context: Ever hear the term "bronchial asthma" and wonder what it means? When people talk about bronchial asthma, they are really talking about asthma, a chronic inflammatory disease of the airways that causes periodic "attacks" of coughing, wheezing, shortness of breath, and chest tightness. According to the CDC, more than 25 million Americans, including 6.8 million children under age 18, suffer with asthma today. Allergies are strongly linked to asthma and to other respiratory diseases such as chronic sinusitis, middle ear infections, and nasal polyps. Most interestingly, a recent analysis of people with asthma showed that those who had both allergies and asthma were much more likely to have nighttime awakening due to asthma, miss work because of asthma, and require more powerful medications to control their symptoms. Asthma is associated with mast cells, eosinophils, and T lymphocytes. Mast cells are the allergy-causing cells that release chemicals like histamine. Histamine is the substance that causes nasal stuffiness and dripping in a cold or hay fever, constriction of airways in asthma, and itchy areas in a skin allergy. Eosinophils are a type of white blood cell associated with allergic disease. T lymphocytes are also white blood cells associated with allergy and inflammation. These cells, along with other inflammatory cells, are involved in the development of airway inflammation in asthma that contributes to the airway hyperresponsiveness, airflow limitation, respiratory symptoms, and chronic disease. In certain individuals, the inflammation results in the feelings of chest tightness and breathlessness that's felt often at night (nocturnal asthma) or in the early morning hours. Others only feel symptoms when they exercise (called exercise-induced asthma). Because of the inflammation, the airway hyperresponsiveness occurs as a result of specific triggers. Bronchial asthma triggers may include: Smoking and secondhand smoke Infections such as colds, flu, or pneumonia Allergens such as food, pollen, mold, dust mites, and pet dander Exercise Air pollution and toxins Weather, especially extreme changes in temperature Drugs (such as aspirin, NSAIDs, and beta-blockers) Food additives (such as MSG) Emotional stress and anxiety Singing, laughing, or crying Perfumes and fragrances Acid reflux With bronchial asthma, you may have one or more of the following signs and symptoms: Shortness of breath Tightness of chest Wheezing Excessive coughing or a cough that keeps you awake at night Because asthma symptoms don't always happen during your doctor's appointment, it's important for you to describe your, or your child's, asthma signs and symptoms to your health care provider. You might also notice when the symptoms occur such as during exercise, with a cold, or after smelling smoke. Asthma tests may include: Spirometry: A lung function test to measure breathing capacity and how well you breathe. You will breathe into a device called a spirometer. Peak Expiratory Flow ( PEF): Using a device called a peak flow meter, you forcefully exhale into the tube to measure the force of air you can expend out of your lungs. Peak flow monitoring can allow you to monitor how well your asthma is doing at home. Chest X-ray: Your doctor may do a chest X-ray to rule out any other diseases that may be causing similar symptoms. Once diagnosed, your health care provider will recommend asthma medication (which can include asthma inhalers and pills) and lifestyle changes to treat and prevent asthma attacks. For example, long-acting anti-inflammatory asthma inhalers are often necessary to treat the inflammation associated with asthma. These inhalers deliver low doses of steroids to the lungs with minimal side effects if used properly. The fast-acting or "rescue" bronchodilator inhaler works immediately on opening airways during an asthma attack. If you have bronchial asthma, make sure your health care provider shows you how to use the inhalers properly. Be sure to keep your rescue inhaler with you in case of an asthma attack or asthma emergency. While there is no asthma cure yet, there are excellent asthma medications that can help with preventing asthma symptoms. Asthma support groups are also available to help you better cope with your asthma.