ASTHMA

Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs.

If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.

For many asthma sufferers, timing of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma asthma symptoms only when exercising. This is called exercise-induced bronchoconstriction(EIB), or exercise-induced asthma(EIA). staying active is an important way to stay healthy, so asthma shouldn’t keep you on the sidelines.

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

When your asthma symptoms become worse than usual, it’s called an asthma attack. Severe asthma attack may require emergency care, and they can be fatal.

The symptoms of asthma

Common asthma symptoms include:

. Coughing, especially at night

. Wheezing

. Shortness of breath

. Chest tightness, pain, or pressure

Still, 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 asthma 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 extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others, might have asthma symptoms every day. In addition, some people may only have asthma during exercise, or asthma with viral infections like colds.

Early symptoms

Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These signs may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.

By recognizing these signs, you can stop an asthma attack or prevent one from getting worse. Early warning signs of asthma include:

. Frequent cough, especially at night

. Losing your breath easily or shortness of breath

. Feeling very tired or weak when exercising

. Wheezing or coughing after exercise

. Feeling tired, easily upset, grouchy, or moody

. Decreases or changes in lung function as measured on a peak flow meter

. Signs of a cold or allergies(sneezing, runny nose, cough, nasal congestion, sore throat, and headache)

. Trouble sleeping

Symptoms of an asthma attack

An asthma attack is the episode in which bands of muscle surrounding 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 produce more and thicker mucus than normal.

All of these factors--bronchospasm, inflammation, and mucus production--cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing 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

The severity of an asthma attack can escalate rapidly, so it’s important to treat these symptoms immediately once you recognize them.

Symptoms in children

Asthma affects many children all over the world and is the one of the leading cause of chronic illness in children. For unknown reasons, the incidence of asthma in children is steadily increasing. While asthma symptoms can begin at any age, most children have their first asthma symptoms by age 5.

Not all children with asthma wheeze. Chronic coughing with asthma may be the only obvious sign, and a child’s asthma may go unrecognized if the cough is attributed to recurrent bronchitis.

Unusual asthma symptoms

Not everyone with asthma has the usual symptoms of cough, wheezing, and shortness of breath. Sometimes individuals have unusual asthma symptoms that may not appear to be related to asthma. Some “unusual” asthma symptoms may include the following:

. Rapid breathing

. Sighing

. Fatigue

. Inability to exercise properly

. Difficulty sleeping or nighttime asthma

. Anxiety

. Difficulty concentrating

. Chronic cough without wheezing

Asthma symptoms can be mimicked by other conditions such as bronchitis, vocal cord dysfunction, and even heart failure.

Infections trigger asthma symptoms

Sometimes a virus or bacterial infection is an asthma trigger. For instance, you might have a cold virus that triggers your asthma symptoms. Or your asthma can be triggered by a bacterial sinus infection. Sinusitis with asthma is common.

Tests and diagnosis of asthma

A doctor diagnoses asthma by taking a thorough medical history and performing tests to measure how well your lungs work.

Physical exam

To rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease(COPD), your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.

Lung function

You may be given lung(pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:

. Spirometry: this test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.

. Peak flow: a peak flow meter is a simple device that measures how hard you can breather out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse.

Other tests to diagnose asthma include:

. Methacholine challenge- methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways.

. Nitric oxide test-This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath.

. Imaging tests-A chest X-ray and high-resolution CT scan of your lungs and nose cavities(sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.

. Allergy testing- this can be performed by a skin test or blood test.

. Sputum eosinophils-This test looks for certain white blood cells(eosinophils) in the mixture of saliva and mucus(sputum) you discharge during coughing.

. Provocative testing for exercise and cold-induced asthma- In these tests, you doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air.

Asthma can be classified into four general categories:

Mild intermittent: mild symptoms up to two days a week and up to two nights a month

Mild persistent: symptoms more than twice a week, but no more than once in a single day

Moderate persistent: symptoms once a day and more than one night a week

Severe persistent: symptoms throughout the day on most days and frequently at night

Treatment and management

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and managment. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms.

Controller medications are taken daily and include inhaled corticosteroids.

Combination inhalers conatain an inhaled corticosteroid plus a long-acting beta-agonist(LABA). LABAs are symptom-controllers that are helpful in opening your airways. However, in certain people they may carry some risks.

LABAs should never be prescribed as the sole therapy for asthma and are recommended to be used only along with inhaled corticosteroids.

Leukotriene modifiers are oral medications and help relieve symptoms for up to 24 hours.

Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. These include short-acting beta-agonists.

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. They can cause serious side effects if used on a long term basis.

If you are pregnant, you may be hesitant about taking medications, including those for asthma. This can be a mistake for your health and that of your baby. Continue taking your prescribed asthma medications and make an appointment with your doctor to discuss treatments that will help you have a healthy pregnancy.

Allergy medications may help if your asthma is triggered or worsened by allergies. These include:

. Allergy shots(immunotherapy). over time, allergy shots gradually reduce your immune system reaction to specific allergens.

. Injection medication ,such as Omalizumab, is given every 2-4 weeks and is specific for people who have allergies and severe asthma. It acts by altering the immune system.

Bronchial thermoplasty- isn’t widely available nor right for everyone and is used for sever asthma that doesn’t improve with inhaled corticosteroids or other long-term asthma medications.

Prevention

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

.follow your asthma action plan.

.get vaccinated for influenza and pneumonia

.identify and avoid asthma triggers

.monitor your breathing

.identify and treat attacks early

.take your medication as prescribed

.pay attention to increasing quick-relief inhaler use

 

 

The above article serves only as reference. Kindly refer to your primary care provider for complete consultation and treatment.

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