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Asthma — Triggers

What triggers asthma attacks? If you have asthma, then shouldn’t you know the answer?

Asthma is a chronic lung condition characterized by difficulty in breathing. People with asthma have extra sensitive and/or hyper-responsive airways. During an asthma attack, the airways become irritated and react by narrowing and constricting, causing increased resistance, and obstructing the flow of the air passages to and from the lungs.

The words “trigger factors,” and “triggers” of asthma are used to describe the things that can cause an attack in someone who already has asthma.

Many things can bring on, or trigger, an asthma attack, and the causes and triggers vary greatly from person to person. Dogs and cats cause attacks in some people. While for others, cold air, tobacco smoke, exercise, and even laughing can trigger attacks. Some people with asthma report that the asthma attacks are worse when they are upset, under stress, or anxious. Some people get asthma if they take aspirin or other painkillers, and some get asthma from fumes or dust at work.

Bad asthma attacks, which force people to go into hospital, often happen after a virus infection of your nose or chest.

The most common triggers for asthma include:

Allergens

* Dander from the skin, hair, or feathers of animals, such as cats, dogs, etc. * Dust mites (contained in house dust) * Pollen from grass and trees * Mold (indoor and outdoor) * Cockroaches

Irritants

* Cigarette smoke * Air pollution * Cold air (for example, if you move from warm indoor air to cold outdoor air. * Strong odors from cooking or painting * Scented products * Allergens or irritants that you may be exposed to at your work such as special chemicals or dusts.

Others

* Breathing tests. Just as the fast breathing in exercise can bring on attacks, the faster and deeper breathing you have to do for most breathing tests can bring on quite a noticeable narrowing of air passages, and can bring on an asthma attack.

* Histamine or methacholine aerosols. Doctors use an inhaled mist of these substances to measure how irritable your air passages are. In asthma they are more irritable than normal. During allergic or asthmatic reactions, the cells in the lungs release histamine. Methacholine mimics the effect of a substance (acetylcholine) released by the nerves in the lung during asthma. Both substances cause an attack in anyone who breathes enough of them, but people who have asthma will get an attack from a much smaller amount. In the test, the amount of asthma produced is small and bearable, and it wears off quickly. The result gives a very useful measurement of the irritation in a persons airways.

* Irritants in asthma inhalers. Some powder inhalers can cause a small amount of chest tightness. Aerosol inhalers need to have a lubricant and this can cause irritation of air passages, and can bring on an asthma attack.

* Some drugs, especially beta-blockers (used for high blood pressure or heart disease).

* Medications such as aspirin and other painkillers.

* Sulfur dioxide, previously used as a preservative in soft drinks and wine. Drinking, or even breathing the air above such a drink, can cause chest tightening within seconds.

* Sulfites in dried fruit or in wine. For example, sodium metabisulphite (E220-227) may trigger asthma, but not via an allergic reaction. It can be found in wine, home-brewed beer, carbonated drinks, prepared meats and prepared salads.

* Indigestion, with stomach acid rising into your gullet. This is called gastro-esophageal reflux, or acid reflux. This causes heartburn and worsens asthma symptoms, especially at night.

* Infections of the lining of the breathing passages, such as colds and flu.

* Crying or laughing

* Exercise.

* Strong emotional response. People with asthma often say that their asthma gets worse if they are crying, upset, or under stress.

This is not a complete list of the things that can trigger asthma.

In addition, people differ in which of these things causes the most asthma, and some people may have trouble with one or more of the triggers. It is important that you identify what triggers your asthma, so that you can avoid or minimize your exposure to it. Your doctor can help you with this.

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