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Asthma flare-ups

Asthma is a medical condition in which the airways in the lungs are swollen (inflamed) and become puffy. In an asthma patient, the airway passages of the lungs are narrowed, and the person cannot breathe easily. During asthma flare-ups or asthma attacks, these symptoms worsen either within a few minutes, hours, days or weeks, thereby increasing the need for reliever medicines. Flare-ups need immediate medical attention as they can be life-threatening. The severity of flare-ups can range from mild to severe.


The following symptoms may be experienced during an asthma flare-up:

  • Difficulties in eating or speaking
  • Difficulties in breathing
  • Rapid breathing
  • Wheezing or whistling sound while breathing
  • Restlessness (in children)
  • Sore stomach
  • Chest tightness or pain
  • Trouble sleeping
  • Coughing especially at night time
  • Sweating
  • Increased heartbeat

In case of severe flare-ups call the doctor right away. The symptoms of severe flare-ups include:

  • Very rapid and hard breathing
  • Chest retractions (sucking in of the area between the ribs or sticking out of the belly)
  • Difficulties in talking and walking
  • Bluish discoloration of lips and fingers
  • Confusion or abnormal behavior


Asthma flare-ups happen when the symptoms of asthma are worsened in a patient. This may include a severe swelling than the normal along with mucus secretion in the lining of the airways. Additionally, the muscles in the airways contract, thereby worsening the breathing problem. Flare-ups can happen when the reliever medicine is not effective or if it works for very few hours. These events cause either a partial or complete obstruction to the movement of air through the lungs.  

Risk factors

The flare-ups can occur in anyone with asthma, but it is more likely to develop in patients with poorly-controlled asthma. Children are more likely to develop asthma flare-ups when compared to adults. The following risk factors can trigger asthma:

  • Smoking
  • Exposure to chemicals, strong odors or pollen
  • Dust
  • Strenuous exercise
  • Changes in weather
  • Having cold or flu
  • Certain allergies
  • Environmental pollutants
  • Emotional stress


The doctor diagnoses flare-ups based on the symptoms and their severity. The family history and personal history of respiratory problems and allergies are collected.

  • Physical examination of the patient is done to check for wheezing sound during breathing.
  • Peak airflow through the lungs using a peak flow meter, movement of chest muscles during breathing.

Further, the following tests may be performed to diagnose the condition:

  • Spirometry to confirm asthma
  • Arterial blood gas (ABG) test to measure oxygen levels
  • Allergy skin test to determine allergens
  • Chest x-rays to look for changes in the lungs and airways


If timely treatment is not provided, asthma flare-up can last for several hours to days. Whenever there is an asthma flare-up, immediately start the asthma action plan as suggested by the doctor during a previous visit. This may include:

  • Identify the warning signs of an asthma flare-up
  • Use rescue medicine to get quick relief and ease the breathing immediately

If medications are not effective, then the doctor might use breathing aids, such as mechanical ventilator for a temporary purpose. The breathing aids are removed once the symptoms of asthma flare-ups subside.

Preventing the worsening of symptoms

The following measures reduce the risk of flare-ups:

  • Maintain proper hygiene to reduce the risk of cold or other illnesses.
  • Take the controller medicines every day without missing a dose even if the symptoms have improved.
  • Take long-term controller medicines such as corticosteroids or other anti-inflammatory medicines exactly as directed by the physician to prevent inflammation of airways.
  • Use rescue medicines exactly as prescribed.
  • Visit the doctor regularly as per the schedule without missing an appointment.
  • Get yearly flu vaccinations.
  • Avoid the triggers such as smoke, pollen, and dust, etc.
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