When we breathe, air goes in and out of the lungs through airways. But people with asthma have a problem with those airways, also called bronchial tubes (say: brong-kee-ul toobz). These tubes are often swollen and puffy on the inside, which means they're not as good for pulling air in and pushing it out. There isn't enough room inside the airway for air to flow.

This swelling in the airways gets worse during an asthma flare-up, making it hard to breathe. During a flare-up, also called an asthma attack or episode, the lungs also may produce a lot of sticky mucus, which clogs the airways. And the muscles around the airways tighten up, making the airways really narrow. All of this can lead to some pretty serious breathing trouble.

What Happens During a Flare-Up?

During a flare-up, a person might have:

• trouble breathing (some people say it's like trying to breathe through a straw)
• a tight or painful feeling in the chest
• a whistling sound when he or she breathes (wheezing)
• a cough

Flare-ups also can cause sweating or make the person feel like his or her heart is beating faster than normal, even though he or she is sitting still.

What Should Kids Do?

If you have asthma, you need to know that every flare-up needs immediate attention. You may need to take medicine, visit your doctor, or go to the emergency department. Your mom or dad can help you learn how to handle asthma flare-ups when they happen, so you'll know what to do.

A flare-up can last a few hours or longer if you don't take your rescue medicine. Often, just a few puffs from an inhaler can help you feel better. Once the flare-up passes, most kids feel fine.

Flare-ups can be handled, but it's even better if you can prevent them from happening. One way to do that is to avoid triggers. We're not talking about triggers on guns! We're talking about things that bring on asthma symptoms. Many kids who have asthma also have allergies, so common triggers include things that cause allergies.

Some of them are pets, animal dander, dust mites (little bugs that live in dust), mold, or cockroaches. Other triggers do not cause allergies, but they simply irritate the airways. These include tobacco smoke, cold air, exercise, and infections, such as colds. If you try to avoid your triggers, you may sometimes be able to prevent asthma flare-ups.

Some flare-ups are serious, but others are mild. Flare-ups can happen suddenly, but can also build up over time, especially in kids who aren't taking the asthma medicine they need.

You won't be able to avoid all triggers or to stop all flare-ups. That means you should always be prepared for one. Learn how you feel when a flare-up is coming on - does your chest hurt or feel tight? Do you feel tired? Do you have a cough, even though you don't have a cold? Does your throat feel itchy? If you have a peak flow meter, this might be a good time to use it.

Get help if you feel like a flare-up is about to happen. Use your rescue medicine as your doctor instructed. Let people around you know what is happening. Don't ignore the attack or hope it will go away on its own. It won't and you might end up in the emergency department.

Preventing Flare-Ups

You also have the power to prevent flare-ups, at least some of the time. Here's what you can do:

• Always have your inhaler and spacer with you.
• Stay away from triggers that you know may cause flare-ups.
• Take your controller medicine as directed. Don't skip it or take less of it because you are feeling better.
• Work with your parents and doctor to follow an asthma action plan.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: March 2007