially if their symptoms aren't severe. But any asthma symptom is serious and can become deadly.

The most common asthma symptoms are:

Coughing, especially at night, with exercise, or when laughing
Trouble breathing
A tight feeling in the chest
Wheezing – a squeaky or whistling sound
Sometimes a cough that won't go away is the only symptom of asthma. Asthma symptoms often happen at night and in the morning, but they can happen any time. They get worse when you are around your asthma triggers.

Is asthma a psychological disorder?

Asthma is not a psychological or emotional disorder, but sometimes a physical display of strong emotion – such as shouting, crying, laughing or rapid breathing – may contribute to an asthma episode. Panic can prevent a person with asthma from relaxing and following instructions properly, which is essential during an attack. Medical scientists have found that behaviors associated with strong emotions can cause bronchial tubes to constrict, which may provoke or worsen an attack.

A chronic disease, such as asthma, can cause emotional strain. Depression may set in when those with asthma believe they cannot participate in normal activities. As a leading cause of work and school absences, asthma can have a significant effect on livelihood, education and emotional well-being.

Is asthma life-threatening?

In severe and poorly controlled cases, asthma can be life-threatening, and the death rate and prevalence of asthma has increased significantly since the late 1970s. Deaths occur more frequently in adults. If there is a single factor leading to severe or fatal asthma attacks, it appears to be a delay in administering appropriate drug therapy.

Working in partnership with an allergist, having an action plan, recognizing the triggers and early warning signals of an impending attack, and using a peak flow meter to detect the degree of bronchial obstruction, can all contribute to a decrease in the frequency and severity of attacks.

Prevention is always the best strategy. A person with asthma should know what situations prompt an attack, such as exposure to allergens, respiratory infections and cold weather, and to avoid these situations whenever possible. If asthma attacks are severe, unpredictable or flare up more than twice a week, then asthma treatment with a long-term control medication is recommended. Long-term medications are preventive, taken daily and can achieve and maintain control of asthma symptoms.

Because inflammation of the lungs and airways plays a critical role in asthma, the most effective medications for long-term control have anti-inflammatory effects. Various forms of anti-inflammatory medication are available and should be discussed with a physician.

One of the most effective anti-inflammatory medications for controlling asthma is inhaled corticosteroids. Taken early and as directed, these medications can improve asthma control, normalize lung function, and possibly prevent irreversible injury to lung airways. Often a single dose taken daily is enough to control asthma. Other anti-inflammatory medications include cromolyn and nedocromil.

Other medications for long-term control of asthma are long-acting inhaled or oral bronchodilators (beta agonists), long-acting theophylline or regular use of oral corticosteroids. Combination therapy (inhaled corticosteroid plus a long-acting beta2-agonist) is the preferred treatment for asthma when inhaled corticosteroids alone do not control the disease.

Unless directed by a physician, asthma patients should never change or discontinue preventive medications, and should always keep an adequate supply available.

For people with allergic asthma, immunotherapy (allergy vaccinations) may offer relief from symptoms prompted by allergens that act as triggers and cannot be avoided. Immunotherapy increases a patient's tolerance to the allergens that prompt asthma symptoms. A recent treatment option called anti-IgE stops an allergic reaction before it begins, helping prevent asthma attacks by blocking the antibody that causes the reaction. The treatment is approved for patients age 12 and older who have moderate-to-severe allergic asthma.

Are corticosteroids safe?

Taken as directed, inhaled corticosteroids are safe, well-tolerated and one of the most effective medications for asthma treatment. Some studies have suggested that inhaled corticosteroids may slightly reduce the rate of growth in children, perhaps by 1 centimeter per year. The reduction may be related to dosage and how long a child takes the drug. The long-term effects of any reduction in growth rate on final adult height is unknown.

Consequently, it is recommended that physicians use the lowest effective dose of these drugs and that they routinely monitor their patients' growth rates. Patients should discuss any concerns with their child's physician and never change or discontinue prescribed asthma medications unless advised by their doctor.

Is there a cure for asthma?

Although asthma symptoms are controllable, a cure for asthma has remained elusive. Preventive treatment, however, should minimize the difficulty an individual experiences with asthma, and allow a normal, active lifestyle.

When should a person see an allergist?

If an individual is having difficulty breathing or is coughing or wheezing, an allergist can help determine the cause of the condition and provide treatment that controls or eliminates the symptoms. Individuals should see an allergist if:

Breathing difficulties are interfering with daily activities
Breathing problems are decreasing the quality of their life
The warning signs of asthma, are present. These include:
shortness of breath
wheezing or coughing, especially at night or after exercise
tightness in the chest
frequent attacks of breathlessness, despite previous
diagnosis and treatment for asthma
An allergist is a physician who specializes in the diagnosis and treatment of asthma and allergies. The allergist has passed a qualifying examination and is specially trained to identify the factors that trigger asthma or allergies, and help the patient prevent or treat the condition.

After earning a medical degree, the allergist completes a three-year residency training program in either internal medicine or pediatrics, followed by a two- or three-year program of study in the field of allergy and immunology. You can be certain that your physician has met these requirements if he or she is certified by the American Board of Allergy and Immunology.

Allergies exist in many different forms. Find out more about the allergy you suffer from:

Cockroach Allergy

Drug Allergies

Dust Allergy

Eye Allergies

Food Allergies

Insect Sting Allergies

Latex Allergy

Mold Allergy

Pet Allergies

Rhinitis

Sinusitis

Skin Allergies

Step 1: Consultation

Your first step is to see a board-certified allergist-immunologist. You may be sent by your primary care physician, follow the recommendation of a family member or friend who is seeing an allergist, or find an allergist certified by the American College of Allergy, Asthma and Immunology (ACAAI) in your area.

Some health plans and HMOs require prior approval to see a specialist. If your request is not immediately honored, ask again and be firm.

Step 2: Testing

Your allergist will obtain a detailed medical history, examine you and evaluate your symptoms. Tests (perhaps lung function tests or x-rays) will be performed to find out the type of your allergic disease. Skin tests or allergy blood tests may be needed to find out the precise causes of your allergic symptoms. Based on the entire clinical evaluation, a diagnosis is made.

If the allergy tests are negative, the allergist can still help find the cause of your symptoms, do not despair. Allergists are also experts in the treatment of nonallergic asthma, rhinitis, food and drug reactions, and other types of problems of your immune system, like frequent infections.

Step 3: Treatment

This is the step where your allergic symptoms and you get better. Allergy treatments are of three types: Prevention. Medication. Immunotherapy.

Prevention: Once identified, the cause of the symptoms may be avoided or removed from your life. For example, a particular food can be avoided, or a pet can be removed from the home or kept away from sleeping areas.

Some causes of allergic symptoms, such as pollen, molds and dust mites, cannot be completely eliminated and are difficult to avoid. Exposure can be reduced, however, by environmental control measures prescribed by your allergist.

Medication: Although prevention comes first, more may be needed. Medications are usually used to decrease allergy symptoms and improve the patient's quality of life, recent advances in medications for asthma and other allergic diseases have been phenomenal. Improvements in drugs have eliminated most of the side effects from older drugs.

The allergy specialist is an expert in the latest safe and effective medications for treating allergic illness.

Immunotherapy ("allergy shots"): If a specific allergy is identified and it cannot be avoided or medications are not sufficient to restore your health, the allergic symptoms may be controlled or eliminated with allergy shots.

Allergy shots have been used since 1911. In the past century, there has been considerable improvement in the effectiveness of this treatment, which decreases a patient's sensitivity (allergy) to a number of allergens, such as cat or ragweed. The treatment is a method for increasing the allergic patient's natural resistance (tolerance) to the things that are triggering the allergic reactions.

This treatment involves injections of small amounts of purified "extracts" of the substances that are causing allergic reactions. For example, the extracts may be derived from pollens, mold spores, animal dander, dust mites or insect venom. The U.S. Food and Drug Administration approve them for this use, and over the years they have been improved considerably.

Allergy shots stimulate the immune system to fight allergies safely, effectively and naturally. Beginning with small doses and increasing them gradually on a weekly or biweekly basis, the therapy continues until a maintenance level is achieved. Then, a maintenance dose is injected every few weeks.

Immunity does not occur immediately, but some patients do begin to feel better quickly. Most patients are continued on monthly injections for 3 to 5 years once they reach the maintenance dose. In some patients, immunity is maintained and treatment can be stopped after several years. For others, treatment may be needed for longer periods of time. Generally the benefits of allergy shots can last for many years, or even a lifetime.

With the immune system restored to good health, few or no medications may be needed. Work or school days are no longer missed. The burden of allergies is lifted, and allergies become something you just don't think about any more. Candidates for allergy shots include most children and adults. Pregnant patients can continue treatment that was started prior to pregnancy.

Allergy shots are prescribed by an allergist and are always given under medical supervision at a location where medical staff and medications are available to handle any serious reaction. Although rare, serious reactions can occur from allergy shots because the treatment involves the substances to which the patient is known to be allergic.

Adverse reactions can occur from allergy shots because treatment involves the injection of substances to which the patient is sensitized. The most common adverse reaction is an immediate red, itching bump at the injection site. In some cases, a similar delayed reaction can occur six to twenty-four hours later. Rare, more severe reactions include generalized itching, chest tightness/wheezing, or dizziness due to a drop in blood pressure. Deaths have been reported from allergy shots at a rate of approximately one in three million injections. This is why allergy shots are given under supervision where medical staff and medications are available to handle serious reactions. As allergists, we feel that the benefits far outweigh the extremely small risk of a serious reaction. It is safe for both children and adults, and even pregnant patients may continue treatment started prior to pregnancy.

An allergist can help you ...

GET TESTED! GET TREATED! GET BETTER!

Why an allergist? An allergist is a doctor specially trained and experienced in the diagnosis and treatment of allergic diseases and related conditions. These include asthma, hay fever, sinusitis, rashes, hives and certain kinds of allergic reactions to foods, insect stings and drugs.

Every board-certified allergist first completes at least three years of specialty training in either internal medicine or pediatrics, and then completes an additional training program of two or more years studying the diagnosis and treatment of allergic and related diseases. Certification by the American Board of Allergy and Immunology requires not only approved training, but also successful completion of a challenging written examination. Every board-certified allergist thus has credentials in at least two specialties and is qualified to care for both children and adults.

As a result, the board-certified allergist-immunologist has the advanced training and expertise in the techniques of finding out what is causing an allergic reaction and how best to solve the problem.

The future

Researchers are now studying ways to go beyond today's methods of treating allergies. We soon may have better and new ways to block the body's allergic response by reducing or inhibiting the release of histamine and other chemicals that cause allergic reactions. Also, a large group of scientific researchers are working in developing the purest, strongest and safest vaccines for allergy.

When these treatments become available, you can be certain that allergists-immunologists will be at the forefront of their use.

But you don't have to wait for the future. Today, you can put the misery of allergies out of your life with the help of an allergist.

Here are definitions of some of the words frequently encountered in literature on allergy and asthma.

Allergy

Allergies are inappropriate or exaggerated reactions of the immune system to substances that, in the majority of people, cause no symptoms. Symptoms of the allergic diseases may be caused by exposure of the skin to a chemical, of the respiratory system to particles of dust or pollen (or other substances), or of the stomach and intestines to a particular food.

Anaphylaxis

Anaphylaxis, or anaphylactic shock, is a severe, frightening and life-threatening allergic reaction. The reaction, although rare, can occur after an insect sting or as a reaction to an injected drug - for example, penicillin or antitetanus (horse) serum. Less commonly, the reaction occurs after a particular food or drug has been taken by mouth.

Antibody

An antibody is a protein (also called an immunoglobulin) that is manufactured by lymphocytes (a type of white blood cell) to neutralize an antigen or foreign protein. Bacteria, viruses and other microorganisms commonly contain many antigens, as do pollens, dust mites, molds, foods, and other substances. Although many types of antibodies are protective, inappropriate or excessive formation of antibodies may lead to illness. When the body forms a type of antibody called IgE (immunoglobulin E), allergic rhinitis, asthma or eczema may result when the patient is again exposed to the substance which caused IgE antibody formation (allergen).

Antigen

An antigen is a substance that can trigger an immune response, resulting in production of an antibody as part of the body's defense against infection and disease. Many antigens are foreign proteins (those not found naturally in the body). An allergen is a special type of antigen which causes an IgE antibody response.

Antihistamine drugs

Antihistamines are a group of drugs that block the effects of histamine, a chemical released in body fluids during an allergic reaction. In rhinitis, antihistamines reduce itching, sneezing, and runny nose.

Anti-inflammatory drugs

Anti-inflammatory drugs reduce the symptoms and signs of inflammation. Although not a drug, immunotherapy ("allergy shots") reduces inflammation in both allergic rhinitis and allergic asthma.

Asthma

Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems. People with asthma have acute episodes or when the air passages in their lungs get narrower, and breathing becomes more difficult. Sometimes episodes of asthma are triggered by allergens, although infection, exercise, cold air and other factors are also important triggers.

Bronchitis

Bronchitis is an inflammation of the bronchi (lung airways), resulting in persistent cough that produces consideration quantities of sputum (phlegm). Bronchitis is more common in smokers and in areas with high atmospheric pollution.

Bronchodilator drugs

Bronchodilators are a group of drugs that widen the airways in the lungs.

Bronchus

Any of the larger air passages that connect the trachea (windpipe) to the lungs. The plural form of "bronchus" as "bronchi."

Contact dermatitis

Contact dermatitis is an inflammation of the skin or a rash caused by contact with various substances of a chemical, animal or vegetable nature. The reaction may be an immunologic response or a direct toxic effect of the substance. Among the more common causes of a contact dermatitis reaction are detergents left on washed clothes, nickel (in watch straps, bracelets and necklaces, and the fastenings on underclothes), chemicals in rubber gloves and condoms, certain cosmetics, plants such as poison ivy, and topical medications.

Corticosteroid drugs

Corticosteroids are a group of anti-inflammatory drugs similar to the natural corticosteroid hormones produced by the cortex of the adrenal glands. Among the disorders that often improve with corticosteroid treatment include asthma, allergic rhinitis, eczema and rheumatoid arthritis.

Digestive system
The digestive system is the group of organs that breaks down food into chemical components that the body can absorb and use for energy and for building and repairing cells and tissues.
Eczema
An inflammation of the skin, usually causing itching and sometimes accompanied by crusting, scaling or blisters. A type of eczema often made worse by allergen exposure is termed "atopic dermatitis".

Epinephrine
Epinephrine is a naturally occurring hormone, also called adrenaline. It is one of two chemicals (the other is norepinephrine) released by the adrenal gland. Epinephrine increases the speed and force of heart beats and thereby the work that can be done by the heart. It dilates the airways to improve breathing and narrows blood vessels in the skin and intestine so that an increased flow of blood reaches the muscles and allows them to cope with the demands of exercise. Epinephrine has been produced synthetically as a drug since 1900. It remains the drug of choice for treatment of anaphylaxis.

Extrinsic asthma

Extrinsic asthma is asthma that is triggered by an allergic reaction, usually something that is inhaled.

Hay fever

See Rhinitis.

Histamine

Histamine is a chemical present in cells throughout the body that is released during an allergic reaction. Histamine is one of the substances responsible for the symptoms on inflammation and is the major reason for running of the nose, sneezing, and itching in allergic rhinitis. It also stimulates production of acid by the stomach and narrows the bronchi or airways in the lungs.

Hives

See Urticaria.

Immune system

The immune system is a collection of cells and proteins that works to protect the body from potentially harmful, infectious microorganisms (microscopic life-forms), such as bacteria, viruses and fungi. The immune system plays a role in the control of cancer and other diseases, but also is the culprit in the phenomena of allergies, hypersensitivity and the rejection of transplanted organs, tissues and medical implants.

Immunoglobulins
Immunoglobulins, also known as antibodies, are proteins found in blood and in tissue fluids. Immunoglobulins are produced by cells of the immune system called B-lymphocytes. Their function is to bind to substances in the body that are recognized as foreign antigens (often proteins on the surface of bacteria and viruses). This binding is a crucial event in the destruction of the microorganisms that bear the antigens. Immunoglobulins also play a central role in allergies when they bind to antigens that are not necessarily a threat to health and provoke an inflammatory reaction.

Immunotherapy
Immunotherapy ("allergy shots") is a form of preventive and anti-inflammatory treatment of allergy to substances such as pollens, house dust mites, fungi, and stinging insect venom. Immunotherapy involves giving gradually increasing doses of the substance, or allergen, to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, perhaps by causing production of a particular "blocking" antibody, which reduces the symptoms of allergy when the substances is encountered in the future.

Inflammation

Inflammation is the redness, swelling, heat and pain in a tissue due to chemical or physical injury, or to infection. It is a characteristic of allergic reactions in the nose, lungs, and skin.

Intrinsic asthma

Intrinsic asthma is asthma that has no apparent external cause.

Lymphocyte

A lymphocyte is any of a group of white blood cells of crucial importance to the adaptive part of the body's immune system. The adaptive portion of the immune system mounts a tailor-made defense when dangerous invading organisms penetrate the body's general defenses.

Mast cell

Mast cells play an important role in the body's allergic response. Mast cells are present in most body tissues, but are particularly numerous in connective tissue, such as the dermis (innermost layer) of skin. In an allergic response, an allergen stimulates the release of antibodies, which attach themselves to mast cells. Following subsequent allergen exposure, the mast cells release substances such as histamine (a chemical responsible for allergic symptoms) into the tissue.

RAST
RAST is an abbreviation for RadioAllergoSorbent Test, a trademark of Pharmacia Diagnostics, which originated the test. RAST is a laboratory test used to detect IgE antibodies to specific allergens.

Respiratory system
The respiratory system is the group of organs responsible for carrying oxygen from the air to the bloodstream and for expelling the waste product carbon dioxide.

Rhinitis

Rhinitis is an inflammation of the mucous membrane that lines the nose, often due to an allergy to pollen, dust or other airborne substances. Seasonal allergic rhinitis also is known as "hay fever," a disorder which causes sneezing, itching, a runny nose and nasal congestion.
Sinus

The sinuses (paranasal sinuses) are air cavities within the facial bones. They are lined by mucous membranes similar to those in other parts of the airways.

Sinusitis

Sinusitis is inflammation of the membrane lining the facial sinuses, often caused by bacterial or viral infection.

Theophylline

Theophylline is a bronchodilator drug, given by mouth, that widens the airways to the lung. It also is used to prevent attacks of apnea (cessation of breathing) in premature infants and to treat heart failure because it stimulates heart rate and increases urine excretion.

Urticaria

Urticaria is a skin condition, common known as hives, characterized by the development of itchy, raised white lumps surrounded by an area of red inflammation