Asthma

We don’t know why some people have asthma and other people don’t. We do know that certain things can put you at higher risk — like allergies, substances in the environment (smoke, fumes, toxins) genetics (DNA) and respiratory (lung) infections. Our job is to find out what triggers your asthma and give you ways to manage the attacks and make them less severe.

What to expect at your first appointment

At your first visit, we’ll ask about your health history and your family’s health history, too. Then we’ll ask you to tell us about your symptoms. We’ll also want to know if you have any allergies, if you get eczema (a bumpy rash caused by allergies) and if you have any other lung diseases.

We might also do a chest X-ray to get a better look at your lungs. Then, you’ll have some more tests to help us diagnose your asthma.

Our experts keep a close eye on you during these tests to make sure you’re safe and as comfortable as possible. The results can help us better understand what causes your asthma attacks.

Spirometry and peak expiratory flow testing

Spirometry and peak expiratory flow testing let us see how well your lungs work by measuring how much air you can breathe out and how quickly you can do it (airflow). For this pain-free test, we’ll have you take a deep breath and blow into a tube. The tube will be connected to a machine called a spirometer or to a small handheld device that takes measurements.

You might do the test again after you take a bronchodilator, which relaxes and opens your airways. That way, we can compare measurements with and without the medication.

Allergy testing

Allergy testing usually involves intentionally but carefully exposing you to small doses of potential allergens — like certain foods, pet dander or pollen — all of which can trigger asthma. We might have you eat or inhale these things. Or we might do tests where we put small amounts on your skin and scratch it to see how your skin reacts.

Bronchoprovocation

Bronchoprovocation is a big word that basically means we’ll try to upset (provoke) your lungs to cause an asthma attack on purpose. For this test, you’ll inhale very cold air or air that contains certain substances that may trigger asthma.

Biomarker testing

Asthma biomarker testing, which isn’t widely available, can be helpful if your asthma isn’t getting better, even with treatments.

Biomarkers are things in your body that could help us understand what might be causing your asthma. They can also give us an idea of how you might respond to different types of treatments. We look for biomarkers in your breath, spit (saliva) and blood.

For example, a fractional exhaled nitric oxide (FeNO) test measures how much nitric oxide you make when you breathe out. If you have high levels of nitric oxide, it could mean your airways are inflamed. Knowing this can help us design a more personalized treatment plan for the best results.

Meet Our Asthma Team

Getting asthma treatment at Cleveland Clinic means you’ll work with a team of compassionate and experienced healthcare providers who’ll personalize your asthma treatment to match your needs. Your care team could include:

• Otolaryngologists.
• Allergists.
• Pulmonologists.
• Immunologists (immune system experts).
• Rheumatologists.
• Gastroenterologists.
• Primary care providers.
• Psychologists.
• Physician assistants.
• Nurse practitioners.

While we can’t make asthma go away for good, we can help you manage it and reduce how bad your attacks are and how often you have them.

We’ll work with you to craft and follow a personalized asthma action plan. It’ll consider the conversations you’ve had with your providers, as well as your test results and diagnosis. Your plan will explain:

• What triggers your asthma — allergens, irritants, intense emotions, exercise, certain medications or cold air.
• Ways you can avoid or reduce exposure to those triggers.
• How to know when you’re having an asthma attack.
• What to do during an attack.
• What medicines to take, including how much and when.
• When and how to seek emergency medical attention.

And once you start the plan, you’ll keep seeing us regularly to make sure your plan is working and make any changes to it as we go.

Asthma medications

Cleveland Clinic offers a wide variety of medications to treat asthma. They range from proven, traditional options to the newest innovations. And we may combine long-term medications to prevent attacks and quick solutions to treat your attacks when they happen.

Your medications could include:

• Allergy shots, which intentionally expose your body to triggers so that it learns to tolerate them.
• Bronchial thermoplasty, which shrinks and relaxes muscles in your lungs using heat to avoid asthma attacks.
• Corticosteroids or other anti-inflammatory drugs, in inhaler or pill form, which reduce swelling in your airways.
• Metered-dose inhalers containing different types of medications, like corticosteroids or bronchodilators, to help open your airways and reduce inflammation.
• Biological therapies made from cells that target antibodies in your body to keep inflammation and asthma symptoms from starting.

Other support

When you come to Cleveland Clinic for asthma treatment, you’ll also get support to help you live with this chronic (lifelong) condition.

Our dietitians can help you eat nutritious foods and maintain a weight that’s healthy for you. If you smoke, we can help you kick that habit. We can also connect you with mental health professionals if stress is making your asthma symptoms worse. And we’ll make sure your vaccinations (shots) are up to date to prevent infections that can worsen asthma.

Taking the Next Step

While we can’t completely get rid of your asthma, we can help you learn to live with it and breathe easier. At Cleveland Clinic, we’ll teach you to recognize what triggers your asthma. And we’ll help you manage it so you can play sports, enjoy activities and make it through the day without worrying about your next attack. We’ll help you control your asthma, so it doesn’t control you.