Asthmatic people have airways that are very sensitive to certain irritants and allergens, going into spasm when exposed to even normal amounts. During an asthma episode the muscles surrounding the bronchial tubes constrict and the lining inside the tubes swells and produces an excessive amount of mucous. Triggers of asthma are divided into two groups, irritants and allergens. The most potent (and preventable) irritant is secondhand cigarette smoke; other irritative triggers include viral infections, rapid environmental changes in temperature and humidity, ozone, smoke from a fireplace and sometimes exercise. Allergens responsible for triggering the bronchial narrowing include dust, molds, pet dander, foods, and certain drugs. Some people with asthma only have an attack when two or more triggers are present at the same time. To help control asthma it is important to identify the various triggering mechanisms that affect symptoms and try to remove them from the environment.

The airway spasm and mucus plugging that occurs in asthma lead to a variety of symptoms. Although asthma attacks vary in severity, during an attack most have a hard time breathing and often make wheezing sounds (whistling or squeaking sounds with respiration) in the process. Cough is also common from irritation of the sputum. Typically the onset is sudden and you may experience tightness in the chest, severe breathlessness, fatigue, and panic from a feeling of suffocation. No two asthmatics react the same way and not every asthma attack is an obvious one. For instance, some asthmatics may only have a constant cough or only experience wheezing during vigorous exercise.

No one knows why some develop asthma, but the condition tends to run in families. If both parents have asthma, at least one in three of their kids may have similar symptoms. However, a considerable number of kids who wheeze have no close relatives with asthma. There is some indication that exposure to certain injurious agents, such as cigarette smoke (even as a fetus), increases the risk for acquiring asthma.

While there is no cure for asthma, great strides have been made in its treatment. The first approach is to identify the triggering mechanisms and try to prevent exposure to those substances. While avoidance of the offending trigger is recommended, it is often difficult, especially when a beloved pet or common substances like house dust are involved.

Medication prescribed to treat and prevent asthma is usually taken orally or inhaled. Antibiotics are not helpful unless a secondary infection is present. The two main types of medications used to treat asthma attacks are bronchodilators and anti-inflammatories. Bronchodilators are medications that relax the muscles around the air tubes to relieve the attack. Examples included various preparations of theophylline and adrenaline-like medications. . These drugs should be given as often as necessary but as little as needed because of side effects, including stomach upset, rapid heart beat, and nervousness. Bronchodilators can be administered by mouth or may be inhaled. There has been a trend in recent years to rely on inhaled agents, which offer the child increased benefits with fewer side effects. Medication can be given by a hand-held inhaler or a nebulizer, which consists of an air compressor that delivers medication as a "mist" so the drug us distributed directly where it is needed.

In severe attacks, steroids are helpful by treating air tube inflammation. These drugs are very effective and when used in occasional short courses are safe and control asthma flare-ups unresponsive to other treatments. The physician should always be consulted before using steroids.

People with frequent asthma attacks can be given a medication called cromolyn which blocks allergy-related chemicals from being released in the lung. Allergy shots may benefit some with asthma under the guidance of an allergist.

A severe asthma attack is a medical emergency and you should be prepared to call your physician or go immediately to a hospital emergency department. The following signs indicate potential problems:

• Blue or gray lips or flaring nostrils

• The child prefers to sit up and lean forward on elbows or arms

• The spaces between the ribs become depressed

• The heart rate becomes rapid

• The child is unable to say more than a few words between breaths

• The child is unable to hold down liquids or their medication

Virtually all asthmatics can lead normal lives with active physical activity and minimal inconvenience. While a "twitchy" airway is a life-long problem, many people indeed "outgrow" their asthma as they become teenagers. For these people, the airway apparently becomes less sensitive to the different triggers that in the past set off their illness. Though asthma can be a serious disease - and a frightening one - it needn’t ruin the quality of life for its suffers. The important thing to remember is that modern treatment for asthma is both effective and safe. Keep a positive attitude and strive to maintain a normal life style.