Asthma

What is asthma?

Asthma, sometimes referred to as bronchial asthma, is a chronic disease affecting the lungs. This disorder usually doesn't resolve on its own but requires continuous medical care. Without proper treatment, the condition could result in fatalities. Currently, over 25 million individuals in the United States, including up to 5 million minors, are affected by asthma.

What is an asthma attack?

During normal in and out breathing, the muscles around the airways usually relax to allow easy and quiet airflow. However, with an asthma attack, inflammation, bronchospasm, and increased mucus production could occur.

Inflammation occurs when the airway lining gets swollen, affecting the in and out passage of air from the lungs. With bronchospasm, muscles surrounding the airways tighten, making them narrow and limit airflow. On the other hand, the increased mucus production blocks the airways during an asthma attack.

Tightening of the air passage can result in a wheezing sound. Sometimes, an uncontrolled asthma attack is referred to as a flare-up or exacerbation.

Types of Asthma

Medical practitioners classify asthma according to the causes and severity of the symptoms. They often identify the condition as;

• Intermittent: Asthma that occurs sporadically, allowing for normal periods between attacks.
• Persistent: Symptoms are frequent and could vary from mild to moderate to severe. The severity of the condition is often based on the symptoms and how the attack can affect one's daily activities.

Types based on causes:

• Allergic: Allergens such as mold, pet dander, and pollens can trigger asthma attacks in people prone to allergies.
• Non-allergic: Outside factors such as diseases, stress, environmental conditions, and exercise can lead to asthma flare-ups.

In addition, asthma may sometimes manifest in other forms like;

• Adult-onset: A type of asthma that develops after 18 years old
• Pediatric: This asthma usually occurs in children below five years, though they have a chance of outgrowing the disease. Therefore, in such a situation, it is important to consult with the physician to manage the condition, determine if an inhaler is necessary for an attack, and understand the risks involved.

Other types of asthma:

• Exercise-induced: Also known as exercise-induced bronchospasm, this type of asthma can be provoked by exercise.
• Occupational asthma: Occurs mainly in individuals or workers exposed to irritating substances.
• ACOS (asthma COPD overlap syndrome): This happens if a person has COPD (chronic obstructive pulmonary disease) and asthma simultaneously - the two conditions result in breathing difficulties.

Who Can Get Asthma?

Everyone is susceptible to asthma regardless of age. Having allergies and frequent exposure to tobacco smoke, including second hand smoke, also increases the possibility of developing the condition.

Statistically, women are more prone to asthma. Similarly, asthma is more frequent in those of Afro-Caribbean descent.

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Symptoms and Causes of Asthma

While researchers have yet to pinpoint the actual causes of asthma, some factors increase the risk of developing the condition. They include;

• Allergies: People with allergies are at higher risk of getting asthma.
• Genetics: Coming from a family with a history of asthma or allergic conditions increases the risk of developing the disease.
• Respiratory infections: Having respiratory infections like RSV (respiratory syncytial virus) can impair the development of children’s lungs, increasing the possibility of an asthma attack.
• Environmental factors: Exposure to air passage irritants such as toxins, allergens, second and thirdhand smoke, and certain fumes can trigger asthma. Infants and minors with developing immune systems are at a higher risk.

Common triggers

Coming into contact with irritating substances or triggers could lead to an asthma attack. Therefore, understanding these triggers can help prevent an attack.

While a trigger may result in an instant attack, others may develop an asthma attack after some hours or even days. Triggers also differ from one person to another. However, some of the common asthma triggers are;

• Air pollution: Outside factors such as car exhaust, emissions from factories, and wildfire smoke can lead to an asthma attack.
• Mold: Found in damp environments, molds can trigger problems even in non-allergic people.
• Dust mites: Although microscopic, dust mites are found in homes and could trigger an attack in people with asthma.
• Exercise: Certain physical activities can lead to an attack in some people.
• Pets: Pet dander can irritate the air passage when breathing for those who are allergic and could eventually trigger an attack.
• Pests: Household pests such as cockroaches and mice can trigger an asthma attack.
• Tobacco smoke: Smoking or being around a smoker increases the risk of getting asthma. Therefore, it is best to avoid smoking in enclosed areas if quitting isn't an option.
• Strong chemicals: Certain chemicals and smells may cause attacks in asthmatic people.
• Occupational exposures: Exposure to things like wood dust, flour dust, and cleaning products at the workplace can trigger an asthma attack.

Signs and Symptoms

Asthmatic people often have noticeable signs and symptoms resembling those of respiratory infections. They include;

• Coughing, especially during the night
• Chest pain, tightness, or pressure
• Shortness of breath
• Wheezing

Asthma symptoms can vary with every flare, and some people can experience different signs at different periods with chronic asthma. Moreover, the symptoms may differ between the attacks.

Tests and Diagnosis

How is asthma diagnosed?

The practitioner typically begins by reviewing your medical history as well as your family health records. Furthermore, they will inquire about the symptoms you have and ask if you have any history of lung problems, allergies, and even eczema.

The diagnostic tests may include spirometry to measure airflow through the lungs. This test will be applied to analyse and monitor your treatment progression. Chest X-rays and blood and skin tests may also be required.

Treatment and Management

Available asthma treatment options

There are options to assist in managing asthma, and the medical provider may also give a prescription targeted at controlling the symptoms.

The available options are;

• Bronchodilators: These drugs help relax airway muscles and allow air and mucus to move freely. They also ease asthma symptoms and are recommended for intermittent and chronic conditions.
• Anti-inflammatory drugs: They help minimize mucus production and swelling in the airways to enable easy in and outflow of air to the lungs. The practitioner may also prescribe daily use of these medications to control and prevent chronic asthma symptoms.

Asthma medications can be administered in various ways, including inhalers (metered-dose inhaler or nebulizer) and oral drugs.

Asthma Control

Asthma treatment mainly aims to control the symptoms. In other words, it implies that one can carry out their daily activities at home and work, have minimal or no symptoms, get uninterrupted sleep, and rarely use the rescue inhaler.

Monitoring Asthma Symptoms

Tracking asthma symptoms is important in managing the condition. The healthcare provider can thus use a PF (peak flow) meter to measure the speed of airflow from the lungs, make necessary medication adjustments, and check if the symptoms are worsening.

Prevention

Preventing asthma attack

If you are diagnosed with asthma today, the most important thing to do is identify and avoid the possible triggers to prevent an attack. Although you cannot protect yourself from developing the disease, minimizing the risks through preventive measures is crucial.

Prognosis

Outlook for people with asthma

Asthmatic people can equally lead productive lives and even participate in various activities, including sports. While the medical practitioner can assist in managing symptoms, you should also identify the triggers to manage and prevent the attacks.

Living with Asthma

Asthma action plan

The asthma action plan guides you on medication usage (when and how), what to do depending on your symptoms, and the right time to seek medical assistance. While your healthcare provider will help you create a suitable asthma action plan, inquire about anything unclear.

What to do in case of a severe asthma attack

Severe asthma attack requires immediate medical attention. So, the first thing to do in this situation is to use the rescue inhaler to open the air passage. Unlike a maintenance inhaler used every day, a rescue inhaler has fast-acting medications that help when the symptoms are persistent or when the attack is severe.

However, if the rescue inhaler isn't responsive or is not available, seek emergency care if you notice the following symptoms;

• Panic or anxiety
• Chest pain or pressure
• Relentless coughing or severe wheezing when breathing
• Bluish lips and fingernails in light-skinned people; whitish or grey gums or lips in dark-skinned individuals
• Difficulty speaking
• Rapid breathing
• Pale or sweaty face