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Overview

Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.

Symptoms

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times - such as when exercising - or have symptoms all the time.

Asthma signs and symptoms include:

Shortness of breath

Chest tightness or pain

Wheezing when exhaling, which is a common sign of asthma in children

Trouble sleeping caused by shortness of breath, coughing or wheezing

Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

Asthma signs and symptoms that are more frequent and bothersome

Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)

The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

Exercise-induced asthma, which may be worse when the air is cold and dry

Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust

Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander)

When to see a doctor

Seek emergency treatment

Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen - and when you need emergency treatment. Signs of an asthma emergency include:

Rapid worsening of shortness of breath or wheezing

No improvement even after using a quick-relief inhaler

Shortness of breath when you are doing minimal physical activity

Contact your doctor

See your doctor:

If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.

To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.

If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often.

Don't take more medication than prescribed without consulting your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.

To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.

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Causes

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste

Respiratory infections, such as the common cold

Physical activity

Cold air

Air pollutants and irritants, such as smoke

Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)

Strong emotions and stress

Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine

Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Risk factors

A number of factors are thought to increase your chances of developing asthma. They include:

Having a blood relative with asthma, such as a parent or sibling

Having another allergic condition, such as atopic dermatitis - which causes red, itchy skin - or hay fever - which causes a runny nose, congestion and itchy eyes

Being overweight

Being a smoker

Exposure to secondhand smoke

Exposure to exhaust fumes or other types of pollution

Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

Complications

Asthma complications include:

Signs and symptoms that interfere with sleep, work and other activities

Sick days from work or school during asthma flare-ups

A permanent narrowing of the tubes that carry air to and from your lungs (bronchial tubes), which affects how well you can breathe

Emergency room visits and hospitalizations for severe asthma attacks

Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Prevention

While there's no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.

Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life.

Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.

Identify and avoid asthma triggers. A number of outdoor allergens and irritants - ranging from pollen and mold to cold air and air pollution - can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.

Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath.

But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter. A peak flow meter measures how hard you can breathe out. Your doctor can show you how to monitor your peak flow at home.

Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.

When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed. Also, immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.

Take your medication as prescribed. Don't change your medications without first talking to your doctor, even if your asthma seems to be improving. It's a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you're using your medications correctly and taking the right dose.

Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.

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Find out what can trigger asthma and how to relieve your symptoms and breathe easier.

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What Is Asthma?

Asthma is a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and it makes it hard to breathe. Severe asthma can cause trouble talking or being active. You might hear your doctor call it a chronic respiratory disease. Some people refer to asthma as " bronchial asthma."

Asthma is a serious disease that affects about 25 million Americans and causes nearly 1.6 million emergency room visits every year. With treatment, you can live well. Without it, you might have to go to the ER often or stay at the hospital, which can affect your daily life.

What Does Asthma Feel Like?

Asthma is marked by inflammation of the bronchial tubes, with extra sticky secretions inside the tubes. People with asthma have symptoms when the airways tighten, inflame, or fill with mucus.

There are three major signs of asthma:

Airway blockage. When you breathe as usual, the bands of muscle around your airways are relaxed, and air moves freely. But when you have asthma, the muscles tighten. It's harder for air to pass through.

Inflammation. Asthma causes red, swollen bronchial tubes in your lungs. This inflammation can damage your lungs. Treating this is key to managing asthma in the long run.

Airway irritability. People with asthma have sensitive airways that tend to overreact and narrow when they come into contact with even slight triggers.

These problems may cause symptoms such as:

Not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your symptoms may also vary from one asthma attack to the next, being mild during one and severe during another.

Some people with asthma may go for long periods without having any symptoms. Others might have problems every day. In addition, some people may have asthma only during exercise or with viral infections like colds.

Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require medical help right away. It is important to recognize and treat even mild asthma symptoms to help you prevent severe episodes and keep asthma under better control.

When to see your doctor
Get medical help right away if you have serious symptoms including:

Fast breathing

Pale or blue face, lips, or fingernails

The skin around your ribs pulls inward when you breathe in

Trouble breathing, walking, or talking

Symptoms that don't get better after you take medication

What Is an Asthma Attack?

An asthma attack is the episode in which bands of muscle around the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed, and the cells lining the airways make more and thicker mucus than normal.

All of these things -- bronchospasm, inflammation, and mucus production -- cause symptoms such as trouble breathing, wheezing, coughing, shortness of breath, and trouble with normal daily activities.

Other symptoms of an asthma attack include:

Severe wheezing when breathing both in and out

Coughing that won't stop

Very rapid breathing

Chest pain or pressure

Tightened neck and chest muscles, called retractions

Difficulty talking

Feelings of anxiety or panic

Pale, sweaty face

Blue lips or fingernails

An asthma attack can get worse quickly, so it's important to treat these symptoms right away.

Without immediate treatment, such as with your asthma inhaler or bronchodilator, it will become harder to breathe. If you use a peak flow meter at this time, the reading will probably be less than 50% of your usual or normal peak flow reading.. Many asthma action plans suggest interventions starting at 80% of normal.

As your lungs continue to tighten, you won't be able to use the peak flow meter at all. Your lungs will tighten so there is not enough air movement to make wheezing. You need to go to a hospital right away. Unfortunately, some people think that the disappearance of wheezing is a sign of improvement and don't get emergency care.

Without proper treatment, over time, you may be unable to speak and will get a bluish coloring around your lips. This color change, known as cyanosis, means you have less and less oxygen in your blood. It can cause a loss of consciousness and death.

If you have an asthma attack, follow the "Red Zone" or emergency instructions in your asthma action plan right away. These symptoms happen in life-threatening asthma attacks. You need medical attention right away.

How Is Asthma Classified?

Doctors rank how bad asthma is by its symptoms:

1. Mild intermittent asthma. Mild symptoms less than twice a week. Nighttime symptoms less than twice a month. Few asthma attacks.

2. Mild persistent asthma. Symptoms three to six times a week. Nighttime symptoms three to four times a month. Asthma attacks might affect activities.

3. Moderate persistent asthma. Daily asthma symptoms. Nighttime attacks five or more times a month. Symptoms may affect activities.

4. Severe persistent asthma. Ongoing symptoms both day and night. You have to limit your activities.

Your asthma may be getting worse if:

You have symptoms more often and they interfere more with your daily life.

You have a hard time breathing. You can measure this with a device called a peak flow meter.

You need to use a quick-relief inhaler more often.

Types of Asthma

There are several:

Adult-onset asthma. Asthma can start at any age, but it's more common in people younger than 40.

Status asthmaticus. These long-lasting asthma attacks don't go away when you use bronchodilators. They're a medical emergency that needs treatment right away.

Asthma in children. Symptoms can vary from episode to episode in the same child. Watch for problems like:

Coughing often, especially during play, at night, or while laughing. This may be the only symptom.

Less energy or pausing to catch their breath while they play

Fast or shallow breathing

Saying their chest hurts or feels tight

A whistling sound when they breathe in or out

Seesaw motions in their chest because of trouble breathing

Shortness of breath

Tight neck and chest muscles

Weakness or fatigue

Exercise-induced bronchoconstriction. You might hear this called exercise-induced asthma. It happens during physical activity, when you breathe in air that's drier than what's in your body, and your airways narrow. It can affect people who don't have asthma, too. You'll notice symptoms within a few minutes after you start to exercise, and they might last 10 to 15 minutes after you stop.

Allergic asthma. Things that trigger allergies, like dust, pollen and pet dander, can also cause asthma attacks.

Nonallergic asthma. This type flares in extreme weather. It could be the heat of summer or the cold of winter. It could also show up when you're stressed or have a cold.

Occupational asthma. This usually affects people who work around chemical fumes, dust, or other irritating things in the air.

Eosinophilic asthma. This severe form is marked by high levels of white blood cells called eosinophils. It usually affects adults between 35 and 50 years old.

Nocturnal asthma. Your asthma symptoms get worse at night.

Aspirin-induced asthma. You have asthma symptoms when you take aspirin, along with a runny nose, sneezing, sinus pressure, and a cough.

Cough-variant asthma. Unlike with other types, the only symptom of this kind of asthma is a long-term cough.

Asthma Causes and Triggers

When you have asthma, your airways react to things in the world around you. Doctors call these asthma triggers. They might cause symptoms or make them worse. Common asthma triggers include:

Infections like sinusitis, colds, and the flu

Allergens such as pollens, mold, pet dander, and dust mites

Irritants like strong odors from perfumes or cleaning solutions

Air pollution

Tobacco smoke

Cold air or changes in the weather, such as temperature or humidity

Gastroesophageal reflux disease (GERD)

Strong emotions such as anxiety, laughter, sadness, or stress

Medications such as aspirin

Food preservatives called sulfites, found in things like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices

Asthma Risk Factors

Things that might make you more likely to have asthma include:

Things in the world around you before you're born or while you're growing up

Whether your parents have asthma, especially your mother

Your genes

Your race. Asthma is more common in people of African American or Puerto Rican descent.

Your sex. Boys are more likely to have asthma than girls. In teens and adults, it's more common in females.

Your job

Other conditions like lung infections, allergies, or obesity

Asthma Diagnosis

If you think you have asthma, see your doctor. They may refer you to a lung doctor, called a pulmonologist, or a specialist in allergy and immunology.

The doctor will start with a physical exam and ask about your symptoms and medical history.

You'll have tests to see how well your lungs work, which may include:

Spirometry. This simple breathing test measures how much air you blow out and how fast.

Peak flow. These measure how well your lungs push out air. They're less exact than spirometry, but they can be a good way to test your lungs at home, even before you feel any symptoms. A peak flow meter can help you figure out what makes your asthma worse, whether your treatment is working, and when you need emergency care.

Methacholine challenge. This and similar tests involve using triggers or challenges. Adults are more likely to have this test than children. You might get it if your symptoms and spirometry test don't clearly show asthma. During this test, you inhale a chemical called methacholine before and after spirometry to see if it makes your airways narrow. If your results fall at least 20%, it is possible that you have asthma. Your doctor will give you medicine at the end of the test to reverse the effects of the methacholine.

Exhaled nitric oxide test. You breathe into a tube connected to a machine that measures the amount of nitric oxide in your breath. Your body makes this gas normally, but levels could be high if your airways are inflamed.

Other tests you might get include:

Chest X-ray. It isn't an asthma test, but your doctor can use it to make sure nothing else is causing your symptoms. An X-ray is an image of the inside of your body, made with low doses of radiation.

CT. This test takes a series of X-rays and puts them together to make a view of your insides. A scan of your lungs and sinuses can identify physical problems or diseases (like an infection) that may cause breathing problems or make them worse.

Allergy tests. These can be blood or skin tests. They tell if you're allergic to pets, dust, mold, and pollen. Once you know your allergy triggers, you can get treatment to prevent them -- and asthma attacks.

Sputum eosinophils. This test looks for high levels of white blood cells (eosinophils) in the mix of saliva and mucus (sputum) that comes out when you cough.

Asthma Treatment

Many asthma treatments can ease your symptoms. Your doctor will work with you to make an asthma action plan that will outline your treatment and medications. They might include:

Inhaled corticosteroids. These medications treat asthma in the long term. That means you'll take them every day to keep your asthma under control. They prevent and ease swelling inside your airways, and they may help your body make less mucus. You'll use a device called an inhaler to get the medicine into your lungs. Common inhaled corticosteroids include:

Leukotriene modifiers. Another long-term asthma treatment, these medications block leukotrienes, things in your body that trigger an asthma attack. You take them as a pill once a day. Common leukotriene modifiers include:

Long-acting beta-agonists. These medications relax the muscle bands that surround your airways. You might hear them called bronchodilators. You'll take these medications with an inhaler, even when you have no symptoms. They include:

Combination inhaler. This device gives you an inhaled corticosteroid and a long-acting beta-agonist together to ease your asthma. Common ones include:

Theophylline. It opens your airways and eases tightness in your chest. You take this long-term medication by mouth, either by itself or with an inhaled corticosteroid.

Short-acting beta-agonists. These are known as rescue medicines or rescue inhalers. They loosen the bands of muscle around your airways and ease symptoms. Examples include:

Anticholinergics. These bronchodilators prevent the muscle bands around your airways from tightening. Common ones include:

You can get ipratropium in an inhaler or as a solution for a nebulizer, a device that turns liquid medicine into a mist that you breathe in through a mouthpiece. Tiotropium bromide comes in a dry inhaler, which lets you breathe in the medicine as a dry powder.

Oral and intravenous corticosteroids. You'll take these along with a rescue inhaler during an asthma attack. They ease swelling and inflammation in your airways. You'll take oral steroids for a short time, between 5 days and 2 weeks. Common oral steroids include:

You're more likely to get steroids injected directly into a vein if you're in the hospital for a bad asthma attack. This will get the medication into your system more quickly.

Biologics. If you have severe asthma that doesn't respond to control medications, you might try a biologic:

Omalizumab (Xolair) treats asthma caused by allergens. You get it as an injection every 2 to 4 weeks.

Other biologics stop your immune cells from making things that cause inflammation. These drugs include:

Tezepelumab-ekko (Tezspire) is a first-in-class medicine indicated for the add-on maintenance treatment of adult and pediatric patients aged 12 years and older. Taken by injection, it targets a specific molicule that causes inflammation in the airways.
Home remedies
Medication will probably be key to getting your asthma under control, but you can do some things at home to help.

Avoid asthma triggers.

Exercise regularly.

Stay at a healthy weight.

Take care of conditions that can trigger symptoms, such as GERD.

Do breathing exercises to ease symptoms so you need less medication.

Some people use complementary treatments such as yoga, acupuncture, biofeedback, or supplements like vitamin C and ding chuan tang. Talk to your doctor before trying any of these.

Asthma Complications

When it's not under control, asthma can cause problems with your daily life, such as:

Asthma can also lead to serious medical conditions including:

Pneumonia and other complications from common infections like the flu

Early delivery or the loss of a pregnancy

Permanently narrowed bronchial tubes in your lungs

Lung collapse

Respiratory failure

Asthma Attack Prevention

Your action plan will include different ways to keep your asthma under control and prevent attacks. These might include:

Know your triggers, and stay away from them.

Follow your doctor's instructions on taking your asthma medications. Let them know if you notice that you're using a quick-relief inhaler more often.

Keep track of your condition and learn the signs that it might be getting worse. A peak flow meter can help.

Know what to do if you think your asthma is getting worse.

Talk to your doctor about vaccines to lower your chances of certain conditions. You might get vaccinations for COVID-19, flu, pneumonia, shingles, or whooping cough (pertussis).

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Asthma is a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and it makes it hard to breathe. Severe asthma can cause trouble talking or being active. You might hear your doctor call it a chronic respiratory disease. Some people refer to asthma as " bronchial asthma."

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Overview

Emphysema is a lung condition that causes shortness of breath. In people with emphysema, the air sacs in the lungs (alveoli) are damaged. Over time, the inner walls of the air sacs weaken and rupture - creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.

When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter.

Most people with emphysema also have chronic bronchitis. Chronic bronchitis is inflammation of the tubes that carry air to your lungs (bronchial tubes), which leads to a persistent cough.

Emphysema and chronic bronchitis are two conditions that make up chronic obstructive pulmonary disease (COPD). Smoking is the leading cause of COPD. Treatment may slow the progression of COPD, but it can't reverse the damage.

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Symptoms

You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually.

You may start avoiding activities that cause you to be short of breath, so the symptom doesn't become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you're at rest.

When to see a doctor

See your doctor if you've had unexplained shortness of breath for several months, especially if it's getting worse or it's interfering with your daily activities. Don't ignore it by telling yourself it's because you're aging or out of shape. Seek immediate medical attention if:

You're so short of breath, you can't climb stairs

Your lips or fingernails turn blue or gray with exertion

You're not mentally alert

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Causes

The main cause of emphysema is long-term exposure to airborne irritants, including:

Tobacco smoke

Marijuana smoke

Air pollution

Chemical fumes and dust

Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It's called alpha-1-antitrypsin deficiency emphysema.

Risk factors

Factors that increase your risk of developing emphysema include:

Smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible. The risk for all types of smokers increases with the number of years and amount of tobacco smoked.

Age. Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.

Exposure to secondhand smoke. Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.

Occupational exposure to fumes or dust. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. This risk is even greater if you smoke.

Exposure to indoor and outdoor pollution. Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants - car exhaust, for instance - increases your risk of emphysema.

Complications

People who have emphysema are also more likely to develop:

Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.

Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.

Large holes in the lungs (bullae). Some people with emphysema develop empty spaces in the lungs called bullae. They can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.

Prevention

To prevent emphysema, don't smoke and avoid breathing secondhand smoke. Wear a mask to protect your lungs if you work with chemical fumes or dust.

Show references

1. What is COPD? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/copd/#. Accessed Jan. 9, 2017.

2. Mason RJ, et al. COPD: Pathogenesis and natural history. In: Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Jan. 11, 2017.

3. Goldman L, et al., eds. Chronic obstructive pulmonary disease. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Jan. 12, 2017.

4. AskMayoExpert. Chronic obstructive pulmonary disease. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.

5. Longo DL, et al., eds. Chronic obstructive pulmonary disease. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://www.accessmedicine.com. Accessed Jan. 11, 2017.

6. Weiss ST. Chronic obstructive pulmonary disease: Risk factors and risk reduction. http://www.uptodate.com/home. Accessed Jan. 11, 2017.

7. Han MK, et al. Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging. http://www.uptodate.com/home. Accessed Jan. 11, 2017.

8. Ferguson GT, et al. Management of stable chronic obstructive pulmonary disease. http://www.uptodate.com/home. Accessed Jan. 11, 2017.

9. What is bronchitis? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi. Accessed Jan. 9, 2017.

10. Jong EC, et al. Travel with chronic medical conditions. In: Travel and Tropical Medicine Manual. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2008.

11. Gautret P, et al. Travel-associated illness in older adults (>60 y). Journal of Travel Medicine. 2012;19:169.

12. Fishwick D, et al. Occupational chronic obstructive pulmonary disease: A standard of care. Occupational Medicine. 2015;65:270.

13. Support and community. American Lung Association. http://www.lung.org/support-and-community/. Accessed Jan. 23, 2017.

14. COPD treatment options. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/educational/copd/breathing-better/treatment-options.htm. Accessed Jan. 23, 2017.

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Emphysema is a lung problem that makes it hard to catch your breath. It's one of the conditions that make up chronic obstructive pulmonary disease (COPD).

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SOURCES:

National Institutes of Health -- National Heart, Lung, and Blood Institute: "What IS COPD?"

COPD Foundation: "What is COPD?"

The Journal of Clinical Investigation: "Molecular pathogenesis of emphysema."

Albert, R. Clinical Respiratory Medicine, Mosby Elsevier, 2008.

American Lung Association: "Diseases A-Z: Emphysema."

National Heart, Lung, and Blood Institute: "Diseases and Conditions Index: COPD."

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SOURCES: National Institutes of Health -- National Heart, Lung, and Blood Institute: "What IS COPD?" COPD Foundation: "What is COPD?" The Journal of Clinical Investigation: "Molecular pathogenesis of emphysema." Albert, R. Clinical Respiratory Medicine, Mosby Elsevier, 2008. American Lung Association: "Diseases A-Z: Emphysema." National Heart, Lung, and Blood Institute: "Diseases and Conditions Index: COPD."

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Overview

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.

Symptoms

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.

Signs and symptoms of pneumonia may include:

Chest pain when you breathe or cough

Confusion or changes in mental awareness (in adults age 65 and older)

Cough, which may produce phlegm

Fatigue

Fever, sweating and shaking chills

Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)

Nausea, vomiting or diarrhea

Shortness of breath

Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

When to see a doctor

See your doctor if you have difficulty breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you're coughing up pus.

It's especially important that people in these high-risk groups see a doctor:

Adults older than age 65

Children younger than age 2 with signs and symptoms

People with an underlying health condition or weakened immune system

People receiving chemotherapy or taking medication that suppresses the immune system

For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition.

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Causes

Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your immune system, even if your health is generally good.

Pneumonia is classified according to the types of germs that cause it and where you got the infection.

Community-acquired pneumonia

Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. It may be caused by:

Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you've had a cold or the flu. It may affect one part (lobe) of the lung, a condition called lobar pneumonia.

Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces milder symptoms than do other types of pneumonia. Walking pneumonia is an informal name given to this type of pneumonia, which typically isn't severe enough to require bed rest.

Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings and vary depending upon geographic location.

Viruses, including COVID-19. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some cases it can become very serious. Coronavirus 2019 (COVID-19) may cause pneumonia, which can become severe.

Hospital-acquired pneumonia

Some people catch pneumonia during a hospital stay for another illness. Hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia.

Health care-acquired pneumonia

Health care-acquired pneumonia is a bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.

Aspiration pneumonia

Aspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Risk factors

Pneumonia can affect anyone. But the two age groups at highest risk are:

Children who are 2 years old or younger

People who are age 65 or older

Other risk factors include:

Being hospitalized. You're at greater risk of pneumonia if you're in a hospital intensive care unit, especially if you're on a machine that helps you breathe (a ventilator).

Chronic disease. You're more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease (COPD) or heart disease.

Smoking. Smoking damages your body's natural defenses against the bacteria and viruses that cause pneumonia.

Weakened or suppressed immune system. People who have HIV/AIDS, who've had an organ transplant, or who receive chemotherapy or long-term steroids are at risk.

Complications

Even with treatment, some people with pneumonia, especially those in high-risk groups, may experience complications, including:

Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.

Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing machine (ventilator) while your lung heals.

Fluid accumulation around the lungs (pleural effusion). Pneumonia may cause fluid to build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to have it drained through a chest tube or removed with surgery.

Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus.

Prevention

To help prevent pneumonia:

Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with your doctor about getting these shots. The vaccination guidelines have changed over time so make sure to review your vaccination status with your doctor even if you recall previously receiving a pneumonia vaccine.

Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease. Children who attend a group child care center should also get the vaccine. Doctors also recommend flu shots for children older than 6 months.

Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.

Don't smoke. Smoking damages your lungs' natural defenses against respiratory infections.

Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.

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Pneumonia - Learn about the symptoms, causes and treatment of this serious lung infection.

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What Is Pneumonia?

Pneumonia is a lung infection that can range from mild to so severe that you have to go to the hospital.

It happens when an infection causes the air sacs in your lungs (your doctor will call them alveoli) to fill with fluid or pus. That can make it hard for you to breathe in enough oxygen to reach your bloodstream.

Anyone can get this lung infection. But infants younger than age 2 and people over age 65 are at higher risk. That's because their immune systems might not be strong enough to fight it.

You can get pneumonia in one or both lungs. You can also have it and not know it. Doctors call this walking pneumonia. Causes include bacteria, viruses, and fungi. If your pneumonia results from bacteria or a virus, you can spread it to someone else.

Lifestyle habits, like smoking cigarettes and drinking too much alcohol, can also raise your chances of getting pneumonia.

Causes of Pneumonia

Bacteria, viruses, or fungi can cause pneumonia.

Common causes include:

Flu viruses

Cold viruses

RSV virus (the top cause of pneumonia in babies age 1 or younger)

Bacteria called Streptococcus pneumoniae and Mycoplasma pneumoniae

Some people who are in the hospital get "ventilator-associated pneumonia" if they got the infection while using a ventilator, a machine that helps you breathe.

If you get pneumonia while you're in a hospital and aren't on a ventilator, that's called "hospital-acquired" pneumonia. But most people get "community-acquired pneumonia," which means they didn't get it in a hospital.

Pneumonia Diagnosis

Your doctor will start with questions about your symptoms and your medical history, like whether you smoke and whether you've been around sick people at home, school, or work. Then, they'll listen to your lungs. If you have pneumonia, they might hear cracking, bubbling, or rumbling sounds when you breathe in.

If your doctor thinks you might have pneumonia, they'll probably give you tests, including:

Blood tests to look for signs of a bacterial infection

A chest X-ray to find the infection in your lungs and how far it's spread

Pulse oximetry to measure the level of oxygen in your blood

A sputum test to check the fluid in your lungs for the cause of an infection

If your symptoms started in the hospital or you have other health problems, your doctor might give you more tests, such as:

An arterial blood gas test to measure the oxygen in a small amount of blood taken from one of your arteries

Bronchoscopy to check your airways for blockages or other problems

A CT scan to get a more detailed image of your lungs

A pleural fluid culture, in which the doctor removes a small amount of fluid from the tissues around your lungs to look for bacteria that might cause pneumonia

Pneumonia Complications

Pneumonia can have complications, including:

Bacteremia, in which bacteria spread into your blood. This can cause septic shock and organ failure.

Trouble breathing, which might mean you need to use a breathing machine while your lungs heal.

Fluid buildup between the layers of tissue that line your lungs and chest cavity. This fluid can also become infected.

Lung abscess, when a pocket of pus forms inside or around your lung.

Symptoms of Pneumonia

Your symptoms can vary depending on what's causing your pneumonia, your age, and your overall health. They usually develop over several days.

Common pneumonia symptoms include:

Chest pain when you breathe or cough

Cough that produces phlegm or mucus

Fatigue and loss of appetite

Fever, sweating, and chills

Nausea, vomiting, and diarrhea

Shortness of breath

Along with these symptoms, older adults and people with weak immune systems might be confused or have changes in mental awareness, or they might have a lower-than-usual body temperature.

Newborns and infants may not show any signs of infection. Or they might vomit, have a fever and a cough, and seem restless or tired.

If you have a new cough, fever, or shortness of breath, call your doctor to ask about whether it could be COVID-19. Illness with the new coronavirus can also lead to pneumonia.

Pneumonia Treatment

Your doctor can tell you which treatment is right for you.

If you have bacterial pneumonia, you'll get antibiotics. Make sure you take all of the medicine your doctor gives you, even if you start to feel better before you're through with it.

If you have viral pneumonia, antibiotics won't help. You'll need to rest, drink a lot of fluids, and take medicine for your fever.

If your symptoms are severe or if you have other conditions that make you more likely to have complications, your doctor may send you to the hospital. While you're there, your doctor will probably give you fluids or antibiotics through an IV tube. You may even need oxygen therapy or breathing treatments.

With any kind of pneumonia, recovery will take time. You're going to need lots of rest. You might need a week off your usual routines, and you could still feel tired for a month.

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Pneumonia is a lung infection that can range from mild to so severe that you have to go to the hospital. It happens when an infection causes the air sacs in your lungs (your doctor will call them alveoli) to fill with fluid or pus.

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Overview

Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale.

Lung cancer is the leading cause of cancer deaths worldwide.

People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer.

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Symptoms

Lung cancer typically doesn't cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur when the disease is advanced.

Signs and symptoms of lung cancer may include:

A new cough that doesn't go away

Coughing up blood, even a small amount

Shortness of breath

Chest pain

Hoarseness

Losing weight without trying

Bone pain

Headache

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

If you smoke and have been unable to quit, make an appointment with your doctor. Your doctor can recommend strategies for quitting smoking, such as counseling, medications and nicotine replacement products.

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Causes

Smoking causes the majority of lung cancers - both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer.

How smoking causes lung cancer

Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately.

At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.

Types of lung cancer

Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have.

The two general types of lung cancer include:

Small cell lung cancer. Small cell lung cancer occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.

Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

Risk factors

A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled, such as your family history.

Risk factors for lung cancer include:

Smoking. Your risk of lung cancer increases with the number of cigarettes you smoke each day and the number of years you have smoked. Quitting at any age can significantly lower your risk of developing lung cancer.

Exposure to secondhand smoke. Even if you don't smoke, your risk of lung cancer increases if you're exposed to secondhand smoke.

Previous radiation therapy. If you've undergone radiation therapy to the chest for another type of cancer, you may have an increased risk of developing lung cancer.

Exposure to radon gas. Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes.

Exposure to asbestos and other carcinogens. Workplace exposure to asbestos and other substances known to cause cancer - such as arsenic, chromium and nickel - can increase your risk of developing lung cancer, especially if you're a smoker.

Family history of lung cancer. People with a parent, sibling or child with lung cancer have an increased risk of the disease.

Complications

Lung cancer can cause complications, such as:

Shortness of breath. People with lung cancer can experience shortness of breath if cancer grows to block the major airways. Lung cancer can also cause fluid to accumulate around the lungs, making it harder for the affected lung to expand fully when you inhale.

Coughing up blood. Lung cancer can cause bleeding in the airway, which can cause you to cough up blood (hemoptysis). Sometimes bleeding can become severe. Treatments are available to control bleeding.

Pain. Advanced lung cancer that spreads to the lining of a lung or to another area of the body, such as a bone, can cause pain. Tell your doctor if you experience pain, as many treatments are available to control pain.

Fluid in the chest (pleural effusion). Lung cancer can cause fluid to accumulate in the space that surrounds the affected lung in the chest cavity (pleural space).

Fluid accumulating in the chest can cause shortness of breath. Treatments are available to drain the fluid from your chest and reduce the risk that pleural effusion will occur again.

Cancer that spreads to other parts of the body (metastasis). Lung cancer often spreads (metastasizes) to other parts of the body, such as the brain and the bones.

Cancer that spreads can cause pain, nausea, headaches, or other signs and symptoms depending on what organ is affected. Once lung cancer has spread beyond the lungs, it's generally not curable. Treatments are available to decrease signs and symptoms and to help you live longer.

Prevention

There's no sure way to prevent lung cancer, but you can reduce your risk if you:

Don't smoke. If you've never smoked, don't start. Talk to your children about not smoking so that they can understand how to avoid this major risk factor for lung cancer. Begin conversations about the dangers of smoking with your children early so that they know how to react to peer pressure.

Stop smoking. Stop smoking now. Quitting reduces your risk of lung cancer, even if you've smoked for years. Talk to your doctor about strategies and stop-smoking aids that can help you quit. Options include nicotine replacement products, medications and support groups.

Avoid secondhand smoke. If you live or work with a smoker, urge him or her to quit. At the very least, ask him or her to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and seek out smoke-free options.

Test your home for radon. Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be remedied to make your home safer. For information on radon testing, contact your local department of public health or a local chapter of the American Lung Association.

Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work. Follow your employer's precautions. For instance, if you're given a face mask for protection, always wear it. Ask your doctor what more you can do to protect yourself at work. Your risk of lung damage from workplace carcinogens increases if you smoke.

Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful. For instance, researchers hoping to reduce the risk of lung cancer in heavy smokers gave them beta carotene supplements. Results showed the supplements actually increased the risk of cancer in smokers.

Exercise most days of the week. If you don't exercise regularly, start out slowly. Try to exercise most days of the week.

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Learn about the approaches doctors take to treating this deadly form of cancer, including minimally invasive surgery, targeted therapy and immunotherapy.

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Lung Cancer

Lung cancer and smoking often, but not always, go hand in hand. As lung cancer stages advance, lung cancer symptoms include coughing, wheezing, shortness of breath, and bloody mucus. Treatment includes surgery, chemotherapy, and/or radiation.

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Lung cancer and smoking often, but not always, go hand in hand. As lung cancer stages advance, lung cancer symptoms include coughing, wheezing, shortness of breath, and bloody mucus. Treatment includes surgery, chemotherapy, and/or radiation.

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Overview

Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic.

Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking.

Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks.

However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).

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Symptoms

For either acute bronchitis or chronic bronchitis, signs and symptoms may include:

Cough

Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color - rarely, it may be streaked with blood

Fatigue

Shortness of breath

Slight fever and chills

Chest discomfort

If you have acute bronchitis, you might have cold symptoms, such as a mild headache or body aches. While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks.

Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years.

If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. At those times, you may have an acute infection on top of chronic bronchitis.

When to see a doctor

See your doctor if your cough:

Lasts more than three weeks

Prevents you from sleeping

Is accompanied by fever higher than 100.4 F (38 C)

Produces discolored mucus

Produces blood

Is associated with wheezing or shortness of breath

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Causes

Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis.

The most common cause of chronic bronchitis is cigarette smoking. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition.

Risk factors

Factors that increase your risk of bronchitis include:

Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis.

Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection.

Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes.

Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis.

Complications

Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD).

Prevention

To reduce your risk of bronchitis, follow these tips:

Avoid cigarette smoke. Cigarette smoke increases your risk of chronic bronchitis.

Get vaccinated. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help protect you from getting the flu. You may also want to consider vaccination that protects against some types of pneumonia.

Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using alcohol-based hand sanitizers.

Wear a surgical mask. If you have COPD, you might consider wearing a face mask at work if you're exposed to dust or fumes, and when you're going to be among crowds, such as while traveling.

# data[].attributes.attachment_link.description
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common.

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SOURCES:

American Journal of Respiratory and Critical Care Medicine: "Chronic Bronchitis and Chronic Obstructive Pulmonary Disease."

Contemporary Clinic: "Chronic Bronchitis."

Familydoctor.org: "Chronic Bronchitis."

International Journal of Chronic Obstructive Pulmonary Disease: "Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes."

Johns Hopkins Medical Health Library: "Chronic Bronchitis."

MedlinePlus: "Chronic Bronchitis."

University of California San Francisco Health: "Chronic Bronchitis."

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SOURCES: American Journal of Respiratory and Critical Care Medicine: "Chronic Bronchitis and Chronic Obstructive Pulmonary Disease." Contemporary Clinic: "Chronic Bronchitis." Familydoctor.org: "Chronic Bronchitis." International Journal of Chronic Obstructive Pulmonary Disease: "Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes." Johns Hopkins Medical Health Library: "Chronic Bronchitis."