Every first Tuesday in May is World Asthma Day, an opportunity to discuss this condition affecting more than 300 million people worldwide.

Although it may seem like a complex disease, understanding it is the first step to living well with it… and it is possible.

What happens in the lungs when you have asthma?

Asthma is a chronic inflammatory disease of the airways that causes intermittent airflow obstruction to the lungs. In people with asthma, the airways (bronchi and bronchioles) become inflamed and narrowed due to the body's immune response to certain stimuli.

This inflammation leads to increased mucus production and contraction of the muscles in the airway walls (bronchospasm), making it difficult for air to enter and exit. The characteristic symptoms of this condition include difficulty breathing, chest tightness, coughing, and wheezing (wheezing when exhaling). These episodes can be triggered by various environmental factors, allergens, or physical stimuli, known as "triggers."

What can trigger an asthma attack?

Triggers vary from person to person, but the most common include:

• Dust mites, pollen, mold, and pet hair.
• Strenuous physical exercise, especially in cold weather.
• Sudden changes in temperature or humidity.
• Emotional stress and anxiety can be potent triggers of asthma attacks due to their impact on the nervous and respiratory systems.
• Cigarette smoke (be careful not to smoke around someone with asthma!).
• Respiratory infections such as colds or flu: Untreated allergic rhinitis can worsen asthma; the nose and lungs are connected, and nasal conditions can trigger or aggravate respiratory symptoms.

It's important to note that asthma can begin in adulthood, even in people who have never had respiratory symptoms before. This type is known as late-onset asthma.

There are different stages of asthma, and understanding the classification greatly helps with diagnosis and treatment:

• Mild intermittent asthma. Symptoms occur no more than two days a week or twice a month.
• Mild persistent asthma. Symptoms occur more than twice a week.
• Moderate persistent asthma. Symptoms occur daily and at least one night each week. Flares also last for several days.
• Severe persistent asthma. In this stage, symptoms occur several times a day, almost every day. You may also experience symptoms many nights a week. This stage of asthma may not respond well to treatment.

People with asthma may move in and out of these stages depending on how their medications work or how frequently symptoms occur.

In addition, there are specific forms such as allergic asthma, exercise-induced asthma, which can affect even high-performance athletes, such as swimmers or runners, or occupational asthma, which occurs due to exposure to substances in the workplace.

How to diagnose asthma:

Clinical evaluation is combined with studies that help confirm the diagnosis and rule out other causes of respiratory symptoms.

These are some of the tests:

1. Spirometry: The most common and essential test, as it provides estimates of bronchial narrowing by checking the amount of air you can exhale after a deep inhalation and how quickly you can exhale.
2. Peak expiratory flow: An expiratory flow meter is a simple device that measures how forcefully you can exhale. Lower-than-normal peak expiratory flow values ​​are a sign of possible lung malfunction.

Additional tests:

1. Methacholine challenge test: Methacholine is a known asthma trigger. When inhaled, it causes the airways to narrow slightly. If you react to methacholine, you likely have asthma. This test can be used even if the initial pulmonary function test yielded normal results.
2. Imaging tests: A chest X-ray can help identify structural abnormalities or diseases (such as an infection) that may cause or worsen breathing problems.
3. Allergy tests: Allergy tests can be performed through skin or blood tests. If allergy triggers are identified, your doctor may recommend allergy shots.
4. Cold- and exercise-induced asthma challenge tests: In these tests, the doctor measures airway obstruction, and then the person must perform intense physical activity or inhale cold air several times.
5. Finally, blood tests are complementary, not diagnostic, but are useful in identifying the type of asthma and guiding treatment. What is measured? The level of IgE antibodies in the blood, which increases in people with allergies, and the number of eosinophils, a type of white blood cell associated with allergic reactions and inflammation.

Although asthma has no cure, it can be very well controlled:

Today, there are two main types of medications:

• Quick-relief or "rescue" medications, such as bronchodilators, which help open the airways during an attack.
• Long-term control medications, such as inhaled corticosteroids, are used daily to reduce inflammation and prevent symptoms.

With proper treatment, a good routine that includes monitoring your breathing and avoiding triggers, many people with asthma lead active, fulfilling, and stress-free lives.

On this World Asthma Day, the invitation is clear: if you feel short of breath more than usual or have persistent symptoms, visit a professional. Knowing your diagnosis is the first step to living a better life.