Common causes and symptoms

What triggers asthma?

Factors that contribute to this chronic inflammatory disease vary from one person to another. The one thing all sufferers have in common is that airways become inflamed, narrow and fill with mucus build-up when a person comes in contact with a specific trigger (cause). A trigger can use an attack immediately after exposure or even several days (sometimes weeks) later.

Triggers and causes can be mild for some individuals and more severe in others. It’s important to understand what triggers can lead to an asthma attack as a way to control the condition. Your doctor will carefully assess what factors were present when you first experienced symptoms or an attack as the best way to determine the different triggers that most apply to you. As a sufferer, you may not have reactions to all of your triggers. Some reactions to specific triggers may be milder or more severe. You may have only one trigger, or many. Working closely with your doctor will help to determine the cause/s of your asthma, and thus the best ways to avoid or control the symptoms of the condition.

Some of the most common triggers that contribute as causes of asthma are:

• Allergies: Approximately 80% of asthma sufferers have an allergy to airborne substances. These include grass, trees, mould, weed pollens, dust mites, animal dander and even cockroach particles.
• Upper respiratory infections (viral or bacterial): Inflammation and mucus build-up in the membranes lining the sinuses can cause sinusitis. The secretion of excess mucus also narrows the airways prompting a sinusitis-induced asthma attack. It is important to treat a sinus infection swiftly, as well as any other respiratory infections such as cold and flu, and bronchitis to help alleviate asthma symptoms. It is also important to take additional care for up to two months after an infection, as airways may still be sensitive and narrow easily after recovery.
• Food and food additives: An asthmatic reaction (food-induced anaphylaxis) to this trigger can range from mild to life-threatening, but very rarely causes an isolated attack without the presence of other symptoms. Foodstuffs that most commonly trigger a reaction include peanuts, soy, wheat, eggs, cow’s milk, fresh fruits, shrimp and other shellfish, and fish. Preservatives, such as sulphite (sodium and bisulfite, potassium bisulfite, and sodium sulfite) can also cause an asthmatic reaction.
• Heartburn and GERD: The majority of asthma sufferers also experience severe heartburn (or gastroesophageal reflux disease), most commonly at night (when lying down). When stomach acid travels back up into the oesophagus, irritation and inflammation occurs, causing an asthma attack. A doctor may suggest a change in diet and medications to assist in keeping attacks at bay.
• Physical activity / exercise: Increased physical activity can often cause a narrowing of the airways in the majority of individuals suffering from asthma, and typically triggers symptoms of chest tightness, difficulties with breathing and coughing. Symptoms usually happen quickly (within 5 to 15 minutes) of strenuous exercise and subside within an hour. It’s not uncommon for another attack to occur within a 12-hour period. Asthmatic sufferers are often encouraged to warm-up slowly before partaking in any exercise activity to reduce the probability of an attack.
• Medications: Medicinal triggers can include aspirin or anti-inflammatory based drugs. Ibuprofen, naproxen and beta-blockers are known to trigger asthmatic reactions. A sensitivity to medications will need to be documented by your doctor. It is also a good idea to double check all medication ingredients before taking anything recommended by a pharmacist.
• Smoking: Symptoms of coughing and wheezing can worsen with persistent / regular smoking habits. Those who are asthmatic are generally discouraged from smoking as a result, and also as a way to protect the lungs. Asthma sufferers can also experience an attack when exposed to smoke from wood-burning appliances or fireplaces.
• Other triggers: These can include perfume (fragrances), cleaning agents, occupational dust or vapours, air pollution, weather changes (cold air and humidity) and even strong emotions related to stress or anxiety.

What are the signs and symptoms of asthma?

Some sufferers may experience symptoms periodically, while others will experience symptoms every day. Some may experience different signs of the condition at different times, while others may not experience all of the most common symptoms at once.

Some sufferers may only experience asthmatic reactions when exercising or when ill with a viral infection.

The most common symptoms are:

• Chest pain or a tightness in the chest
• Shortness of breath
• Coughing and / or wheezing
• A whistling sound (when exhaling / breathing)
• Sleeping problems (as a result of the above-mentioned symptoms)

Early warning signs of a potential asthma attack can include:

• A frequent cough (especially at night or following exercise)
• Fatigue or moodiness
• Sleeping problems
• Tiredness or feeling weak when exercising
• Easily becoming short of breath
• Signs of allergy or a viral infection (sneezing, nasal congestion, runny nose, headache or sore throat)

Symptoms of an asthma attack include:

• Severe wheezing (when inhaling and exhaling)
• Chest pain or intense pressure
• Persistent coughing
• Intense or rapid breathing
• Difficulties with being able to talk
• Tightened chest and neck muscles
• Pale and / or sweaty face
• Blue lips and / or blue fingernails
• Anxiety or panic

Signs of a worsening condition are:

• Common symptoms becoming more frequent and disruptive to your daily life
• Increased breathing difficulties
• A more frequent need to use a quick-relief inhaler

What happens when a person experiences an asthma attack?

Muscles around the airways spasm when inflamed and the lining of the mucosal membrane begins to swell. The excess mucus produced also causes the airways to narrow, which in turn forces them to try and work harder to breath. As a result of narrowing and resistance in the airways, breathing becomes increasingly difficult and causes symptoms of coughing (due to irritation inside the airways), wheezing and shortness of breath. Coughing with an asthma attack is also often the body’s way of trying to rid itself of the excess mucus.

Severity of an asthma attack can escalate very quickly. In some instances, and attack can be life-threatening, so it is vital to treat any recognised signs or symptoms immediately.

During an attack, a person’s breathing becomes increasingly laboured and the lungs continuously tighten. In dire situations, a person experiencing an attack will be completely unable to speak and will develop a bluish colouring around their lips (cyanosis). When this occurs, a person may lose consciousness with less and less oxygen in their bloodstream. An asthma emergency requires aggressive treatment, and swiftly.

The disappearance of wheezing or whistling sounds is not necessarily a sign of improvement in the condition of a person experiencing an attack. It is an impending sign of a silent chest where the person is no longer breathing. It is important to transport anyone having an attack to a medical facility as soon as possible for prompt emergency care.