Johns Hopkins Pediatric Allergy Clinic
Pamela Guerrerio, MD, PhD
Corinne Keet, MD, MS
Elizabeth Matsui, MD, MHS
Robert Wood, MD
Teri Holbrook, CPNP
What is asthma?
Asthma is a condition where there is inflammation in the lungs. Just like you get inflammation when you have a mild skin infection, so that your skin may be red, tender, and/or puffy, people with asthma have inflammation in their lungs. The inflammation causes the airways, which are like tubes in the lungs, to be narrower, so that it is hard to breathe. The inflammation is irritating to the muscles that surround the airways (air tubes), so that the muscles around the air tubes flex (or contract), and squeeze the airways closed, which also makes it hard to breathe. As long as the inflammation is not controlled, the muscles around the airways will continue to be irritated and squeeze the airways closed.
How is asthma diagnosed?
There is not a medical test for asthma. A person is diagnosed with asthma when he or she has repeated episodes of asthma-like symptoms that improve with asthma medications.
How is asthma treated?
Asthma is treated with medication and by reducing exposure to the things that trigger asthma symptoms.
There are two kinds of medicines. One type of medicine treats the inflammation in the lungs, and the other type of medicine treats the spasm of the muscles around the airways.
(1) C ontroller medications:
These medications keep the inflammation in your child’s lungs under control. They
are anti-inflammatory medications and include medicines such as fluticasone (Flovent), budesonide (Pulmicort), montelukast (Singulair) and others. These types of medicines will not make your child feel better right after taking them. It may take a couple of weeks for these types of medicines to have their full effect. These medicines should be taken every day, even on days when your child has no asthma symptoms.
(2) R eliever medications:
These medications cause the muscle that is around the airways to relax so that the
airways can open again. These medicines include medicines like albuterol (Ventolin, Proventil, ProAir) and levalbuterol (Xopenex). These medicines work in a few minutes and make patients feel better quickly. These medicines are used as needed, but the goal is to get the lung inflammation under good control with controller medicine so that your child does not need the reliever medication very often.
The other important part of treating asthma is reducing exposure to things in your child’s environment that trigger asthma symptoms. Allergy testing helps to identify the allergens that are triggering your child’s asthma. If the exposures can be reduced or even eliminated, then there is less inflammation in your child’s lungs.
How do I know if my child’s asthma is under good control?
If your child keeps having asthma symptoms every couple of days, this may be a sign that your child’s asthma is not under good control and that he or she may need a change in his or her asthma medicines. Other signs of poor control are waking up at night with cough or trouble breathing and trouble with exercise. Asthma symptoms include episodes of coughing.
If your child is having coughing, wheezing, or chest tightness more than twice a week OR waking up at night
with asthma symptoms more than one to two times a month, call your doctor to discuss whether there needs to be an increase in your child’s asthma medicine.
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