Unfortunately asthma is one of the most common chronic diseases worldwide and the prevalence is increasing, especially among children.

Fortunately asthma can be treated and controlled so that almost all patients can:

• Prevent troublesome symptoms night and day
• Prevent serious attacks
• Require little or no reliever medication
• Have productive, physically active lives
• Have (near) normal lung function.

Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing particularly at night or in the early morning.

Asthma is a chronic inflammatory disorder of the airways. Chronically inflamed airways are hyperresponsive; they become obstructed and airflow is limited (by bronchoconstriction, mucus plugs, and increased inflammation) when airways are exposed to various risk factors.

Common risk factors include exposure to allergens such as domestic dust mites (in bedding, carpets, and fabric-upholstered furnishings), animals with fur, cockroach, pollens and molds; occupational irritants; tobacco smoke; air pollution; respiratory (viral) infections; exercise, strong emotional expressions; chemical irritants and drugs (such as aspirin and beta blockers). There is good evidence that asthma occurs in families.

Asthma severity can be intermittent, or it can be persistently mild, moderate, or severe. Severity varies among individuals, does not necessarily relate to the frequency or persistence of symptoms, and can change in one individual over time. Treatment decisions are made based on severity.

A stepwise approach to pharmacologic treatment to achieve and maintain control of asthma should take into account current treatment, pharmacologic properties and availability of anti-asthma treatments, and economic considerations.

Asthma attacks (or exacerbations) are episodic, but airway inflammation is chronically present. For many patients, medication must be taken every day to control symptoms, improve lung function, and prevent attacks. Medications may also be required to relieve acute symptoms, such as wheezing, chest tightness, and cough.

Asthma care requires a partnership between the patient and the health care professional. The aim is to provide patients the ability to control their asthma with guidance from the health care professional.

Asthma is not a cause for shame. Olympic athletes, famous leaders, other celebrities, and ordinary people live successful lives with asthma.

Asthma may be preventable. For infants with a family history of asthma or atopy, it is thought that avoiding exposure to passive smoking and to domestic dust mite, cat, and cockroach allergens may help prevent the initial development of asthma. For adults, avoiding exposure to smoke and to chemical sensitizers in the workplace is helpful.