Today, we’re conducting a mini biology class diving into the pathophysiology of asthma, as in, exactly how asthma works in the human body. (Just call us SELF University.) If you’re always ready to dig into the details of how certain health conditions work, you’re in luck. Same goes if you have asthma and you’re not sure why your respiratory system seems to lose any semblance of cool in some situations.
The way asthma works is pretty complex, but it centers around the airways in your body that help you breathe.
Your airways extend from your nose and mouth to your lungs and work to carry air in and out of your body, according to the National Heart, Lung, and Blood Institute (NHLBI). They may be upstanding workers and do this job just fine. But, if you have asthma, your airways can get inflamed when you’re exposed to certain triggers. “[Asthma is] really a disease of inflammation,” Timothy McGee, D.O., a pulmonologist at Northwestern Medicine Central DuPage Hospital, tells SELF, because inflammation is what kick-starts the asthma chain of events.
This airway inflammation can cause swelling that prompts the muscles around your airways to constrict, making it harder for them to transmit life-giving oxygen and carry waste products like carbon dioxide out of your system. It also throws your airways’ mucus production into higher gear than usual. These factors can create the (im)perfect storm that leads to asthma symptoms including shortness of breath, a cough, wheezing (a whistling sound when you breathe), chest tightness, and more.
It’s entirely possible to have a pretty mild reaction to a trigger, so your symptoms go away on their own or respond quickly to medication. But if they get worse, you might have an asthma attack (also called an asthma exacerbation), which can be life-threatening.
There’s a wide range of triggers that can spark asthma’s domino effect, but some are more common than others.
Asthma triggers vary from person to person, and different doctors will see some more than others. Dr. McGee, for example, tends to encounter a lot of patients whose asthma flares due to pollen, dust mites, and mold. Pulmonologist Ryan Thomas, M.D., director of the Multidisciplinary Severe Asthma Team at Michigan State University, tells SELF he often sees patients whose asthma is exacerbated by a viral infection or exercise.
Other common triggers include pet dander, cold air, air pollutants and irritants like smoke, certain medications including beta blockers, aspirin, ibuprofen, and naproxen, strong emotions such as stress, sulfites and preservatives added to some foods, and gastroesophageal reflux disease (GERD), a condition that causes stomach acids to back up into your throat, the Mayo Clinic says.
If you read that list and noticed a lot of overlap with common allergens that transform certain seasons into hell on Earth for some people, you’re right on target. It’s not uncommon for people with asthma to also grapple with allergies, thanks to a fascinating yet also inconvenient phenomenon known as the atopic march. The atopic march is when people with one kind of allergic disease, like eczema, tend to develop others, like allergies and asthma, according to the American Academy of Allergy Asthma & Immunology. If you think about it, it makes perfect sense that when your body has an oversensitivity to certain substances, like dust and pollen, encountering them might make your system light up like a pinball machine, with all sorts of allergy-related symptoms manifesting in many different ways.
Luckily, there are plenty of medications designed to help target asthma’s pathophysiology and stop your airways from freaking out.
If you have asthma, you should sit down with your doctor and create what’s known as an asthma action plan, a written document that spells out the treatments that help keep your asthma under control, along with the protocol you should follow if your symptoms start getting worse. Your asthma action plan may need tweaking at various points because it can take some trial and error to land on the best way of handling your condition.
In general, doctors tend to prescribe two types of drugs for asthma: quick-relief medications and long-term preventive ones.
Quick-relief treatments are meant to calm your airways ASAP when your asthma symptoms act up. Many of them are known as bronchodilators, meaning they fight that airway constriction that starts the asthma cycle, according to the Mayo Clinic. The most common type of quick-relief treatment is short-acting beta agonists, which you breathe in through an inhaler and which typically act within minutes.
Long-term preventive medications, which include things like allergy medications and inhaled corticosteroids, are designed to control your asthma so you’re not as likely to have symptoms in the first place, the Mayo Clinic says. The goal with these drugs is to reduce inflammation in your airways as a whole, so you’ll typically take them every day. “When there is less baseline inflammation, there is a smaller response to triggers, which leads to fewer symptoms,” Dr. Thomas explains.
So, now you know the pathophysiology of asthma. Use this information for good, not evil.
OK, there’s really no way to use this for evil. But, if you have asthma or if you have loved ones who do, knowing this might help make life a little bit easier (or at least answer some questions you had). And if you don’t have asthma and were really just curious about its pathophysiology, well, crushing a biology question at your next trivia night definitely counts as using this for good.