Asthma is an inflammatory condition in which both tissue swelling of the airways (bronchioles) and constriction by smooth muscle surrounding the airways reduces the air flow and traps air inside the lungs. Common symptoms of asthma include: expiratory wheezing, shortness of breath, chest tightness and cough. Asthma exacerbations can be caused by upper airway bacterial infections (sinusitis), viral respiratory infections, acid reflux, exercise and allergen exposures (in allergic individuals). For optimally effectively medical management, all persons with asthma need to undergo allergy testing to identify their triggers.
Allergy testing can reveal sensitivities to potentially avoidable allergens such as pet dander or dust mites. In addition, if seasonal allergen sensitivities are identified, effective medical management can be specifically directed at this issue.
Whenever possible, asthma management should include an initial objective assessment of lung function; this is done with a spirometer. Typically, most children over age 5 can effectively perform pulmonary function testing (PFT). When medical management is done with the assistance of PFT measurements, medications can be adjusted to ensure that a sufficient, but not excessive, amount of medication is being provided. Person who are labeled as "asthmatic" without confirmation by a PFT (demonstrating reversible airway obstruction after the use of a bronchodilator - Albuterol) are at risk for misdiagnosis.
If both the allergy testing and the clinical history suggest that allergens are truly a significant cause of exacerbations for any individual, immunotherapy becomes an asthma treatment option. If allergen triggers are the primary cause for asthma exacerbation, allergy shots may resolve the asthma completely. Asthma is typically considered under poor control if it limits the quality of one's life in any way or if symptom exacerbations are experienced more than twice per week or cause night-time awakenings more than twice per month.