Asthma is a temporary airway obstruction that leads to breathing difficulty and shortness of breath. It’s caused by airway inflammation that can be set off by various triggers, genetic predisposition, or the environment, and can become serious, even fatal, if not controlled. At the University of Michigan Asthma and Airway Center, our multidisciplinary team of specialists from Pulmonary & Critical Care Medicine, Allergy and Clinical Immunology, Public Health, and Patient Education work together to comprehensively treat and educate patients with all levels of asthma severity.
Asthma is a chronic disease that affects more than 10 million Americans, and is caused by congestion of the bronchial tubes, which are the small air passages in the lungs. During an asthma attack, the air passages in the lungs narrow or become blocked by mucus or muscle spasm. This makes breathing difficult and causes wheezing or coughing.
Asthma Symptoms, Risks, and Triggers
Symptoms of asthma include:
- Shortness of breath
- Chest tightness
- Dry, chronic cough
People at risk for asthma often have a parent who has asthma. A severe viral infection can also increase your risk for developing asthma, as does having allergies or atopy (immediate allergic reactions). Asthma often starts in childhood, with many people growing out of it by adulthood. While boys are more likely to have asthma during childhood, more females have asthma as adults.
Common asthma triggers include:
- Viral infections
- Allergies, such as ragweed and pollen, aspirin, animal dander, or dust
- Chemical exposures, such as cleaning with bleach in a non-ventilated area
- Acid reflux (heartburn can spill chemicals from the gastrointestinal tract into airway)
- Cold air, during winter or from air conditioning
Categories of Asthma: Diagnosis and Treatment
At the U of M Asthma and Airway Center, to diagnose your asthma, we take a complete history and conduct a thorough exam, which includes listening for wheezing. We also conduct breathing tests, such as pulmonary function testing, which is a series of procedures that measures both the capacity and effectiveness of your lungs, as well as the force of your breathing. A chest x-ray and allergy testing may be required. Along with diagnosing asthma, we also classify your asthma (which helps determine treatment) into one of the following categories:
Mild intermittent asthma: The majority of patients fall into this category. Includes wheezing once or twice a week. Rarely waking up at night. May need a rescue inhaler at times.
Mild persistent asthma: Coughing, wheezing, and chest tightness 3 to 6 times a week. May wake up at night coughing a few times a month. On a day-to-day basis, your peak flow meter (an at-home device to measure your lung function) will drop more than 20%. May require daily medical therapy that’s either inhaled or taken orally.
Moderate persistent asthma: You have daily symptoms of coughing, wheezing, and chest tightness. Awakening more than 5 times a month. Peak flow meter reading in the 60-80% range. Most likely on a daily inhaled corticosteroid treatment.
Severe persistent asthma: About 7% of asthmatics fall into this group. Continuous symptoms of coughing, wheezing, and chest tightness. Regular awakening at night. Peak flow meter reading often less than 60%. People in this category generally have many emergency room visits. More labor intensive treatments, with testing every couple of weeks. May require oral steroids on a daily basis.
Other treatment options are also available, such as Anti-IgE therapy – a shot given twice a month to prevent immunoglobulin E (an antibody that causes allergic reactions) from binding to cells. It is usually reserved for patients not responding to previous treatments. Experimental antifungal treatment (taken orally) can also help those with chronic severe asthma, who also test positive for fungal allergies.
Fatal Asthma Attacks and Asthma Education
Those with symptoms occurring at least 5-6 times a week and a couple of times at night a month are more at risk for a fatal asthma attack. Everyone is different, so it’s important for you to know when your asthma is flaring, which you can tell by your daily peak flow meter reading and whether you are still having tightness even after using your rescue inhaler. The University of Michigan Asthma and Airway Center team will teach you to how to use the peak flow meter and read it properly. We’ll also provide you a thorough education about asthma, including recognizing symptoms, identifying and avoiding triggers, and properly administering your medication. In addition, we’ll help you develop an individualized asthma action plan so you know what to do at home, when you should call your doctor, and when you need to get to the emergency room.
Research shows educational programs that encourage more self-management on the part of patients can dramatically improve their health by reducing hospital admissions, emergency room visits, sleep disturbances, and absenteeism from work. When patients participate in educational programs, they are much more likely to use their medications correctly, they experience fewer severe asthma symptoms, and asthma is much less likely to interfere with their daily lives.
Clinical trials are an important part of our program, and can provide novel treatment therapies to patients before they are available widely. At any time, you can ask your doctor or any of our health care professionals about opportunities, or you can view or sign up for studies that are currently recruiting participants at UMClinicalStudies.org.
Our research includes:
- Studying leukotriene (a chemical the body releases due to an inflammatory stimulus, such as an allergen) modifiers in relation to obesity.
- We are also looking at whether bariatric surgery can improve asthma.
- A sleep apnea study is looking for a connection between asthma and the airway becoming obstructed during sleep.
- An on-going community study is looking at providing education to low-income, poorly educated individuals to improve asthma control.
Make an Appointment
To schedule an appointment to discuss your need for asthma treatment, call us at 888-287-1084.