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Asthma

Well-controlled asthma should feel like not having asthma at all.

Asthma is chronic airway inflammation causing intermittent wheeze, cough, chest tightness, and breathlessness. Modern inhaler-based therapy controls almost all asthma. Poor control usually reflects under-treatment or poor inhaler technique.

Causes & risk factors

  • Genetic predisposition
  • Allergens (dust mites, pets, pollen)
  • Air pollution and tobacco smoke
  • Viral infections in childhood
  • Occupational exposures

Symptoms

  • Wheeze, especially on exhale
  • Cough, often worse at night
  • Chest tightness
  • Shortness of breath with exertion or allergens
  • Symptoms responsive to bronchodilator

How it's diagnosed

  • Spirometry showing reversible airway obstruction
  • Peak flow variability over 2 weeks
  • Exhaled nitric oxide (FeNO)
  • Trial of inhaled corticosteroid with response

Evidence-based treatment

  • ICS-formoterol as-needed for mild asthma
  • Daily ICS + rescue inhaler for moderate
  • LABA + ICS combinations for step-up
  • Biologics (omalizumab, dupilumab) for severe
  • Inhaler technique training every visit

Prevention

  • Avoid known triggers
  • Annual flu vaccination
  • Quit smoking, avoid secondhand smoke
  • Action plan for exacerbations

Related symptoms

Asthma — FAQ

Can asthma go away?

Childhood asthma often remits in adolescence but can return in adulthood. Adult-onset asthma is usually lifelong but fully controllable.