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Asthma is a disorder of the lungs, which causes the airways of the lungs to be affected. It occurs as a result of excessive sensitivity of the lung airways, to various stimuli.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Adult-Onset Asthma
  • Bronchial Asthma
  • Exercise-Induced Asthma

What is Asthma in Adults? (Definition/Background Information)

  • Asthma is a disorder of the lungs, which causes the airways of the lungs to be affected. It occurs as a result of excessive sensitivity of the lung airways, to various stimuli
  • Swelling and narrowing of the airways occur, which results in a variety of symptoms, such as wheezing, difficulty in breathing, persistent cough, and painful chest tightness
  • When Asthma is diagnosed in people older than 20 years, it is called Adult-Onset Asthma

Asthma may be of various kinds, namely:

  • Mild intermittent Asthma
  • Mild persistent Asthma
  • Moderate persistent Asthma
  • Severe persistent Asthma

Who gets Asthma in Adults? (Age and Sex Distribution)

Individuals in any age group can be affected by Asthma. It is more common in:

  • Women, who are more commonly affected than men
  • Any individual with a family history of Asthma
  • Any individual, who has a history of allergies
  • Smokers; those who are exposed to tobacco smoke
  • Individuals living in urban areas, due to pollution

All racial and ethnic groups are affected; though, African Americans are at a higher risk than other racial groups.

What are the Risk Factors for Asthma in Adults? (Predisposing Factors)

The following are the risk factors associated with the onset of Asthma in Adults:

  • Pregnant women
  • Women experiencing menopause; women, who are in the practice of taking estrogen for over 10 years or so, following menopause
  • Overweight and obese individuals
  • Those who have suffered certain viral illnesses, like cold, flu
  • Individuals with allergies, those who are exposed to environmental irritants, like smoke, dust, perfumes, etc.
  • Individuals, who have had a serious attack of Asthma, in the past
  • Individuals using over two ‘quick-relief inhalers’ in a month
  • Those affected by other chronic health diseases, like sinusitis or nasal polyps
  • African-Americans have a high risk percentage than Caucasians, and other ethnic groups

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Asthma in Adults? (Etiology)

Asthma is a disorder of the respiratory system, affecting the lungs. It causes the airways to swell, especially the lining of the airways. This causes large amount of mucus to be produced, which is not only thicker than normal, but also in increased quantities.

The airways become narrow, due to an increase in the size of the muscles surrounding the airways. This is called airway muscular hypertrophy. Narrowing of the airways further compounds the difficulty in breathing.

Asthma in Adults is triggered by breathing in, allergy-causing substances called allergens, or by triggers that include:

  • Animal dander (pet hair, skin particles)
  • Cold weather
  • Dust
  • Chemicals in the air
  • Exercise (Exercise-Induced Asthma)
  • Mold
  • Pollen
  • Respiratory infections
  • Strong emotions
  • Stress
  • Tobacco smoke
  • Aspirin, other non-steroidal and anti-inflammatory drugs
  • Gastro esophageal reflux disease (GERD)

What are the Signs and Symptoms of Asthma in Adults?

General signs and symptoms, manifested by Asthma are:

  • Shortness of breath
  • Frequent coughing, especially at night
  • Cough, with or without sputum
  • Pulling-in of the skin between the ribs, when breathing
  • Wheezing, which:
    • Occurs in episodes
    • Usually begins suddenly
    • Is worse at nights or early mornings
    • May subside or go away on its own, without treatment
    • Gets better when using drugs, such as bronchodilators (medicines that open the narrowed airways)
    • Gets worse when breathing in cold air
    • Gets worse with exercise
    • Gets worse with heartburn

Emergency symptoms of Asthma include:

  • Bluish coloration of the lips and face
  • Decreased level of alertness
  • Severe drowsiness, confusion
  • Extreme difficulty in breathing, abnormal breathing pattern
  • Temporary stoppage of breathing
  • Rapid pulse
  • Severe anxiety
  • Sweating
  • Chest pain, tightness in the chest

How is Asthma in Adults Diagnosed?

The diagnostic procedure for Asthma in Adults includes:

  • Physical examination and evaluation of medical history of the individual, including study of the signs and symptoms exhibited by the individual
  • Lung function test: This test is performed with the help of a device, called a spirometer, which measures the amount of air that is exhaled after taking a deep breath. It also measures the speed with which a person can empty their lungs. The various types of lung function tests include:
    • Peak flow test
    • Spirometry test
    • Nitric oxide measurement test
    • Pulse oximetry test
  • Performing a methacholine challenge test: Inhaled methacholine causes airways to become narrow, due to spasm of the muscles surrounding the airways
  • Chestx-ray: Is performed to visually see the structures inside your chest, including the heart, lungs, and bones
  • Arterial blood gas test to measure the amount of oxygen and carbon dioxide in blood. It also determines the acidity in blood
  • Blood tests to measure eosinophil and IgE- immune system protein, called immunoglobulin

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Asthma in Adults?

Complications due to Asthma in Adults could include:

  • An attack of Asthma can disrupt the everyday life, at home, school, work, etc. There is an impact on the quality of life, and it affects those living around us too
  • Lack of sleep, because of night-time symptoms
  • Decreased ability to involve in other activities, exercise
  • Permanent changes in the function of the lungs
  • Persistent cough
  • Breathing difficulty and need for ventilators to breath
  • Severe attacks of Asthma would mean frequent visits to the hospital, which can be very stressful and expensive
  • Delayed response to therapy
  • Pneumonia; inflammation of the lungs
  • Pneumothorax; a collapsed lung, caused by collection of air in the space around the lungs
  • Pneumomediastinum, which is a condition, where there is air in the space in the mediastinum. Mediastinum is a space in the middle part of the chest, between the lungs where organs, such as heart, blood vessels, are located
  • A severe attack can lead to respiratory arrest and failure

How is Asthma in Adults Treated?

Asthma in Adults is a disorder that can be controlled, but not cured. The goals of treatment are:

  • To control airway swelling
  • To stay away from substances that trigger Asthma

Two kinds of medication, used for treatment of are:

  • Control drugs to prevent Asthma attacks
  • Medication that help in producing prompt relief of symptoms, during an Asthma attack

Long-term control drugs:

  • Inhaled steroids help control Asthma by preventing the airways swelling
  • Long-acting beta-agonist inhalers can be used along with inhaled steroid drugs
  • Leukotriene inhibitors medications for persistent Asthma
  • Oral steroids or corticosteroids

Short-term (quick-relief) control drugs: Short-acting bronchodilators (‘quick-acting’ medications used in nebulizers) and short-acting beta-agonists

A severe Asthma attack may need additional modalities of care, which may include a hospital stay, oxygen, breathing assistance, and even intravenous medications.

How can Asthma in Adults be Prevented?

Asthma may only be controlled, but not cured. The following general guidelines may be followed to minimize, or prevent an attack of Asthma:

  • All windows may be suitably kept closed, so that dust or smoke do not enter indoors
  • HEPA filters (a type of air filter) may be fitted to all cooling and heating systems installed at your home/workplace
  • Always keep the humidity to a low level
  • Avoid outdoor work or exercising, when there is a high air pollution, a high pollen count, or high ozone levels (which is said to exacerbate the Asthma condition)
  • Individuals may be administered vaccines for seasonal flu, pandemic H1N1 flu, etc.

As advance precautionary measures, the following factors may be considered:

  • All allergies and sinusitis should be treated, as and when they occur
  • Strictly avoid smoking
  • Avoid the inhalation of smoke or chemicals
  • Avoid the use of wood-burning stoves
  • Discuss with your medical practitioner, the routine you should follow to keep Asthma in check; and follow that established routine
  • Reduce exposure to house dust, mites, cockroaches, pets, and mold

What is the Prognosis of Asthma in Adults? (Outcomes/Resolutions)

  • There is no cure for Asthma. With proper self-management and medical treatment, individuals affected by Asthma can lead a normal life
  • Severe and untreated conditions may lead to complications, which can sometimes be fatal

Additional and Relevant Useful Information for Asthma in Adults:

Asthma in children is called Pediatric Asthma.

What are some Useful Resources for Additional Information?

American Academy of Allergy, Asthma, and Immunology (AAAAI)
555 E. Wells St., Suite 1100 Milwaukee, WI 53202
Phone: (414) 272-6071
Toll-Free: (800) 822-2762
Website: http://www.aaaai.org

References and Information Sources used for the Article:

http://www.nlm.nih.gov/medlineplus/ency/article/000141.htm (accessed on 2/23/2015)

http://www.mayoclinic.com/health/asthma-attack/DS01068/DSECTION=complications (accessed on 2/23/2015)

http://www.thirdage.com/hc/c/asthma-adult-prevention (accessed on 2/23/2015)

http://www.umm.edu/patiented/articles/what_causes_asthma_000004_3.htm (accessed on 2/23/2015)

http://www.cdc.gov/asthma/speakit/default.htm (accessed on 2/23/2015)

http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ (accessed on 2/23/2015)

Helpful Peer-Reviewed Medical Articles:

Apter, A. J. (2013). Advances in adult asthma diagnosis and treatment in 2012: potential therapeutics and gene-environment interactions. [Review]. J Allergy Clin Immunol, 131(1), 47-54. doi: 10.1016/j.jaci.2012.11.020

Cates, C. J., Jaeschke, R., Schmidt, S., & Ferrer, M. (2013). Regular treatment with salmeterol and inhaled steroids for chronic asthma: serious adverse events. [Meta-Analysis Research Support, Non-U.S. Gov't Review]. Cochrane Database Syst Rev, 3, CD006922. doi: 10.1002/14651858.CD006922.pub3

Chauhan, B. F., Chartrand, C., & Ducharme, F. M. (2013). Intermittent versus daily inhaled corticosteroids for persistent asthma in children and adults. [Meta-Analysis Review]. Cochrane Database Syst Rev, 2, CD009611. doi: 10.1002/14651858.CD009611.pub3

Killeen, K., & Skora, E. (2013). Pathophysiology, diagnosis, and clinical assessment of asthma in the adult. [Review]. Nurs Clin North Am, 48(1), 11-23. doi: 10.1016/j.cnur.2012.11.001

Weersink, E. J., Braunstahl, G. J., & Roldaan, A. C. (2013). [Severe asthma in adults]. [Review]. Ned Tijdschr Geneeskd, 157(19), A6232.

Kirenga, B. J., Schwartz, J. I., de Jong, C., van der Molen, T., & Okot-Nwang, M. (2015). Guidance on the diagnosis and management of asthma among adults in resource limited settings. African Health Sciences, 15(4), 1189-1199.

Moazed, F., & Calfee, C. S. (2015). Clearing the Air. Smoking and Incident Asthma in Adults. American journal of respiratory and critical care medicine, 191(2), 123-124

Gibson, P. G., Powell, H., Wilson, A., Abramson, M. J., Haywood, P., Bauman, A., ... & Roberts, J. J. (2002). Self‐management education and regular practitioner review for adults with asthma. The Cochrane Library.