Asthma

Asthma is a chronic (lifetime) disease where normal breathing becomes difficult for the person. When there is excess of mucus secretion from the airways due to inflammation and narrowing of airways, it leads to asthma. Asthma can be mild producing less symptoms or it can be major type causing serious problems in life. Though no cure is available for asthma, much of its symptoms can be managed by medications. Persistent coughing, wheezing and chest tightness are some of the symptoms of asthma and if not taken prompt treatment it can cause life threatening problems like asthma attack.

What are the Characteristics of Asthma?

Asthma gives you trouble by causing three major problems. One is blocking the airway. The muscles of the airways get tightened due to the presence of allergens or mucus secretion making it difficult for the air to move. This would lead to shortness of breath and a whistling sound is produced when the air passes through narrowed or tightened path, which is called wheezing.

Second is the inflammation of the bronchial tubes. The bronchial tubes become swollen and red causing damage to the lungs. Third is the irritability in the airway. The airways of asthmatic people are overly sensitive creating problem of breathing for them whenever they are exposed to dust, fumes, or pollen.

Symptoms :

Symptoms of asthma may not be the same for all people affected with it but there are few common symptoms. Persistent coughing, wheezing, chest tightness, shortness of breath and trouble in sleeping due to repeated coughing are some of the major symptoms of asthma.

Some people may develop these symptoms only when doing exercises and for some there will be symptoms when they are exposed to fumes or other allergens. It can cause great difficulty in breathing and hence they need to carry an inhaler on the go to prevent asthma attack. The symptoms of asthma may increase while exercising, while exposed to chemical fumes and allergens. Again the symptoms may worsen periodically and for some months they carry on without any symptoms.

Asthma Attack :

Asthma attack is a condition in which the muscles that surrounds the airways tighten or become stiff causing increased difficulty in breathing. It can lead to bronchospasm causing inflammation of the airways and secreting more of mucus. Asthma attack can cause symptoms like continuous coughing, rapid breathing, severe wheezing, chest pain (due to tightened muscles), difficulty in talking, feelings of anxiety and excessive sweating.

Types :

There are various types of asthma based on the factors that triggers the symptoms. Four major types of asthma are defined according to medical experts.

Asthma Induced by Exercising :

Some people will develop asthma symptoms while they are doing exercises. It makes the person difficult to breathe due to narrowing of airways causing severe coughing and wheezing. The narrowing of airway begins within minutes of starting the exercise making the person uncomfortable.

Cough Variant Asthma :

In this type of asthma, coughing severely is the only symptom. Cough can be the outcome of many factors like sinusitis, rhinitis, GERD, heartburn and other factors.

Workplace Asthma :

Here the triggering factor is the workplace where there would be exposure to smoke, fumes, and pollen. Farmers, painters, nurses and hairdressers are exposed to this type of asthma risk. They may get persistent coughing or wheezing causing difficulty in breathing.

Nocturnal Asthma :

This is very common type of asthma wherein symptoms appear only during nighttime. Nocturnal asthma causes difficulty in sleeping due to cough and wheezing. Getting asthma attack during night is dangerous and affects the quality of sleep.

Causes :

What exactly triggers asthma is not yet known, but the symptoms occur due to inherited factors or environmental factors. The triggering factor differs from one person to another but for most of them airborne allergens like dust, smoke; pollen, mold, and animal dander induce major symptoms. Asthma can be caused by allergic foods like shellfish or peanuts or cow’s milk, soy and wheat products.

For some people, asthma symptoms may begin after respiratory infections or after exercising. Exposure to cold air, intake of certain medications like Ibuprofen or aspirin, involving in stressful situations, and GERD are also other causes of asthma. For some women, onset of menstrual cycle can trigger symptoms of asthma each month. Smoking can worsen the symptoms of asthma causing irritant coughing and wheezing. An individual having lung infections like upper respiratory infections or sinusitis can develop asthma. These sorts of infections can become major cause of asthma in children. Bad weather, increased humidity and increased anxiety or stress can cause asthma.

Risk Factors :

Asthma can develop at any age but is more common among young adults. Obesity, exposure to passive smoking, exposure to chemical fumes, and workplace related triggering factors increase the risk of developing asthma. Genetics play a crucial role in asthma and you are likely to develop asthma if any of your parents already have it. The baby can develop asthma if the mother smokes during pregnancy. Complications can occur when a person has asthma attack. It may cause bad reputation owing to long period of absence at workplace. For some people, it may cause frequent visits to hospital and sometimes requiring inpatient treatment.

Diagnoses :

Your doctor will complete physical exam and check for the symptoms mentioned above. He may request for spirometry test for measuring lung functions. In addition he may recommend you for methacholine trigger test, imaging tests like chest X-ray, CT scan of lungs, and sputum analysis.

Treatment :

Your doctor will diagnose the type of asthma and determine exact cause that triggers it. He would prescribe medications to keep the symptoms in control. The set of medications will be combination of inhaled corticosteroids and bronchodilators. Many types of quick relief bronchodilators are effective in opening the blocked airway by relaxing the muscles.

The type of treatment depends on your age, intensity of symptoms and the type of asthma. Corticosteroids like mometasone, budesonide, fluticasone and flunisolide are very common inhalers prescribed for asthma. Leukotriene modifiers like Singulair and Zyflo are given for providing immediate relief from symptoms. Beta agonists like Foradil, Salmeterol and Perforomist are long acting inhalers. Theophylline is a cheap bronchodilator used for relaxing the muscles of airways.

Rescue remedies also come in the form of Atrovent, albuterol, levalbuterol and pirbuterol. For some people oral corticosteroids are prescribed in addition to inhalers. To prevent worsening of symptoms and to avoid asthma attack, these quick relief inhalers are highly useful. Allergy based asthma can be managed by immunotherapy and allergy medications. Your doctor will choose the right set of medications based on trial and error approach and you should continue using the medications as per the instructions of your doctor. Follow up is necessary at regular intervals to control the symptoms. Depending on your symptoms, he may reduce the dosage or increase it.

Self Care Approach :

You can always use a peak flow meter to prevent asthma attack and to detect serious symptoms. You can choose for asthma action plan in consultation with your doctor to monitor your symptoms and to manage it.

Lifestyle Changes :

You should identify the factors that trigger asthma and avoid it completely. Using air conditioner device helps in controlling airborne pollution and lowers the humidity level indoor. Keep your house clean and dust-free to minimize the risk of developing allergy related asthma. You can use dust-proof pillow covers and switchover to hardwood flooring instead of carpets. Using dehumidifiers can improve the temperature if you are living in damp climate.

Avoid pets if you are developing symptoms due to animal dander. Make it a practice to wear face-mask whenever you are going out to prevent air pollution. Eat healthy balanced diet, practice exercise regularly to manage your weight. Avoid foods that triggers reflux disease and heartburn. Alternatively, you can practice breathing techniques or go for acupuncture therapy for getting relief from symptoms.

Omega 3 fatty acids is found to reduce inflammation of airway muscles and few herbal remedies like pycnogenol and Indian frankincense can be used for controlling the symptoms. Living with asthma can be stressful and challenging. Share your feelings with your family and you may become depressed if you are forced to limit your outdoor activities. Join a support group and identify how others are dealing with challenges.

Prevention :

Get your vaccination done on time for pneumonia and influenza. Follow the action plan with your doctor. Avoid factors that trigger asthma attack. Eat healthy foods and practice yoga and meditation regularly. Monitor the symptoms using peak flow meter to prevent severe attack. Always carry quick relief inhalers with you to manage sudden asthma attacks.