Centers of Excellence

The Lung Center

Asthma

Asthma is a chronic condition in which your airways narrow and swell and produce extra mucus. This makes breathing difficult and triggers coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

A period of intense difficulty breathing is called an "asthmatic attack" or "asthma flare-up." This can happen when airways are exposed to and react to triggers (allergens and irritants). The following changes occur:

  • The lining of the airways becomes swollen and inflamed.
  • The muscles that surround the airways tighten.
  • More mucus is produced, leading to mucus plugs.

Asthma typically begins in childhood, but it can begin at any age and often continues into adulthood and even old age. The intensity and severity of asthma symptoms varies broadly from patient to patient, and may change over time.

Learn more about asthma and asthma triggers.

Pulmonologists at Brigham and Women's Hospital (BWH) Lung Center work closely with BWH allergists and the Partners Asthma Center, a collaboration among healthcare providers of the Partners HealthCare system. Partners Asthma Center specialists are experts in diagnosing asthma, identifying triggers, establishing a treatment plan and managing symptoms to improve adult patients' long-term quality of life.

Special services include management of difficult-to-control asthma, occupational asthma and asthma among pregnant women. The specialists at the Partners Asthma Center have been treating patients with asthma for more than 25 years and have developed valuable resources for helping patients control their disease.

All physicians at Partners Asthma Center are board certified and are faculty members at Harvard Medical School.

Asthma Topics

Causes of Asthma

Although the exact cause of asthma is unknown, it is believed to be due to a combination of genetic (inherited) and environmental factors. Many patients with asthma have other allergic diseases, including allergic rhinitis and conjunctivitis ("hay fever") and atopic dermatitis (eczema).

Asthma Triggers

  • Airborne allergens (pollen, animal dander, mold, cockroaches, dust mites)
  • Respiratory infections
  • Physical activity (exercise-induced asthma)
  • Air pollutants and irritants (smoke)
  • Certain medications
  • Strong emotions and stress
  • Sulfites and preservatives added to some foods and beverages including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD)
Risk Factors for Asthma

Asthma is most common in:

  • Children and teens ages 5 to 17
  • Those living in cities
  • Male children
  • Older females

Other factors include the following:

  • Personal or family history of asthma or allergies
  • Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
  • Being overweight
  • Being a smoker
  • Exposure to secondhand tobacco smoke
  • Exposure to other types of pollution
  • Exposure to occupational triggers, such as chemicals used in farming, manufacturing or hairdressing
Symptoms of Asthma

Asthma symptoms include:

  • Shortness of breath
  • Difficult breathing that may hurt
  • Tightness in the chest
  • Wheezing or a whistling sound while breathing
  • Coughing
  • Talking and sleeping may be difficult with severe symptoms

Learn more about the signs and symptoms of asthma.

Diagnosis and Classification of Asthma

To diagnose asthma, your physician will examine your chest, measure your lung function, and conduct tests to rule out other possible lung disorders. Your physician will also ask you questions about your symptoms and family history of asthma and allergies.

In addition, your physician will inquire about the frequency with which you experience asthmatic symptoms and the intensity of your symptoms. This will help your physician to determine your asthma's severity and develop an effective plan for treating and managing your symptoms.

Spirometry

Spirometry is an important test to determine your lung function. The spirometer measures the amount of air you breathe out and how quickly you can exhale all the air from your lungs.

Learn more about spirometry.

Other Tests

In addition to spirometry, your physician may also conduct

  • Allergy tests (either a skin or blood test)
  • Exercise tests
  • Imaging tests (a chest X-ray or CT scan)

Read more about how asthma is diagnosed.

Treatment and Management of Asthma

Although there is no cure for asthma, it can be effectively managed. You and your health care team will work together to develop a plan to:

  • Manage chronic symptoms
  • Prevent severe asthmatic attacks
  • Preserve your lung function
  • Enable you to live an active lifestyle

Your management plan will include medications (see below), exercises, emotional support and strategies for avoiding triggers. The plan will depend on your asthma triggers, the severity of your symptoms, your age and other factors. It is important to meet with your doctor on a regular basis to review your plan and make modifications if necessary.

Read more about living with asthma and a sample "action plan" from the National Institutes of Health.

Medications for Asthma

Asthma is treated with both long-term and quick-relief medications.

  • Long-term medications reduce inflammation and prevent symptoms from starting in the first place, but they cannot stop a flare-up in progress.
  • Quick-relief medications relieve asthma symptoms when they become more intense. Be sure to carry your quick-relief medication with you at all times and take the medication as soon as you recognize symptoms. Quick-relief medicines should only be taken when needed and should not replace long-term medicines.

Read more about asthma medications and answers to common asthma medication questions.

Watch Dr. Christopher H. Fanta, Director of the Partners Asthma Center and a pulmonologist in the Women’s Lung Health Program at Brigham and Women’s Hospital, discuss novel treatment approaches for patients with severe asthma.

Asthma During Pregnancy

Having asthma does not mean that you'll have a high-risk pregnancy. It does, however, mean that you'll need extra monitoring and medical care to prevent any possible complications for you and your baby.

Caring for yourself and managing your asthma is the best way to care for your baby. Be sure to:

  • Consult with your obstetrician regularly.
  • Take your asthma medication as prescribed; most asthma medications are safe for you and your baby during pregnancy and while breastfeeding.
  • Monitor your symptoms and meet with your doctor if they worsen.
  • Avoid asthma triggers.
  • Exercise moderately.

Read more about asthma and pregnancy.

What You Should Expect

The Partners Asthma Center brings together the full range of services and expertise of BWH and Partners HealthCare. This collaboration fosters coordinated, multidisciplinary care for patients with asthma.

Our team of experts develops a personalized management plan for your asthma based on current research. Your health will be closely monitored and managed to alleviate or eliminate symptoms, enabling you to confidently resume the activities you enjoy.

Multidisciplinary Care

The Partners Asthma Center includes pulmonary physicians, respiratory therapists, nurse educators and pulmonary function technicians practicing together to provide the finest possible care for both adults and children with asthma. Our specialists also work closely with the allergists at Brigham and Women's Hospital to provide comprehensive, collaborative care for asthma patients.

Resources

Learn more about asthma in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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