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What to know about uncontrolled asthma

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Why is it uncontrolled?Symptoms and risksUncontrolled vs. SevereTreatmentWorking with a healthcare teamSummary
If your asthma symptoms are severe or occur frequently, here’s what you need to know to start getting it back under control.
Medically reviewed by Nick Villalobos, MD
Written by Charlotte Parker
Updated on

Uncontrolled asthma is a term doctors use when asthma symptoms are not well managed and continue to be frequent or severe. It is often a sign that a treatment plan needs reevaluation or adjustment.

If you feel your asthma is not well controlled, it is important to consult with a healthcare professional to learn how to manage your symptoms effectively and reduce the risk of asthma attacks.

Why might asthma be uncontrolled?

Family playing together at the beach, the tide is out and the children are splashing in sandy puddles, not worring about uncontrolled asthma as they researched thoroughly beforehand
Erin Brant/Stocksy United

Doctors consider your asthma to be controlled if you:

  • have few or no symptoms
  • do not have asthma attacks
  • have had no recent emergency medical visits
  • infrequently use reliever medications
  • have no restrictions to everyday activities
  • observe that lung function is within the expected range
  • experience little to no side effects from medications

If this does not describe your experience living with asthma, then it might be because one or more of the following situations apply.

  • Inadequate medication: If you are not using asthma medications as prescribed or using medications that are not effective for your specific asthma type, it may make symptoms worse.
  • Trigger exposure: Frequent exposure to allergens or irritants like pollen, smoke, or pet dander can worsen symptoms.
  • Other conditions: Conditions like sinusitis, allergies, or gastroesophageal reflux disease (GERD) can worsen asthma management.
  • Improper inhaler technique: Not using inhalers correctly can lead to less medication reaching your lungs, making it more difficult to breathe.
  • Lifestyle factors: Smoking, obesity, and stress can negatively affect asthma management.
  • Not following an asthma action plan: If you do not have a personalized action plan or if you have difficulty following one, it can lead to poor management of the condition.

Symptoms and risks of uncontrolled asthma

Symptoms of uncontrolled asthma can include the following situations.

  • Increased symptom frequency: You may experience more coughing, wheezing, shortness of breath, or chest tightness.
  • Night-time symptoms: Asthma symptoms can become worse at night or before you go to sleep. They may also wake you up.
  • Increased reliance on quick-relief inhalers: You may find that you need to use your rescue inhaler more often.
  • Limited activities: You may notice that you cannot carry out your usual day-to-day activities due to your asthma symptoms.

Uncontrolled asthma can bring an increased risk of severe asthma attacks, which can be life threatening. It can also lead to a decline in lung function over time.

It can lead to an increased risk of complications like airway remodeling. This means that over time structural changes can occur within the large and small airways that make them become increasingly narrow. This may lead to an even greater increase in breathing difficulties and reduced quality of life due to symptom frequency and activity limitations.

You may also need to visit the emergency room more often, which can lead to hospital stays.

Uncontrolled vs. severe asthma, what is the difference?

Uncontrolled asthma can occur at any severity level, while severe asthma is a classification of asthma based on its intensity and the treatment required to manage it. Here are the main differences:

Uncontrolled asthma:

  • refers to asthma that is not well managed with current treatment
  • means symptoms are frequent and may interfere with daily activities
  • can occur with any type of asthma, whether mild, moderate, or severe
  • often indicates a need to reassess and adjust treatment strategies

Severe asthma:

  • means symptoms are intense
  • is characterized as being more resistant to standard treatments
  • requires high doses of inhaled corticosteroids with a second controller medication, corticosteroids to prevent it from becoming uncontrolled, or both

How important is medical attention in uncontrolled asthma?

Medical attention is essential to treat uncontrolled asthma. It is extremely important for:

  • preventing complications
  • adjusting treatment
  • identifying triggers
  • monitoring lung function
  • providing education and support
  • developing an action plan

Working with a healthcare team is vital to help ensure you have everything you need to manage your asthma symptoms.

Treating uncontrolled asthma

Managing uncontrolled asthma involves a personalized approach, including a healthcare professional conducting a detailed assessment to identify the causes.

It is important that you notice and manage environmental triggers and understand asthma management thoroughly.

Regular symptom and lung function monitoring are also essential. Your healthcare team can advise when you may need to increase your medication dosages, types, or both and consult specialists for advanced care.

Options for treating asthma

Treating asthma involves making a combination of lifestyle modifications, avoiding triggers, and taking medications. Each person’s asthma is different. Treatment plans should be tailored to your needs and adjusted over time as symptoms change, per your healthcare team’s assessment.

Medication

Here are some of the medications a doctor might prescribe.

Medication typeMedication nameHow the medication works
quick relief medications (Rescue Inhalers)  quick-relief medications (rescue inhalers)  quickly relax muscles around the airways
anticholinergicsipratropium (Atrovent)quickly relieve bronchospasms
long-term-control medications  Inhaled corticosteroids, like fluticasone (Flovent)reduces inflammation in the airways
long-acting beta agonists (LABAs)formoterol (Foradil)helps to open the airways
leukotriene modifiersmontelukast (Singulair)

zafirlukast (Accolate)
reduces inflammation and relaxes airway muscles
combination inhalersfluticasone/salmeterol (Advair)

budesonide/formoterol (Symbicort)
reduces inflammation and relaxes airway muscles
theophyllinetheophylline (Theo-24, Uniphyl)daily pills that help keep the airways open
other remediesbiologic therapies like omalizumab (Xolair) and mepolizumab (Nucala) targets inflammation in severe asthma
oral corticosteroidsprednisone (Deltasone)short-term medication during asthma flare-ups
allergy treatmentsallergy medications like cetirizine (Zyrtec) or immunotherapy (shots)relieves allergic symptoms

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Lifestyle and home remedies for uncontrolled asthma

You should always follow your doctor-prescribed medical treatment plan, but there are also some steps you can take at home to complement the plan.

  • Avoiding triggers: Try to avoid triggers like allergens, irritants, and activities that make your asthma symptoms worse.
  • Breathing exercises: You can try breathing exercises to help manage your breathing and reduce stress.
  • Staying physically active: Staying physically active, like exercising regularly, can help improve your lung function and overall health.

Working with a healthcare team

Working with a healthcare team is the best way to manage asthma. Here are professionals you may speak with and how they can help.

  • Primary care physician (PCP): This healthcare professional is usually your first point of contact for asthma management. They can diagnose, treat, and monitor asthma and refer you to specialists if needed.
  • Pulmonologist: This lung specialist can provide advanced care for more severe or complex asthma cases.
  • Immunologists: These specialists can perform allergy tests and offer treatments like immunotherapy if you receive an allergy-related asthma diagnosis.
  • Nurses and respiratory therapists: These healthcare professionals offer asthma management and inhaler use education and can assist in monitoring your condition.
  • Dietitian: A dietitian can help explore potential food allergies that could contribute to asthma symptoms.
  • Physical therapist or exercise physiologist: These therapists can help develop a safe exercise for staying physically active to help improve lung function without causing worsening asthma symptoms.
  • Mental health professionals: Asthma can be linked with anxiety, depression, and stress, reports the Asthma and Allergy Foundation of America, and research supports this claim. These healthcare professionals can help you manage mental health conditions.

Summary

Asthma, particularly when uncontrolled, requires working with a healthcare team to carefully monitor symptoms and disease progression.

For the best results, it’s important to follow a doctor-prescribed personalized treatment plan, which may include long-term medication therapy, quick-relief inhalers, and lifestyle adjustments.

Regular monitoring, avoiding triggers, and learning proper inhaler techniques are essential.

Remember, effective asthma management not only reduces symptoms but also improves overall quality of life.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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