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Identify and successfully manage adult-onset asthma: avoid permanent lung damage and ER visits by controlling asthma symptoms and avoiding triggers.

Asthma, a chronic lung disease that causes inflammation in and narrowing of airways, is often thought of as a child's disease. But, adults can develop asthma--a condition known as adult-onset asthma--in their 50s, 60s, and beyond. "I do see adult-onset asthma in older women, especially if they have chronic sinusitis," says Elizabeth Jacobson, MD, an asthma and allergy specialist at Weill Cornell's Iris Cantor Women's Health Center.

Causes and symptoms

Many factors may contribute to asthma in a woman's older years, such as obesity, aspirin sensitivity, and changes in hormones. The most common causes are allergies, chronic sinusitis (inflamed, swollen sinus cavities that can cause mucus build-up and inhibit sinus drainage), nasal polyps (growths in the sinuses), and a bad respiratory infection. "A family history also may play a part in developing asthma," says Dr. Jacobson. "If your parents had it, you may be at a higher risk for developing it." Adult-onset asthma symptoms include a feeling of tightness in the chest, difficulty breathing, coughing, and wheezing--a whistling sound when you take a breath.


Unlike childhood asthma, which may flare up occasionally, adult-onset asthma can be a daily challenge. Symptoms may interfere with everyday activities, such as exercise or stair climbing, and recreational activities, such as tennis or dancing. Asthma may cause permanent narrowing of the bronchial tubes, and severe asthma attacks may require visits to the emergency room and/or hospitalization. That's why it's important to get it treated as soon as possible.

Diagnosing asthma usually involves a physical exam, an allergy test, and tests of lung function. Your doctor will ask you for a full medical history and will try to rule out potential underlying causes, such as chronic obstructive pulmonary disease (chronic bronchitis and/or emphysema), hiatal hernia, stomach problems, or rheumatoid arthritis, all of which may produce symptoms that mimic asthma.


While asthma isn't curable, it is treatable. The first step is using medications to control symptoms, delivered in sprayed doses that you inhale through your mouth. The delivery system is called an inhaler.

Two main types of mediations treat asthma. One is a corticosteroid, such as fluticasone (Flovent), which reduces the inflammation of asthma in the bronchial tubes. The other is a bronchodilator, which opens the airways. Bronchodilators are available in long-acting forms, such as salmeterol (Serevent), and short-acting forms, such as albuterol (Proventil). "And, there are medications that combine corticosteroids and bronchodilators, to make it easier for patients," says Dr. Jacobson.

Usually, inhalers are used once or twice daily, but dosage and frequency must be tailored to each person's needs.

Managing asthma

Beyond medications, you can treat asthma by avoiding triggers. For example, if flare-ups are caused by cold, dry air, wear a scarf over your nose and mouth when you go outside into cold weather.

If asthma flare-ups are caused by allergies, it's time to get allergies under control. That may involve allergy medications or shots and avoiding allergy triggers. Strategies include ridding your home of dust and mold, staying inside when pollen levels are high, and avoiding exposure to air pollutants, such as cigarette smoke, cleaning or workplace chemicals, and hairsprays and other sprayed chemicals.

"If you can't avoid the things that cause allergic reactions, then get rapid treatment after any exposure to potential triggers. This should help you control symptoms," says Dr. Jacobson.

A word of caution

People with asthma who get the flu are at high risk for developing pneumonia. Dr. Jacobson urges everyone with asthma to get a flu shot, as well as the pneumococcal vaccine to protect against pneumonia.


Proper technique in using inhalers is essential for delivering the correct amount of the prescribed drug. The design of different inhaler devices may vary, so read the directions carefully before using an inhaler for the first time. If you have any questions about your inhaler, consult your doctor or pharmacist.


1. Remove the cap from the inhaler and shake the inhaler.

2. Exhale completely, place the mouthpiece of the inhaler in your mouth, and seal your lips around it.

3. Press down on the top of the canister while inhaling slowly and deeply; hold your breath for 10 seconds, and then exhale.

4. If you need to take another dose of medicine, wait one minute, and then repeat the steps described above.

5. If the medication is an inhaled steroid, rinse out your mouth. Spit the water out; do not swallow it.

6. Replace the cap on the inhaler.
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Publication:Women's Health Advisor
Article Type:Disease/Disorder overview
Date:Jan 1, 2016
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